title: Symbiotics in irritable bowel syndrome--better than probiotics alone?
abstract: OBJECTIVE
  Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder associated with significant physical and psychological comorbidity. The etiology of the condition is uncertain but recent research suggests that the gut bacterial composition may play a role in its development. Therefore, manipulation of the intestinal microbiome by using probiotics and symbiotics has the potential to improve patient outcomes in IBS.
  
  
  RESULTS
  Numerous randomized controlled trials suggest a benefit of probiotics in the management of IBS, with a significant reduction in the likelihood of symptoms persisting after therapy, and improvements in abdominal pain, bloating and flatulence when probiotics are compared with placebo. Evidence for the effect of probiotics on quality of life is conflicting. Relatively few randomized controlled trials have examined the effect of symbiotics on outcomes in IBS, but results thus far are promising.
  
  
  CONCLUSIONS
  Probiotics appear to be beneficial in IBS. Data supporting the use of symbiotics is sparse. Whether symbiotics are superior to probiotics is unclear.
authors.affiliation: aLeeds Gastroenterology Institute, St. James's University Hospital bLeeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Gracie
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Ford
mesh_terms: D015746:Abdominal Pain / Q000178:diet therapy / Q000209:etiology; D019587:Dietary Supplements; D005414:Flatulence / Q000178:diet therapy / Q000209:etiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000178:diet therapy*; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D058616:Synbiotics