Lactobacillus paracasei HA-196 and Bifidobacterium longum R0175 Mitigate Irritable Bowel Syndrome

by | Jun 4, 2020 | 2020, Digestive Health, Irritable Bowel Syndrome, Probiotics

Written by Angeline A. De Leon, Staff Writer. Supplementation with both Bifidobacterium longum R0175 (B. longum) and Lactobacillus paracasei HA-196 (L. paracasei) improved irritable bowel syndrome (IBS) symptoms and improved emotional well-being and quality of life in participating subjects.

digestive health - IBSAfflicting over 10% of the human population worldwide, Irritable Bowel Syndrome (IBS) is one of the most common gastrointestinal disorders (GI) 1, and one of the most complex, as well. IBS involves a range of symptoms, but is primarily characterized by abdominal discomfort and alterations in bowel habits 2. Pharmacological interventions are typically designed to address specific symptoms of IBS, but complete symptom mitigation is rarely possible 3,4. Emerging research suggests that part of the pathophysiology of IBS involves gut microbial dysbiosis, or an imbalance in the bacteria of the GI tract 5. Indeed, IBS subjects demonstrate lower levels of Bifidobacterium and Lactobacillus species at the gut-level 6. Newer interventions using probiotic supplementation as a means of managing IBS symptoms are gaining traction, with studies supporting the efficacy of specific strains like Bifidobacterium longum NCC3001 and Lactobacillus acidophilus NCFM for the improvement of IBS pain and bowel movement frequency 7. When combined with standard antibiotic medicine, other probiotic strains like Bifidobacterium longum W11 show the ability to outperform even prescription medication 8. While such probiotic species have been verified for their clinical utility in IBS treatment, the potential efficacy of many other probiotic strains still remains unknown. Thus, a 2020 study 9 published in Nutrients evaluated the effects of Bifidobacterium longum R0175 (B. longum) and Lactobacillus paracasei HA-196 (L. paracasei), two strains that have not been previously studied in the context of IBS, in relation to GI symptoms and psychological well-being of patients.

A randomized, double-blind, placebo-controlled, 3-arm parallel-group study was carried out in a cohort of 251 individuals (mean age = 42.19 years) with a clinical diagnosis of IBS. Subjects were randomized to receive 10 x 109 CFU of freeze-dried B. longum, L. paracasei, or matching placebo daily for 8 weeks. Within each treatment group, subjects were categorized into subtypes: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), or mixed-pattern IBS (IBS-M). At baseline, Week 4, and Week 8, subjects completed the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS) and the Short Form Health Survey (SF-36). Stool samples were collected at baseline and at Week 8.

While no significant between-group differences were apparent on the IBS-SSS after intervention, all three treatment groups showed a significant reduction in total scores from baseline to Week 8 (p < 0.001 for all). From baseline to Week 8, IBS-C participants receiving L. paracasei demonstrated a significant 33% increase in frequency of spontaneous bowel movement (SBM) (p = 0.03) and a significant 43% increase in frequency of complete spontaneous bowel movement (CSBM) (p = 0.02). IBS-C participants receiving B. longum showed a 44% increase in SBM (p = 0.03). Relative to placebo, IBS-D participants receiving L. paracasei and B. longum both experienced a significant decrease in SBM at Week 8 and Week 4, respectively (p < 0.05 for both). Based on the SF-36, both probiotic groups also showed significant improvement in emotional well-being (3% and 4% increase for L. paracasei and B. longum, respectively) and social functioning (8% and 6% increase, respectively), from baseline to Week 8 (p < 0.05 for all scores).

The present study provides initial evidence to support the efficacy of probiotic strains L. paracasei HA-196 and B. longum R0175 in the mitigation of IBS-related symptoms. After 8 weeks of supplementation, both treatment groups exhibited a general reduction in symptom severity, which remained consistent across all three subtypes of IBS. Both probiotics also resulted in significant improvement of SBM and CSBM, specifically increasing frequency in IBS-C patients and decreasing frequency in IBS-D patients over the course of the study. As hypothesized, intake of L. paracasei and B. longum was also reported to improve psychological well-being in general. Future trials are needed to determine how each probiotic strain uniquely interacts with the gut microbiome over time and to compare their performance to more well-studied probiotic species. Limitations of the study are its relatively small sample size and its classification of IBS subtypes based on outdated diagnostic criteria (Rome III vs. Rome IV).

Source: Lewis ED, Antony JM, Crowley DC, et al. Efficacy of Lactobacillus paracasei HA-196 and Bifidobacterium longum R0175 in alleviating symptoms of irritable bowel syndrome (IBS): a randomized, placebo-controlled study. Nutrients. 2020; 12: 1159. DOI: 10.3390/nu12041159.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution(CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Posted June 4, 2020.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

  1. Canavan C, West J, Car
  1. d T. The epidemiology of irritable bowel syndrome. Clinical epidemiology. 2014;6:71-80.
  2. Sultan S, Malhotra A. Irritable Bowel Syndrome. Ann Intern Med. 2017;166(11):Itc81-itc96.
  3. Lewis JH. The risk of ischaemic colitis in irritable bowel syndrome patients treated with serotonergic therapies. Drug Saf. 2011;34(7):545-565.
  4. Munjal A, Dedania B, Cash B. Update on Pharmacotherapy for Irritable Bowel Syndrome. Current gastroenterology reports. 2019;21(6):25.
  5. Tap J, Derrien M, Törnblom H, et al. Identification of an Intestinal Microbiota Signature Associated With Severity of Irritable Bowel Syndrome. Gastroenterology. 2017;152(1):111-123.e118.
  6. Kerckhoffs AP, Samsom M, van der Rest ME, et al. Lower Bifidobacteria counts in both duodenal mucosa-associated and fecal microbiota in irritable bowel syndrome patients. World J Gastroenterol. 2009;15(23):2887-2892.
  7. Barbara G, Cremon C, Azpiroz F. Probiotics in irritable bowel syndrome: Where are we? Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2018;30(12):e13513.
  8. Fanigliulo L, Comparato G, Aragona G, et al. Role of gut microflora and probiotic effects in the irritable bowel syndrome. Acta bio-medica : Atenei Parmensis. 2006;77(2):85-89.
  9. Lewis ED, Antony JM, Crowley DC, et al. Efficacy of Lactobacillus paracasei HA-196 and Bifidobacterium longum R0175 in Alleviating Symptoms of Irritable Bowel Syndrome (IBS): A Randomized, Placebo-Controlled Study. Nutrients. 2020;12(4).