The following is a summary of “Short-Term Efficacy of Bifidobacterium Quadruple Viable Tablet in Patients With Diarrhea-Predominant Irritable Bowel Syndrome: Potentially Mediated by Metabolism Rather Than Diversity Regulation,” published in the July 2023 issue of Gastroenterology and Nutrition by Bai, et al.
For a study, researchers sought to assess the short-term efficacy of Bifidobacterium quadruple viable tablet in patients with diarrhea-predominant irritable bowel syndrome (IBS) and investigate the factors associated with response to probiotics.
A multicenter, randomized, double-blind, placebo-controlled trial was conducted involving 15 hospitals. A total of 290 eligible patients with diarrhea-predominant IBS were randomly assigned to receive either the probiotics or placebo for a 4-week treatment period, followed by a 2-week follow-up. The primary outcome measure was the response rate, defined as the proportion of patients experiencing simultaneous improvement in abdominal pain and diarrhea.
After 4 weeks of treatment, the response rate was significantly higher in the probiotics group (67.59%) compared to the placebo group (36.55%) (P < 0.001). Among patients in the probiotics group, those with higher abdominal pain scores were more likely to respond to treatment (odds ratio 2.674, 95% CI [1.139–6.279]). In the placebo group, responders had lower scores on the Hamilton Depression Scale (0.162 [0.060–0.439]), lower scores on the Hamilton Anxiety Scale (0.335 [0.148–0.755]), and a higher degree of bloating (2.718 [1.217–6.074]). While the probiotics did not significantly alter the diversity of the gut microbiota, they increased the abundance of bacteria producing short-chain fatty acids (SCFAs) such as Butyricimonas (P = 0.048), Pseudobutyrivibrio (P = 0.005), Barnesiella (P = 0.020), and Sutterella (P = 0.020), as well as the concentration of SCFAs including butyric acid (P = 0.010), valeric acid (P = 0.019), and caproic acid (P = 0.046) in feces.
The Bifidobacterium quadruple viable tablet demonstrated significant short-term efficacy in the treatment of diarrhea-predominant IBS, particularly in patients with higher abdominal pain scores. Furthermore, the probiotics were associated with an increased abundance of SCFA-producing bacteria and higher fecal SCFA concentrations compared to placebo.