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Outcome-Specific Efficacy of Different Probiotic Strains and Mixtures in Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis
Network meta-analysis of 81 RCTs (n=9,253) ranked probiotic strains/mixtures by IBS outcome: e.g., Lactobacillus acidophilus DDS-1 ranked highest for IBS-SSS improvement (SUCRA 92.9%), a five-strain mixture ranked first for IBS-QoL (SUCRA 100%), and several Bacillus coagulans formulations led abdominal pain and Bristol stool rankings in IBS-D.
Design
Frequentist network meta-analysis of RCTs to June 2023; 81 RCTs (9,253 participants) in IBS.
Outcome-specific rankings (abstract examples)
- IBS Symptom Severity Score: four strains and five mixtures beat placebo; L. acidophilus DDS-1 had highest SUCRA (92.9%)
- IBS-QoL: five-strain mixture SUCRA 100%
- Abdominal pain: B. coagulans MTCC 5856 SUCRA 96.9%; B. coagulans Unique IS2 92.6%
- IBS-D stool frequency / Bristol form: B. coagulans MTCC 5856 SUCRA 99.6%; S. cerevisiae CNCM I-3856 89.7% (Bristol endpoint)
Evidence hygiene
SUCRA rankings ≠ individual prescription—strain-level evidence is heterogeneous and often industry-sponsored; read forest + risk-of-bias tables.
Publication
Xie M, Luo J, Deng Y, et al. Nutrients. 2023 Sep 4;15(17):3856. PMID 37686889.
Outcomes
- Versus placebo on IBS-SSS, Lactobacillus acidophilus DDS-1 achieved top SUCRA ranking (92.9%) among statistically superior strains/mixtures.
- A five-probiotic mixture achieved SUCRA 100% for IBS-QoL improvement versus other active probiotics/placebo in the network.