title: Probiotics for the treatment of systemic sclerosis-associated gastrointestinal bloating/ distention.
abstract: OBJECTIVE
  Treatment for gastrointestinal tract (GIT) disease in systemic sclerosis (SSc) is challenging as no immunosuppressive or anti-fibrotic therapy is available with clearly proven efficacy. Probiotics are viable, non-pathogenic microorganisms that are hypothesized to improve the composition of the intestinal microbiota from a potentially harmful composition to a composition that is beneficial to the host. Our hypothesis is that GIT symptoms in SSc patients with moderate bloating would improve with probiotic implementation.
  
  
  METHODS
  Ten patients with a moderate-to-severe distention/bloating score (1.25-3.00) on the University of California Los Angeles Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 (UCLA SCTC GIT 2.0), but otherwise stable organ disease not requiring any medication adjustment were recruited from the University of Utah Scleroderma Center. We compared the GIT 2.0 scores at baseline and after 2 months of use of Align (bifidobacterium infantis; 109 CFU per capsule) or Culturelle (lactobacillus GG; 109 CFU per capsule) using paired t-test and calculated effect size (ES).
  
  
  RESULTS
  Significant improvement in total GIT 2.0 score (ES = 0.82), reflux (ES = 0.33), bloating/distention (ES = 1.76), and emotional scales (ES = 0.18) were reported after two months of daily probiotic use.
  
  
  CONCLUSIONS
  This pilot study suggests probiotics significantly improve the reflux, distention/ bloating, and total GIT scales in SSc patients. As hypothesized, the largest effect was seen in distention/bloating scale. Probiotics may be useful for treatment of SSc-associated distention/ bloating.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA. tracy.frech@hsc.utah.edu
authors.forename: Tracy M
authors.initials: TM
authors.lastname: Frech
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
authors.forename: Paul
authors.initials: P
authors.lastname: Maranian
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Frech
authors.forename: Allen D
authors.initials: AD
authors.lastname: Sawitzke
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Murtaugh
mesh_terms: D000328:Adult; D000368:Aged; D000934:Antifoaming Agents / Q000627:therapeutic use; D001644:Bifidobacterium / Q000187:drug effects / Q000378:metabolism; D019587:Dietary Supplements; D005260:Female; D005414:Flatulence / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D005767:Gastrointestinal Diseases / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D041981:Gastrointestinal Tract / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007778:Lactobacillus / Q000187:drug effects / Q000378:metabolism; D008297:Male; D054892:Metagenome / Q000187:drug effects*; D008875:Middle Aged; D010865:Pilot Projects; D019936:Probiotics / Q000627:therapeutic use*; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000934:Antifoaming Agents