Probiotics: a new avenue in ibs management, looking beyond motility

Mayur Mayabhate

Background: Bacterial dysbiosis is considered to be an important contributory factor to the development of IBS.

Methods: A survey was conducted with 91 physicians across India to determine the usage profile of probiotics in IBS patients and to assess their awareness about the importance of maintaining the cold chain for ensuring the viability of the probiotic bacteria and the benefits of indigenous strains of bacteria as probiotics.

Results: Antispasmodics, anxiolytics and laxatives/antidiarrheals were the first line agents used by 66%, 39% and 30% treating physicians respectively. Probiotics are chosen as first line of therapy by almost 60% of the physicians. 97% of physicians opined that probiotics help in restoring the GI flora balance in IBS patients. Probiotics improve stool frequency, consistency, bloating and flatulence in IBS patients as opined by 65%, 61%, 58% physicians respectively. 94% physicians were aware that probiotics are heat labile and have to be refrigerated. 69% physicians confirmed that they are aware about indigenous strains of probiotics being better than foreign strains.

Conclusions: The appropriate use of probiotics offers an opportunity for “The Gut Makeover” in order to restore and optimise the health and diversity of the intestinal microbiome. Probiotics preparations containing lactobacillus and Bifidobacterium are heat labile thus needs to be refrigerated at appropriate temperature. Indigenous bacteria are better adapted due to strong local conditioning effect and have competitor advantage to stay longer with extended transit time in gut, and thereby exerting the prolonged beneficial effects.

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