Skip to main content

Advertisement

SpringerLink
Log in

Is Bacillus coagulans supplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management?

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the superiority of low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet plus Bacillus coagulans supplementation to low FODMAP diet alone in the reduction of irritable bowel syndrome (IBS) symptoms.

Methods

In this randomized clinical trial, fifty IBS patients who met Rome IV criteria for IBS were randomly assigned to receive a low FODMAP diet plus either a probiotic or a placebo capsule for 8 weeks. Probiotic capsules contained 109B. coagulans spores and 400 mg inulin, while placebo capsules consisted of 500 mg rice starch.

Results

Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001). Moreover, the frequency of patients with clinical improvement in IBS-symptom severity scale (IBS-SSS) was significantly more in probiotic group compared to placebo group (P = 0.038).

Conclusion

Our results indicate that the addition of probiotic supplement containing B. coagulans to the low FODMAP diet might be superior to low FODMAP diet in alleviating IBS symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ford AC, Moayyedi P, Chey WD, Harris LA, Lacy BE, Saito YA, Quigley EMM, for the ACGTFoMoIBS (2018) American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome. Am J Gastroenterol 113(2):1–18. https://doi.org/10.1038/s41395-018-0084-x

    Article  PubMed  Google Scholar 

  2. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG (2014) A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 146(1):67-75.e65. https://doi.org/10.1053/j.gastro.2013.09.046

    Article  CAS  Google Scholar 

  3. Dionne J, Ford AC, Yuan Y, Chey WD, Lacy BE, Saito YA, Quigley EMM, Moayyedi P (2018) A systematic review and meta-analysis evaluating the efficacy of a gluten-free diet and a low FODMAPs diet in treating symptoms of Irritable Bowel Syndrome. Am J Gastroenterol 113(9):1290–1300. https://doi.org/10.1038/s41395-018-0195-4

    Article  CAS  PubMed  Google Scholar 

  4. Chen B, Kim JJ, Zhang Y, Du L, Dai N (2018) Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. https://doi.org/10.1007/s00535-018-1476-9

    Article  PubMed  Google Scholar 

  5. Parkes GC, Brostoff J, Whelan K, Sanderson JD (2008) Gastrointestinal microbiota in irritable bowel syndrome: their role in its pathogenesis and treatment. Am J Gastroenterol 103(6):1557

    Article  Google Scholar 

  6. Ford AC, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, Soffer EE, Spiegel BM, Moayyedi P (2014) Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol 109(10):1547–1561. https://doi.org/10.1038/ajg.2014.202(quiz 1546, 1562)

    Article  PubMed  Google Scholar 

  7. Staudacher HM, Lomer MCE, Farquharson FM, Louis P, Fava F, Franciosi E, Scholz M, Tuohy KM, Lindsay JO, Irving PM, Whelan K (2017) A diet low in FODMAPs reduces symptoms in patients with irritable bowel syndrome and a probiotic restores bifidobacterium species: a randomized controlled trial. Gastroenterology 153(4):936–947. https://doi.org/10.1053/j.gastro.2017.06.010

    Article  CAS  PubMed  Google Scholar 

  8. Barbara G, Cremon C (2018) Probiotics in irritable bowel syndrome: where are we? Neurogastroenterol Motil 30(12):e13513. https://doi.org/10.1111/nmo.13513

    Article  PubMed  Google Scholar 

  9. Nyangale EP, Farmer S, Cash HA, Keller D, Chernoff D, Gibson GR (2015) Bacillus coagulans GBI-30, 6086 modulates Faecalibacterium prausnitzii in older men and women. J Nutr 145(7):1446–1452. https://doi.org/10.3945/jn.114.199802

    Article  CAS  PubMed  Google Scholar 

  10. Sudha MR, Jayanthi N, Aasin M, Dhanashri RD, Anirudh T (2018) Efficacy of Bacillus coagulans unique IS2 in treatment of irritable bowel syndrome in children: a double blind, randomised placebo controlled study. Benef Microb 9(4):563–572. https://doi.org/10.3920/bm2017.0129

    Article  CAS  Google Scholar 

  11. Majeed M, Nagabhushanam K, Arumugam S, Majeed S, Ali F (2018) Bacillus coagulans MTCC 5856 for the management of major depression with irritable bowel syndrome: a randomised, double-blind, placebo controlled, multi-centre, pilot clinical study. Food Nutr Res. https://doi.org/10.29219/fnr.v62.1218

    Article  PubMed  PubMed Central  Google Scholar 

  12. Majeed M, Nagabhushanam K, Natarajan S, Sivakumar A, Ali F, Pande A, Majeed S, Karri SK (2016) Bacillus coagulans MTCC 5856 supplementation in the management of diarrhea predominant Irritable Bowel Syndrome: a double blind randomized placebo controlled pilot clinical study. Nutr J 15:21. https://doi.org/10.1186/s12937-016-0140-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Drossman DA (2016) Functional gastrointestinal disorders: history, pathophysiology, clinical features, and Rome IV. Gastroenterology 150(6):1262–1279 (e1262)

    Article  Google Scholar 

  14. Baron M (2009) A patented strain of Bacillus coagulans increased immune response to viral challenge. Postgrad Med 121(2):114–118

    Article  Google Scholar 

  15. Francis CY, Morris J, Whorwell PJ (1997) The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 11(2):395–402

    Article  CAS  Google Scholar 

  16. Francis CY, Morris J, Whorwell PJ (1997) The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 11(2):395–402

    Article  CAS  Google Scholar 

  17. Rogha M, Esfahani MZ, Zargarzadeh AH (2014) The efficacy of a synbiotic containing Bacillus coagulans in treatment of irritable bowel syndrome: a randomized placebo-controlled trial. Gastroenterol Hepatol Bed Bench 7(3):156

    PubMed  PubMed Central  Google Scholar 

  18. Abhari K, Shekarforoush SS, Hosseinzadeh S, Nazifi S, Sajedianfard J (2015) The effects of prebiotic, probiotic and synbiotic diets containing Bacillus coagulans and inulin on serum lipid profile in the rat. Veterinary Science Development 5(2):5919

    Google Scholar 

  19. Majeed M, Nagabhushanam K, Natarajan S, Sivakumar A, Ali F, Pande A, Majeed S, Karri SK (2015) Bacillus coagulans MTCC 5856 supplementation in the management of diarrhea predominant Irritable Bowel Syndrome: a double blind randomized placebo controlled pilot clinical study. Nutr J 15(1):21

    Article  Google Scholar 

  20. Cruz-Aguliar RM, Wantia N, Clavel T, Vehreschild M, Buch T, Bajbouj M, Haller D, Busch D, Schmid RM, Stein-Thoeringer CK (2018) An Open-Labeled Study on Fecal Microbiota Transfer in Irritable Bowel Syndrome patients reveals improvement in abdominal pain associated with the relative abundance of Akkermansia muciniphila. Neurogastroenterol Motil. https://doi.org/10.1111/nmo.13513

    Article  Google Scholar 

  21. Dolin B (2009) Effects of a proprietary Bacillus coagulans preparation on symptoms of diarrhea-predominant irritable bowel syndrome. Methods Find Exp Clin Pharmacol 31(10):655–659

    Article  CAS  Google Scholar 

  22. Urgesi R, Casale C, Pistelli R, Rapaccini G, De Vitis I (2014) A randomized double-blind placebo-controlled clinical trial on efficacy and safety of association of simethicone and Bacillus coagulans (Colinox®) in patients with irritable bowel syndrome. Eur Rev Med Pharmacol Sci 18(9):1344–1353

    CAS  PubMed  Google Scholar 

  23. Basturk A, Artan R, Yilmaz A (2016) Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: a randomized controlled trial. Turk J Gastroenterol 27:439–443

    Article  Google Scholar 

  24. Hun L (2009) Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS. Postgrad Med 121(2):119–124

    Article  Google Scholar 

  25. Kalman DS, Schwartz HI, Alvarez P, Feldman S, Pezzullo JC, Krieger DR (2009) A prospective, randomized, double-blind, placebo-controlled parallel-group dual site trial to evaluate the effects of a Bacillus coagulans-based product on functional intestinal gas symptoms. BMC gastroenterology 9(1):85

    Article  Google Scholar 

Download references

Acknowledgment

We thank Professor Shahram Shekarforoush and Pardis Roshd Mehregan Company, Iran for donating probiotic supplements.

Author information

Authors and Affiliations

  1. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Khadijeh Abhari, Saeede Saadati, Fatemeh Hosseini-Oskouiee, Zahra Yari, Golbon Sohrab, Ehsan Hejazi & Azita Hekmatdoost

  2. Department of Food Technology, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hedayat Hosseini

  3. Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran

    Shahram Agah

  4. Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Amir Sadeghi

Authors
  1. Khadijeh Abhari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Saeede Saadati
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fatemeh Hosseini-Oskouiee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zahra Yari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hedayat Hosseini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Golbon Sohrab
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ehsan Hejazi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shahram Agah
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Amir Sadeghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Azita Hekmatdoost
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Azita Hekmatdoost.

Ethics declarations

Conflict of interest

There is no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abhari, K., Saadati, S., Hosseini-Oskouiee, F. et al. Is Bacillus coagulans supplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management?. Eur J Nutr 59, 2111–2117 (2020). https://doi.org/10.1007/s00394-019-02060-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-019-02060-y

Keywords

Search

Navigation