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Do probiotic yoghurt drinks help IBS?

Q Is there any evidence to support the use of probiotic yoghurt drinks in irritable bowel syndrome?

A Literally 'for life', probiotics are dietary supplements of normal intestinal microflora, with little or no pathogenicity. Surviving acid and bile, they colonise mucosal surfaces. This produces positive benefits on health through increased mucosal immunity, recovery of the gut barrier to bacterial translocation, elimination of toxins and competitive elimination of microbial pathogens.

Bacteroides spp. and bifidobacteria comprise 99 per cent of the normal gut flora.

Since flatulence, bloating and altered stool consistency are found in IBS and small intestinal bacterial overgrowth, probiotics may replenish the natural balance of micro-organisms. Probiotics also increase

? galactosidase, and decrease urease because of the rise in gut lactobacilli, bifidobacteria and S. thermophilus.

Probiotics have been of proven benefit in IBS in 10 of 12 trials, including five double-blinded ones. But the high placebo response to any dietary intervention in IBS may be a confounding factor, and there is little data on the efficacy of probiotic yoghurt drinks, particularly the 'beneficial' bifidobacterium, Lactobacillus acidophilus, L. GG and L. casei.

A double-blind randomised, controlled study of 40 patients with IBS who took L. plantarum for four weeks showed treated patients had significant reductions in flatulence and abdominal pain at six and 52 weeks. Some 95 per cent of patients improved, compare with 15 per cent of those in the placebo group.

If patients feel better with a pleasant non-toxic treatment there is little to lose by trying probiotic yoghurt drinks.

Marina Morgan is consultant medical microbiologist at the Royal Devon and Exeter Hospital

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