Background -
Irritable bowel syndrome (IBS) is a poorly understood functional gastrointestinal
disorder and is a major cause of abdominal discomfort and gut dysfunction. IBS
symptoms encompass abdominal pain, bloating, flatulence and irregular bowel
movements such as constipation, diarrhoea and alternating bowels, bloating,
flatulence and irregular bowel movements. Physiological studies have shown that
manipulation of the intestinal microbiota by antibiotics, prebiotics or probiotics can
affect intestinal functions in the pathogenesis of IBS. The probiotic concept suggests
that supplementation of the intestinal microbiota with the right type and number of
live microorganisms can improve gut microbiota composition and promote health in
IBS sufferers.
Aim -
The aim of the main clinical trial is to determine whether ingestion of fermented milk
containing Bifidobacterium animalis DN-173010 is associated with improved
defecation frequency, stool consistency and quality of life in black South African
females with constipation-predominant IBS (IBS-C).
Methods -
A pilot and process evaluation approach was employed during the current study to
examine and understand the feasibility of implementing the study and to explore the
facilitating implementation of the main clinical trial. Twenty black female participants,
aged 18-60, with IBS-C were recruited from the practices of gastroenterologists,
specialist physicians and medical doctors in Soweto. Participants fulfilling the Rome
III criteria for IBS-C and inclusion criteria were randomized into two groups to
participate in a 4-week, double blind, placebo controlled study. The placebo group
received unflavoured sweetened, white base yoghurt and the intervention group
received similar yoghurt with the probiotic, Bifidobacterium animalis DN-173010
[>3,4X10⁷ CFU/g]. Participants were required to record their bowel movements daily
and IBS symptoms weekly in questionnaires during the four-week study period.
Quality of life was assessed at baseline and at the end of the treatment period.
Participants visited the study unit weekly to collect the placebo or probiotic study
products and return the completed questionnaires during the study period.
Results -
Seventeen participants completed the study (eight intervention and nine placebo).
There were not significant differences in IBS symptoms between the two groups, but
differences were observed overtime within groups. The severity of abdominal pain
score within both groups was statistically significant (p=0.004), and the number of
days with pain was also statistically significant (p=0.00001). The frequency of normal stools reported was statistically significant different compared to all the other
stool types (constipation and loose stools) throughout the four-week study period in
both the intervention and placebo group. There was no significant difference in the
quality of life between the intervention group compared to the placebo group.
Conclusion -
Process evaluation allows for the monitoring of a programme and corrections of
problems as they occur. The intervention is feasible to implement, acceptable and
safe to participants. The study indicates that consumption of the probiotic
Bifidobacterium animalis DN-173010 for four weeks is not superior to the placebo in
relieving IBS symptoms. / MSc (Dietetics), North-West University, Potchefstroom Campus, 2014
| Identifer | oai:union.ndltd.org:NWUBOLOKA1/oai:dspace.nwu.ac.za:10394/11953 |
| Date | January 2013 |
| Creators | Rammbwa, Matodzi Yvonne |
| Source Sets | North-West University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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