Related Experiment Video
Updated: Mar 14, 2026
Perturbations of Circulating miRNAs in Irritable Bowel Syndrome Detected Using a Multiplexed High-throughput Gene Expression Platform
Published on: November 30, 2016
Probiotics for Irritable Bowel Syndrome: An Updated Systematic Review and Meta-Analysis With Trial Sequential
Ansel Shao Pin Tang1, Jingxuan Quek1, Farisah Sulaimi2
1NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Background:
Recent years have seen greater interest, and hence, many trials published on the topic of probiotics as a treatment for irritable bowel syndrome (IBS). Given the anticipated "multiplicity problem" and inadequacy of traditional meta-analysis, this study aims to evaluate the efficacy of probiotics in alleviating symptoms of IBS and improve quality of life through a trial sequential analysis (TSA).
Methods:
Medline, Embase, Web of Science, and Cochrane were screened for randomized controlled trials (RCTs) comparing probiotics to placebo in adult patients with IBS. Primary outcomes included changes in IBS Symptom Severity Score (IBS-SSS) and IBS Quality of Life (IBS-QOL) scores. A traditional pairwise meta-analysis conducted in DerSimonian and Laird was conducted, with subsequent TSA. Study quality was graded according to risk-of-bias 2 (ROB-2), and certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Results:
A total of 40 studies were included. Overall, probiotics demonstrated significant improvements in IBS-SSS (MD: 33.42, 95% confidence interval [CI]: -55.96 to -10.88, p < 0.01) but nonsignificant improvements in IBS-QOL (MD: 1.79, 95% CI: -3.00-6.57, p = 0.46). TSA conducted on IBS-SSS demonstrated current evidence has not reached the required information size. Cumulative Z-curve demonstrated no evidence of futility, benefit, or detrimental effect. Evaluation by ROB-2 indicates the majority of studies were of low risk of bias, while GRADE evaluation of existing evidence demonstrated low certainty of evidence, mainly attributed to inconsistency.
Discussion:
TSA findings recommend further high-powered trials. GRADE evaluation emphasizes the importance of standardization in future trials and further efforts to identify sources of heterogeneity.
More Related Videos
Related Concept Videos
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:21Drugs for Treatment of Constipation-Predominant IBS
01:30Irritable Bowel Syndrome III: Medical and Nursing Management
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...