IBS is a 3-letter acronym that strongly impacts the lives of millions of people worldwide. It stands for irritable bowel syndrome, a complex condition that exhibits various forms, depending on the predominant stool pattern: diarrhea, constipation, mixed or undetermined. It is estimated that about 10% of the population is affected by IBS, and is rather helpless to face its very unpleasant symptoms. The etiology of IBS is poorly understood and multifactorial. Alteration of the gut microbiota is likely to be involved, among other factors, resulting in the investigation of probiotic-based treatments.
A yeast used for baking, brewing… and treating IBS!
A recently published study showed that a probiotic yeast, called Saccharomyces cerevisiae I-3856, helps control abdominal pain and improve the quality of life of patients with constipation-predominant IBS (1). This information results from a clinical trial in which Biofortis was involved. Our clinical investigation unit was designated by the Sponsor (Lesaffre) as the coordinating center, out of a total of 14 centers. Biofortis was also responsible for the overall study management, and for blood and stool analyses, being the study’s central lab as well. Overall, 456 patients experiencing IBS with predominant constipation were recruited to participate in the study for about 2 years. After a 2 to 4-week run-in period to confirm eligibility, patients were randomly allocated to receive the probiotic or a placebo daily for 8 weeks. The trial was double-blinded, i.e. neither the patients nor the investigators knew which treatment was assigned to whom. The patients completed daily questionnaires related to their gastrointestinal symptoms and stool movements, and weekly or monthly questionnaires related to quality of life, physical activity, food habits and anxiety / depression. Blood and stool were collected during the study on a subset of patients only.
Abdominal pain relief and quality of life improvement
The rate of responders (defined as patients with a reduction in abdominal pain ≥ 30% between week 5 and week 8 of treatment, as compared to baseline), was significantly higher in the S. cerevisiae group than in the placebo group (45.1% vs 33.9%, p=0.017). As another efficacy endpoint, the area under the curve of abdominal pain between week 5 and week 8 was also lower in the probiotic group than in the placebo group, although the difference was not statistically significant (p=0.073). On average, patients of both groups experienced a relief of abdominal pain throughout the study, demonstrating a placebo effect, but the relief was higher in the active group, showing an additional treatment effect. In addition to symptom relief, the overall quality of life score was higher after 8 weeks of probiotic supplementation than with the placebo (p=0.047).
The present clinical trial confirms the benefits of S. cerevisiae I-3856 on constipation-predominant IBS, which had been suggested by previous studies(2-4). Further investigations are needed to understand the mechanism of action, which may rely on gut-microbiota interactions.
1. Mourey, Florian, Amélie Decherf, Jean-François Jeanne, Mathieu Clément-Ziza, Marie-Lise Grisoni, François Machuron, Sophie Legrain-Raspaud, Arnaud Bourreille, et Pierre Desreumaux. « Saccharomyces Cerevisiae I-3856 in Irritable Bowel Syndrome with Predominant Constipation ». World Journal of Gastroenterology 28: 22:250922.
2. Pineton de Chambrun G, Neut C, Chau A, Cazaubiel M, Pelerin F, Justen P, Desreumaux P. A randomized clinical trial of Saccharomyces cerevisiae versus placebo in the irritable bowel syndrome. Dig Liver Dis 2015; 47: 119-124 [PMID: 25488056 DOI: 10.1016/j.dld.2014.11.007]
3. Spiller R, Pélerin F, Cayzeele Decherf A, Maudet C, Housez B, Cazaubiel M, Jüsten P. Randomized double blind placebocontrolled trial of Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: improvement in abdominal pain and bloating in those with predominant constipation. United European Gastroenterol J 2016; 4: 353-362 [PMID: 27403301 DOI: 10.1177/2050640615602571]
4. Gayathri R, Aruna T, Malar S, Shilpa B, Dhanasekar KR. Efficacy of Saccharomyces cerevisiae CNCM I-3856 as an addon therapy for irritable bowel syndrome. Int J Colorectal Dis 2020; 35: 139-145 [PMID: 31807856 DOI: 10.1007/s00384-019-03462-4]
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