Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective evidence-based medicine (EBM) review is to determine whether or not probiotics are effective in improving quality of life in adults with irritable bowel syndrome.

STUDY DESIGN: A systematic review of three double-blind randomized controlled trials (RCTs) written in the English language, published between the years 2016 and 2018.

DATA SOURCES: Three randomized controlled trials were published in peer-reviewed journals and found using PubMed and GoogleScholar databases.

OUTCOME(S) MEASURED: All three of the included studies measured the quality of life in adults with irritable bowel syndrome (IBS) utilizing the self-reported IBS-QOL questionnaire.

RESULTS: Each of the RCTs demonstrated an improvement in the quality of life in patients with IBS. One study (Preston K, Krumian R, Hattner J, de Montigny D, Stewart M, Gaddam S. Benef Microbes. 2018;9(5):697-706. doi: 10.3920/BM2017.0105) found improvement in QOL at the conclusion of the trial at 12 weeks, but did not include a measure of precision. However, Mezzasalma et al. (Biomed Res Int. 2016;2016:4740907. doi: 10.1155/2016/4740907) and Ishaque et al. (BMC Gastroenterol. 2018;18(1):9. doi: 10.1186/s12876-018-0788-9) both showed a statistically significant (p < 0.001) increase in patients’ quality of life following the intervention versus placebo at the conclusion of the study on day 60 and at the follow-up visit at five months, respectively. However, Ishaque et al. (BMC Gastroenterol. 2018;18(1):9. doi: 10.1186/s12876-018-0788-9) failed to have comparable baseline data between the two treatment arms.

CONCLUSIONS: The three randomized-controlled trials provided varying degrees of evidence that probiotic supplementation can improve quality of life in patients who suffer from irritable bowel syndrome. Mezzasalma et al. (Biomed Res Int. 2016;2016:4740907. doi: 10.1155/2016/4740907) provided sufficient data to support the efficacy in probiotic use and effect on IBS. However, the studies by Preston et al. (Benef Microbes. 2018;9(5):697-706. doi: 10.3920/BM2017.0105) and Ishaque et al. (BMC Gastroenterol. 2018;18(1):9. doi: 10.1186/s12876-018-0788-9) demonstrated similar outcomes but with less reliability. Further research is necessary in order to solidify the role that these probiotics can play in managing IBS.

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