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Probiotic supplementation (IBS-focused evidence)
Multi-strain and single-strain probiotic preparations have been tested against placebo in dozens of adult IBS randomised trials; updated meta-analyses report heterogeneous benefits and GRADE certainty that is often low to very low depending on strain and endpoint.
Scope
Probiotic supplementation here indexes live-microorganism preparations swallowed for irritable bowel syndrome (IBS) symptom endpoints—not faecal microbiota transplantation regulatory protocols, fermented-food-only interventions unless trialised as defined strains, or antibiotic comparators.
Evidence anchors (PubMed)
- Strain-tiered MA update: Goodoory et al. 2023 (Gastroenterology; PMID 37541528;
goodoory-2023-probiotics-ibs-meta-gastroenterology) — 82 RCTs (n = 10,332); GRADE ranges from moderate (Escherichia strains for global symptoms) down to very low for many combination products; adverse-event pooled risk not significantly higher across 55 AE-reporting trials.
Distinct protocols
- Marine omega-3 (
marine-omega-3-supplementation) — different mechanism trials. - Magnesium (
magnesium-supplementation) — mineral motility/sleep adjacent narratives, not probiotic colonisation claims.
Evidence hygiene
Strain identity matters—do not merge 299V evidence with unrelated Bacillus trade-name blends without reading the MA strata.
Evidence
- Efficacy of Probiotics in Irritable Bowel Syndrome: Systematic Review and Meta-analysis.
- Comparative efficacy and tolerability of probiotics for antibiotic-associated diarrhea: Systematic review with network meta-analysis.
- Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome
- Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
- Probiotics for preventing acute upper respiratory tract infections
- Outcome-Specific Efficacy of Different Probiotic Strains and Mixtures in Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis
- Probiotics for the Prevention of Antibiotic-associated Diarrhea in Adults: A Meta-Analysis of Randomized Placebo-Controlled Trials
- Early use of probiotics might prevent antibiotic-associated diarrhea in elderly (>65 years): a systematic review and meta-analysis