The new synbiotic studied was a powder mixture containing Lactobacillus paracasei DKGF1 – a strain isolated from kimchi – and Opuntia humifusa, also known as prickly pear cactus.
Existing trial findings have shown that L. paracasei could significantly improve IBS symptoms. As for prickly pear cactus, it is a rich source of fibre, antioxidants, and isohamnetin – a flavonoid from the fruit.
On the other hand, findings from an animal model showed that synbiotic supplementation led to greater improvement in stool consistency in Wistar rats with induced IBS, as compared to the placebo group and those which took only the probiotic.
In the present study, a total of 67 seniors who were 60 years old and above took part in the randomised, double-blind, placebo-controlled trial.
They were randomised to take the synbiotics or placebo once per day. Tools including 5-point Likert scale on the Subject Global Assessment (SGA) and Visual Analog Scale (VAS) scores were used to detect the degree of improvement in IBS symptoms.
The lower the VAS score, the higher the extent of improvement in symptoms.
Participants with improvements in overall symptoms in at least two out of four weeks of the trial were considered ‘overall responders’.
Writing in Gut and Liver, the researchers said that the number of overall responders was consistently higher in the intervention group throughout the trial.
The proportion of participants who were qualified as ‘overall responder’ was 51.5 per cent in the intervention group, while this figure was 23.5 per cent in the placebo group.
In addition, there was significant reduction in abdominal pain in the intervention group as compared to the placebo group.
The proportion of participants in the intervention group who reported an improvement in abdominal pain was 81.8 per cent in the intervention group and only 58.8 per cent in the placebo group.
Psychological well-being was also better in the intervention group, with three in five reporting an improvement in psychological wellbeing. Only one in five said so in the placebo group.
The symptoms of IBS include recurrent abdominal pain, bloating, and altered bowel habits.
Commenting on the findings, the researchers explained that IBS might be associated with changes in the gut microbiome, as there tend to be lower concentration of Lactobacilli and Bifidobacteria, but a higher amount of Enterobacteriaceae and Bacteroides in IBS patients.
“The core microbiota groups including Lactobacilli decrease and their stability is reduced in old age. In this population, synbiotics may yield greater clinical benefits than in other age groups,” the researchers said.
A sub-group analysis found that synbiotic supplementation had significantly improved abdominal pain and defecation symptoms.
In the study, 16 patients were classified as constipation dominant IBS (IBS-C) or diarrhoea dominant IBS (IBS-D).
The percentage of subjects who reported consistent improve in both abdominal pain and stool form or consistency were significantly higher in the synbiotic group (85.7 per cent) than in the placebo group (22.2 per cent).
“Among the patients with IBS-C, we noted a positive response in no patient in the placebo group and in all four patients in the synbiotic group.
“Among the patients with IBS-D, two of six patients in the placebo group and two of three patients in the synbiotic group showed a response,” the researchers said.
Source: Gut and Liver
Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Oh JH et al