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Pubmed-"Impact of Saccharomyces boulardii CNCM I-745 on bacterial overgrowth and composition of intestinal microbiota in IBS-D patients: results of a randomized pilot study"

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Dig Dis. 2023 Jan 11. doi: 10.1159/000528954. Online ahead of print.


Background Small intestinal bacterial overgrowth (SIBO) is associated with diarrhea-predominant irritable bowel syndrome (IBS-D). Probiotics like S. boulardii CNCM I-745 (Sb) may be efficacious in balancing the microbiota. This randomized open label study assessed the effect of Sb in patients with bacterial overgrowth associated with IBS-D and its impact on the intestinal microbiota. Methods Patients were randomized to receive for 15 days; S. boulardii + dietary advice (Sb+DA) or dietary advice (DA) only. SIBO was assessed by the lactulose hydrogen breath test (LHBT). Symptoms were assessed with the IBS Symptom Severity Scale (IBS-SSS) and stool consistency with the Bristol Stool Form Scale. Microbiota and mycobiota were analyzed by 16S rDNA and ITS2. Results 54 patients were included, among them 48 (27 Sb+DA, 21 DA) were evaluated. Decrease of hydrogen excretion was slightly higher in Sb+DA group, 41% vs 29% in DA group, and IBS-SSS total score were reduced by -134 and -93, respectively The proportion of patients with diarrhea was lower in the Sb+DA group than in the DA group (25.9% compared to 47.6%) Bacterial and fungal microbiota showed that S. boulardii CNCM I-745 treatment was associated with several modifications. Interestingly, F. prausnitzii was more abundant in Sb-treated patients with marked clinical improvement. The safety of Sb was excellent. Conclusions In patients with SIBO, S. boulardii CNCM I-745 associated with dietary advice reduced bacterial overgrowth and improved digestive symptoms while restoring the intestinal microbiota. The increased abundance of F. prausnitzii coupled with symptom improvement merits further research.

PMID:36630947 | DOI:10.1159/000528954

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