Evaluation and comparison of therapeutic effects of probiotics and colloidal bismuth subcitrate on abdominal bloating

BACKGROUND: Functional abdominal bloating is one of the functional gastrointestinal disorders (FGIDs). Here, we aimed to investigate and compare the effects of probiotics and colloidal bismuth subcitrate on abdominal bloating. METHODS: This was a double-blinded randomized clinical trial performed on 125 patients with functional abdominal bloating in Isfahan in 2020-2021. At the beginning of the study, information on the frequency of abdominal bloating, its severity, the occurrence of early satiety, frequency of borborygmus, frequency of belching, and the frequency of defecation per week was collected. Patients were divided into 3 groups receiving familact probiotic pills that contained 7 bacterial strains, colloidal bismuth subcitrate tablets, and placebo pills for 4 weeks. Afterwards, the frequency and severity of abdominal bloating and other symptoms were compared. RESULTS: After 2 weeks, patients in the probiotic group had a significantly lower frequency of abdominal bloating compared to other groups (P= 0.006). After 4 and 8 weeks, patients in the probiotic group and bismuth group had a lower frequency of bloating )3.18±3.02, 4.11±3.34) compared to placebo (5.10±3.54) (P= 0.001 and P= 0.037, respectively). During the study, patients in the probiotic group had a significantly lower bloating severity (41.90% had no symptom) compared to bismuth and placebo groups (12.50 ,12.00% had no symptom) (p< 0.05). The frequency of borborygmus was significantly lower in the probiotic group after 2 and 4 weeks during the study compared to other groups (1.62±0.2 Vs 2.69±0.3, 2.45±0.3 ) (P= 0.010 and P= 0.013, respectively). CONCLUSION: According to our data, consumption of probiotics improves the frequency and severity of abdominal bloating and reduces borborygmus. Colloidal bismuth subcitrate also has significant effects.