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Short-term probiotic therapy alleviates small intestinal bacterial overgrowth, but does not improve intestinal
Dong Shin Kwak1, Dae Won Jun, Jae Gu Seo
1aDepartment of Internal Medicine, Hanyang University School of Medicine, Seoul bCell Biotech Co., Ltd, Gimpo, Republic of Korea.
Aim:
: Although numerous animal studies suggest that probiotic therapy has beneficial effects in various liver diseases, the evidence for beneficial effects in human liver disease is controversial. This study was carried out to investigate the efficacy of probiotic therapy in alleviating small intestinal bacterial overgrowth (SIBO) and permeability in chronic liver disease.
Methods:
Fifty-three patients with chronic liver disease were randomized to either probiotic therapy or placebo. Six bacterial species were used: Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium longum, Lactobacillus acidophilus, Lactobacillus rhamnosus, and Streptococcus thermophilus. After 4 weeks, changes in the composition of fecal bacteria, SIBO, intestinal permeability, and clinical symptoms were examined.
Results:
Three of the six probiotic species, B. lactis, L. rhamnosus, and L. acidophilus, increased in the feces of the probiotic therapy group (P<0.001), whereas there was no change in fecal microbiota in the placebo group. SIBO disappeared in many individuals of the probiotic therapy group, but none in the placebo (24 vs. 0%, P<0.05). General gastrointestinal symptoms also improved more in the probiotic group and improvement in intestinal permeability was slightly but not significantly more frequent in the probiotic arm than the placebo arm (50 vs. 31.3%, P=0.248). Numbers of lactobacilli in stool were correlated negatively with intestinal permeability (P for trend<0.05). Liver chemistry did not improve significantly in either group.
Conclusions:
We conclude that short-term probiotic administration in chronic liver disease is effective in alleviating SIBO and clinical symptoms, but ineffective in improving intestinal permeability and liver function.
Insights
Probiotic therapy effectively reduced small intestinal bacterial overgrowth (SIBO) and improved gastrointestinal symptoms in chronic liver disease patients. However, it did not significantly improve intestinal permeability or liver function in this short-term study.
Area of Science:
- Gastroenterology and Hepatology
- Microbiology
- Clinical Nutrition
Background:
- Animal studies suggest probiotic benefits in liver disease, but human evidence is controversial.
- Chronic liver disease is associated with small intestinal bacterial overgrowth (SIBO) and altered intestinal permeability.
- Investigating probiotic efficacy in human chronic liver disease is crucial.
Purpose of the Study:
- To evaluate the efficacy of probiotic therapy in alleviating SIBO and intestinal permeability in patients with chronic liver disease.
- To assess the impact of probiotics on clinical symptoms and liver function in this patient group.
Main Methods:
- A randomized controlled trial involving 53 chronic liver disease patients.
- Probiotic group received six bacterial species (Bifidobacterium and Lactobacillus species, Streptococcus thermophilus) for 4 weeks.
- Placebo group received no active treatment.
- Fecal microbiota, SIBO, intestinal permeability, and clinical symptoms were assessed.
Main Results:
- Three probiotic species (B. lactis, L. rhamnosus, L. acidophilus) increased in feces of the probiotic group.
- SIBO resolved in a significantly higher proportion of the probiotic group compared to placebo (24% vs. 0%).
- Gastrointestinal symptoms improved more in the probiotic group; intestinal permeability and liver function showed no significant improvement.
Conclusions:
- Short-term probiotic administration is effective in alleviating SIBO and clinical symptoms in chronic liver disease.
- Probiotic therapy did not demonstrate significant efficacy in improving intestinal permeability or liver function in this study.
- Further research may be needed to explore long-term effects or specific probiotic strains for liver disease management.
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