Olivia Kitz

Number 6
Up to Date and Probiotics Improving Digestion

For this assignment, I chose the topic of whether or not probiotics improve digestion.
The first article I read was “A randomized, double-blind, controlled study and pooled analysis of
two identical trials of fermented milk containing probiotic Bifidobacterium lactis CNCM I-2494
in healthy women reporting minor digestive problems.” The probiotic fermented milk (PFM)
containing Bifidobacterium lactis CNCM I-2494 improved gastrointestinal (GI) well-being and
digestive symptoms in a previous trial involving women reporting minor digestive symptoms.
The objective of this trial was to confirm these findings in a second study and in a pooled
analysis of both studies. In the second study, no significant difference was observed in the
percentage of women reporting an improvement in GI well-being. This second study did not
confirm improvement on the primary endpoint. However, a pooled analysis of the two trials
showed improvement in GI well-being and digestive symptoms in women reporting minor
digestive symptoms. Because of this, I would grade this a 1B: Strong recommendation,
moderate quality evidence. The benefits clearly outweigh the risk and burdens. Evidence from
randomized, controlled trials with important limitations (inconsistent results, methodologic
flaws, indirect or imprecise), or very strong evidence of some other research design. Further
research (if performed) is likely to have an impact on our confidence in the estimate of benefit
and risk and may change the estimate.

The second article I read was “Beneficial effects of probiotic Bifidobacterium and
galacto-oligosaccharide in patients with Ulcerative Colitis: a randomized controlled study.” The
effects of a live Bifidobacterium breve strain Yakult, a probiotic contained in bifidobacteria-
fermented milk, and galacto-oligosaccharide (GOS) as synbiotics in UC patients were examined.
Forty-one patients with mild to moderate UC were assigned to two groups; one group was
treated with the synbiotics and the other was not and was the control group. The treatment
group ingested 1 g of the probiotic powder three times a day, and 5.5 g of GOS once a day for
one year. At the start and the end of this study, colonoscopic index and the amount of
myeloperoxidase in a lavage solution were used as disease activity indices. Bacterial counts in
the feces at the start and the end of this study were also examined. Results showed that after
one year of treatment with the synbiotics, the clinical status of the UC patients significantly
improved. The synbiotics significantly reduced the fecal counts of Bacteroidaceae and fecal pH.
From this finding, we can conclude that the administration of the probiotic can improve the
clinical condition of patients with UC and improves digestion. These results should still be
performed at a larger scale, randomized placebo-controlled trial. I would also grade this a 1B
because of the strong recommendation. Although the evidence seems overwhelming and the
benefits outweigh the risks, further research is likely to have an impact on our confidence that
this indeed helps improve digestion in UC patients. This study was very small, however there is
still strong evidence that suggests we should conduct a larger study.
 The third article I read was “Effects of Bifidobacterium longum and Lactobacillus
rhamnosus on Gut Microbiota in Patients with Lactose Intolerance and Persisting Functional
Gastrointestinal Symptoms: A Randomised, Double-Blind, Cross-Over Study.” The study aimed to
test if probiotic and vitamin B6 treatment was useful or not to alleviate symptoms in LI patients
through a positive modulation of gut microbial composition and relative metabolism. It aimed
to test the efficacy of a novel formulation of Bifidobacterium longum BB536 and Lactobacillus
rhamnosus HN001 plus vitamin B6 in 23 LI subjects with persistent symptoms during a lactose-
free diet. Symptoms, microbiome, and metabolome were measured at baseline and after 30
days in a crossover, randomized, double-blind study. The study found that Compared with the
placebo, the administration of probiotics and vitamin B6 significantly decreased bloating
constipation. The findings clearly showed the importance of selected probiotics and vitamin B6
to alleviate symptoms and gut dysbiosis in lactose intolerant patients with persistent functional
gastrointestinal symptoms. Again, I would give this a Grade 1(B) because there is high quality
evidence/strong recommendations. The benefits were clearly stated and further research would
help impact the level of confidence that we have on this topic. This study was also small, but the
findings were consistent among all of the participants.