Efficacy of probiotic supplementation and impact on fecal microbiota in patients with inflammatory bowel disease: a systematic review and meta-analysis of randomized controlled trials

Abstract

 

Context: Research regarding the treatment of inflammatory bowel disease (IBD) with probiotics has not yielded consistent results.

Objective

The aim of this meta-analysis was to evaluate the efficacy of probiotics supplementation in patients with IBD.

Data Sources

Randomized controlled trials (RCTs) evaluating the efficacy of probiotics in patients with IBD were searched in PubMed, the Google Scholar database, Web of Science, and CrossRef for the period July 2003 to June 2023.

Data Extraction

The RCTs were extracted, independently by 2 authors, according to the PICOS criteria.

Data Analysis

Seven studies, including a total of 795 patients, met the study criteria. Five end points were selected to evaluate the efficacy. Of these, 3 indicators showed a statistically significant difference in efficacy: C-reactive protein (odds ratio [OR]: –2.45, 95% confidence interval [CI]: –3.16, –1.73, P < .01), the number of fecal Bifidobacterium (OR: 3.37, 95% CI: 3.28, 3.47, P < .01), and Lactobacillus(OR: 2.00, 95% CI: 1.91, 2.09, P < .01). The other 2 indicators (disease activity for Crohn’s disease and for ulcerative colitis) showed no statistically significant difference, while the OR reflected a positive correlation.

Conclusion

Probiotics supplementation may have a positive effect on IBD by reducing clinical symptoms, reducing the serological inflammatory markers, and increasing favorable gut flora in patients with IBD. Additional RCTs are needed to evaluate the therapeutic effect of probiotics in IBD.

C-reactive protein, disease activity, inflammatory bowel disease, intestinal microenvironment, probiotics