title: Short-term probiotic therapy alleviates small intestinal bacterial overgrowth, but does not improve intestinal permeability in chronic liver disease.
abstract: OBJECTIVE
  : Although numerous animal studies suggest that probiotic therapy has beneficial effects in various liver diseases, the evidence for beneficial effects in human liver disease is controversial. This study was carried out to investigate the efficacy of probiotic therapy in alleviating small intestinal bacterial overgrowth (SIBO) and permeability in chronic liver disease.
  
  
  METHODS
  Fifty-three patients with chronic liver disease were randomized to either probiotic therapy or placebo. Six bacterial species were used: Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium longum, Lactobacillus acidophilus, Lactobacillus rhamnosus, and Streptococcus thermophilus. After 4 weeks, changes in the composition of fecal bacteria, SIBO, intestinal permeability, and clinical symptoms were examined.
  
  
  RESULTS
  Three of the six probiotic species, B. lactis, L. rhamnosus, and L. acidophilus, increased in the feces of the probiotic therapy group (P<0.001), whereas there was no change in fecal microbiota in the placebo group. SIBO disappeared in many individuals of the probiotic therapy group, but none in the placebo (24 vs. 0%, P<0.05). General gastrointestinal symptoms also improved more in the probiotic group and improvement in intestinal permeability was slightly but not significantly more frequent in the probiotic arm than the placebo arm (50 vs. 31.3%, P=0.248). Numbers of lactobacilli in stool were correlated negatively with intestinal permeability (P for trend<0.05). Liver chemistry did not improve significantly in either group.
  
  
  CONCLUSIONS
  We conclude that short-term probiotic administration in chronic liver disease is effective in alleviating SIBO and clinical symptoms, but ineffective in improving intestinal permeability and liver function.
authors.affiliation: aDepartment of Internal Medicine, Hanyang University School of Medicine, Seoul bCell Biotech Co., Ltd, Gimpo, Republic of Korea.
authors.forename: Dong Shin
authors.initials: DS
authors.lastname: Kwak
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Jun
authors.forename: Jae Gu
authors.initials: JG
authors.lastname: Seo
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Chung
authors.forename: Soon-Eung
authors.initials: SE
authors.lastname: Park
authors.forename: Kang Nyeong
authors.initials: KN
authors.lastname: Lee
authors.forename: Waqar
authors.initials: W
authors.lastname: Khalid-Saeed
authors.forename: Hang Lak
authors.initials: HL
authors.lastname: Lee
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Lee
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoon
authors.forename: Ho Soon
authors.initials: HS
authors.lastname: Choi
mesh_terms: D005243:Feces / Q000382:microbiology; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism / Q000382:microbiology*; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010539:Permeability; D019936:Probiotics; D056910:Republic of Korea; D013997:Time Factors; D016896:Treatment Outcome