Plain language summary
Clostridium butyricum (CB) is a probiotic with potential for treating Irritable Bowel Syndrome (IBS). This randomised controlled trial aimed to assess the efficacy and safety of CB in treating diarrhoea-predominant IBS (IBS-D) and analyse the faecal microbiota after treatment. The study was carried out in China. 200 patients with IBS-D were recruited and were given CB or a placebo for four weeks. Researchers looked at changes in IBS symptoms, quality of life, stool consistency and frequency. CB was effective in improving the overall IBS-D symptoms as well as quality of life and stool frequency, but not abdominal pain or bloating. The responder rates (percentage of participants that experienced a reduction of 50 or more points in the IBS symptom severity scale) were higher in CB compared with the placebo, especially for those with moderate to severe IBS symptoms. The faecal microbiota analysis showed changes in the microbial community after treating with CB, including a reduction in the genus Clostridium.
Abstract
Irritable bowel syndrome (IBS) is a common disorder in gastrointestinal system and impairs the quality of life of the patients. Clostridium butyricum (CB) is a probiotics that has been used in several gastrointestinal diseases. The efficacy of CB in treating IBS is still unknown. This prospective, multi-centre, randomized, double-blind, placebo-controlled trial aimed to assess the efficacy and safety of CB in treating diarrhea-predominant IBS (IBS-D) and analyze the fecal microbiota after treatment. Two hundred patients with IBS-D were recruited and were given CB or placebo for 4 weeks. End points included change from baseline in IBS symptoms, quality of life, stool consistency and frequency. Compared with placebo, CB is effective in improving the overall IBS-D symptoms (-62.12 ± 74.00 vs. -40.74 ± 63.67, P = 0.038) as well as quality of life (7.232 ± 14.06 vs. 3.159 ± 11.73, P = 0.032) and stool frequency (-1.602 ± 1.416 vs. -1.086 ± 1.644, P = 0.035). The responder rates are found higher in CB compared with the placebo (44.76% vs. 30.53%, P = 0.042). The change in fecal microbiota was analyzed and function pathways of CB in treating IBS-D were predicted. In conclusion, CB improves overall symptoms, quality of life and stool frequency in IBS-D patients and is considered to be used as a probiotics in treating IBS-D clinically.
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