The efficacy of a synbiotic containing Bacillus Coagulans in treatment of irritable bowel syndrome: a randomized placebo-controlled trial

Aim: We aimed to evaluate the efficacy of a synbiotic containing Bacillus Coagulans in treatment of IBS. Background: Some studies have shown the efficacy of probiotics in the treatment of irritable bowel syndrome (IBS). Patients and methods: Adult IBS patients (n=85) were randomized to receive a synbiotic containing Bacillus Coagulans or placebo for 12 weeks. Frequency of IBS symptoms including abdominal pain (scored 1 to 7), and diarrhea and constipation (scored 1 to 5) was evaluated before and after the intervention and then after nine months follow-up. Results: Twenty-three patients in the synbiotic group and 33 patients in the placebo group completed the study (age = 39.8±12.7 years, 78.6% female). After treatment, more reduction in abdominal pain frequency was observed with synbiotic compared with placebo (score reduction 4.2±1.8 vs. 1.9±1.5, P<0.001). Diarrhea frequency was decreased in the synbiotic group, but not in the placebo group (score reduction 1.9±1.2 vs. 0.0±0.5, P<0.001). Decrease in constipation frequency was the same between the two groups (score reduction 0.9±1.2 vs. 0.8±1.1, P=0.561). After nine months follow-up, abdominal pain frequency was decreased (P=0.016), constipation frequency was increased (P<0.001), and diarrhea frequency remained unchanged in the synbiotic group (P=1.000). In the placebo group, abdominal pain frequency was increased (P<0.001), constipation frequency remained unchanged (P=0.553), and diarrhea frequency was increased (P<0.001). Conclusion: Bacillus Coagulans improves abdominal pain and diarrhea in IBS patients. Further studies on a larger sample of patients are warranted.