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Efficacy of Probiotics in Irritable Bowel Syndrome: Systematic Review and Meta-analysis.
Updated meta-analysis of 82 adult IBS RCTs (n=10,332) versus placebo: strain-specific GRADE judgments ranged from moderate certainty for some Escherichia strains on global symptoms down to very low for many combination products; pooled adverse-event risk was not significantly higher across 55 reporting trials.
Design
- Systematic review + meta-analysis; databases through Mar 2023
- Eligible: RCTs in adults with IBS, probiotics vs placebo
- Outcomes: dichotomous global symptoms, abdominal pain, bloating; continuous SMDs where reported; adverse events
Corpus
- 82 eligible trials; 10,332 patients; only 24 RCTs at low risk of bias across all domains
GRADE headline (abstract)
- Global symptoms: moderate certainty for Escherichia strains; low for several Lactobacillus strains and L. plantarum 299V; very low for many combination products and selected branded blends
- Adverse events: pooled RR of any AE not significantly higher vs placebo across 55 AE-reporting trials (>7000 patients)
Publication
Goodoory VC, Ford AC, et al. Gastroenterology. 2023 Nov;165(5):1240–1255.e28. PMID 37541528.
Outcomes
- 82 RCTs (n=10,332): GRADE ranged from moderate (Escherichia strains for global IBS symptoms) to very low for many combination probiotics per abstract.
- Pooled relative risk of any adverse event was not significantly higher with probiotics vs placebo across 55 trials including >7000 patients.