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Review
. 2024 Dec 18;16(12):e75954.
doi: 10.7759/cureus.75954. eCollection 2024 Dec.

Efficacy of Probiotics in the Management of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Bandar A Almabruk  1 , Ali A Bajafar  2 , Ahmed N Mohamed  3 , Saleh A Al-Zahrani  4 , Naif M Albishi  5 , Rafeef Aljarwan  6 , Rola A Aljaser  7 , Lama I Alghamdi  7 , Turki S Almutairi  8 , Almas S Alsolami  9 , Joud K Alghamdi  10
Affiliations
Review

Efficacy of Probiotics in the Management of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Bandar A Almabruk et al. Cureus. .

Abstract

Irritable bowel syndrome (IBS) significantly impacts quality of life. Probiotics offer relief by modulating gut microbiota, but variability in outcomes necessitates a systematic evaluation of their efficacy. This study aims to evaluate the efficacy of probiotics in improving symptoms of IBS through a systematic review and meta-analysis. A comprehensive search of PubMed and Google Scholar identified studies published between 2014 and 2018. Inclusion criteria focused on randomized controlled trials evaluating probiotics in adult IBS patients diagnosed using standardized criteria. Statistical analysis utilized random effects models to account for heterogeneity, with subgroup analysis performed for IBS subtypes. This review included 23 studies involving 3,288 participants. Probiotics significantly reduced abdominal pain (mean difference = -1.66, 95% CI = -2.39 to -0.93, p < 0.0001) and bloating (mean difference = -2.13, 95% CI = -3.96 to -0.30, p = 0.0224). Improvement in stool habits was significant (mean difference = -1.52, 95% CI = -2.15 to -0.88, p < 0.0001), particularly in diarrhea-predominant IBS. Quality of life improved significantly, with a mean increase of 8.77 points (95% CI = 0.91 to 16.64, p = 0.028). Adverse events were mild and infrequent. However, heterogeneity was high (I² > 90%), reflecting variability in study protocols. Probiotics are effective in reducing IBS symptoms and improving quality of life, mainly in diarrhea-predominant IBS. More research should be conducted that focuses on standardized, long-term trials to refine treatment strategies.

Keywords: abdominal pain; gastrointestinal microbiome; irritable bowel syndrome; probiotics; quality of life.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flowchart showing the selection criteria and inclusion of studies.
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses [12].
Figure 2
Figure 2. Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies.
Figure 3
Figure 3. Risk of bias summary: review authors' judgments about each risk of bias item for each included study.
References [13-35].
Figure 4
Figure 4. Abdominal pain score in irritable bowel syndrome patients at baseline and after probiotics treatment.
References [13-17,19-24,26-33,35].
Figure 5
Figure 5. Bowel habits (constipation/diarrhea) score in irritable bowel syndrome patients at baseline and after probiotics treatment.
References [13-15,19,21,22,24,26-30,32,33,35].
Figure 6
Figure 6. Bloating/abdominal distention/flatus score in irritable bowel syndrome patients at baseline and after probiotics treatment.
References [13,16,17,19,21,22,24,26-35].
Figure 7
Figure 7. Mucus in stool in irritable bowel syndrome patients at baseline and after probiotics treatment.
References [13,15,24,31-33].
Figure 8
Figure 8. Incomplete evacuation in irritable bowel syndrome patients at baseline and after probiotics treatment.
References [13,15-17,24,29,35].
Figure 9
Figure 9. Quality of life (QoL) satisfaction score in irritable bowel syndrome patients at baseline and after probiotics treatment.
References [18,20-23,25-27,29-31,33,35].
Figure 10
Figure 10. Plot showing publication bias and heterogeneity.
See this image and copyright information in PMC

References

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