Systematic review with meta-analysis: Effects of probiotic supplementation on symptoms in functional dyspepsia. (May 2020)

• Record Type: Journal Article
• Authors: Agah, Shahram; Akbari, Abolfazl; Heshmati, Javad; Sepidarkish, Mahdi; Morvaridzadeh, Mojgan; Adibi, Payman; Mazidi, Mohsen; Farsi, Farnaz; Ofori-Asenso, Richard; Talley, Nicholas J.; Feinle-Bisset, Christine
• Is Part Of: Journal of functional foods. Volume 68(2020)
• Publication Date: 2020-05
• Subjects: Functional dyspepsia -- Gastrointestinal -- Probiotics; FD functional dyspepsia -- RCTs randomized, controlled -- RRs risk ratios -- CI confidence interval -- GI gastrointestinal -- IBS irritated bowel syndrome; Functional foods -- Analysis -- Periodicals; Food -- Biotechnology -- Periodicals; Nutrition -- Periodicals; 613.2
• DOI: 10.1016/j.jff.2020.103902
• Languages: English
• ISSNs: 1756-4646

Abstract

Graphical abstract: Highlights: Functional dyspepsia (FD) is a chronic gastrointestinal (GI) disorder. Probiotics have been shown to have beneficial effects in some GI disorders. Lactobacillus strains, may have beneficial effects on H. pylori -associated FD-like symptoms. This review suggested that probiotics could improve GI dyspeptic symptoms in patients with FD. Abstract: The pathophysiology of functional dyspepsia (FD) remains poorly understood, but alterations of the small intestinal microbiome have been observed. The place of probiotics in treatment is uncertain. We performed a systematic review and meta-analysis of the currently available randomized, controlled trials (RCTs) to evaluate the potential beneficial effects and risks of probiotics in FD. Pubmed, EMBASE, Scopus, Web of Science and the Cochrane Controlled Trials Register were searched (up to May 2019) for RCTs evaluating the effects of probiotic supplementation compared to placebo in adults with FD. Two reviewers independently assessed eligibility, trial quality and extracted information from identified articles. To compare the effects of probiotics with placebo, risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random effects models. Six trials, including 422 participants were included but only three RCTs could be included in the meta-analysis. Lactobacillus strains showed potential positive effects in terms of improving upper gastrointestinal (GI) symptoms in patients with FD. Probiotic supplementation tended to improve global dyspepsia score (n = 3 RCTs, risk ratio [RR]: 1.35, 95% CI 0.99 to 1.84; P = 0.061) and bacterial composition in the GI tract. Probiotics were well tolerated without any serious adverse events. While the available data suggest that supplementation with probiotics may improve GI symptoms in patients with FD, the evidence is insufficient to draw clear conclusions regarding efficacy. Thus, high-quality RCTs are needed to establish the beneficial effects of probiotic supplementation on FD outcomes.