A synbiotic mixture improves flatulence in irritable bowel syndrome

P.1.254 A SYNBIOTIC MIXTURE IMPROVES FLATULENCE IN IRRITABLE BOWEL SYNDROME C. Cappello ∗ , F. Tremolaterra, D. Consalvo, C. Ciacci, P. Iovino Policlinico Universitario Federico II, Napoli, Italy Background and aim: Recent data suggest that the intestinal microbiota might play a role in the pathogenesis of irritable bowel syndrome (IBS) A recent metanalysis showed that probiotics reduce symptoms of IBS in adults, according to individual strains.The aim of this study was to test the efficacy of a commercially available synbiotic mixture which contains a concentrations of a range of bacteria (5×109 Lactobacillus plantarum, 2×109 L. casei and L. gasseri, 1×109 Bifidobacterium infantis and B. longum, 1×109 L.sporogenes, 1×109, L. acidophilus and L. salivarus, 5×109 Streptococcus termophilus, and as well as inuline (beneo synergy) as a prebiotic in patients with Rome III IBS. Material and methods: A double-blind, randomized placebo-control clinical trial of the synbiotic mixture (5g BID) vs. placebo over 4-weeks after a 2 weeks run-in period. Primary endpoints: global satisfactory relief of abdominal flatulence and bloating; Patients who reported at least 50% of the weeks of treatment with satisfactory relief were designated as responders. Secondary endpoints: Change in GI symptoms (abdominal pain, flatulence, bloating and urgency) on 100 mm of VAS scales, in stool frequency and bowel functions on validated adjectival scales and in quality of life (SF36). Pre- and post-treatment total and segmental colonic transit time was assessed according to Metcalf et Al. A strict exclusion of concomitant medications that could interfere with the study was requested. Results: 64 IBS patients (synbiotic n=32, 64% females, mean age 38.7±12.6 years) completed the treatment period. Proportions of responders for satisfactory relief of flatulence and bloating were not significantly different between synbiotic and placebo group. Treatment with the synbiotic was associated with reduced flatulence (ANCOVA, p<0.05). Quality of life significantly improved in all scale but the vitality in the synbiotic group, while in the placebo group the significance was reached only in role physical, bodily pain and mental health. No other significantly differences were disclosed in any endpoints, in total and segmental colonic transit measurements between groups. Conclusions: This synbiotic mixture improves flatulence score in patients with IBS. This data are in keeping with a role of intestinal bacteria in the pathophysiology of IBS.