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A multi-strain water-based probiotic supplement in the management of irritable bowel syndrome or irritable bowel syndrome-like symptoms and quality of life: A real-world evidence study conducted in the United Kingdom

Simon Rudland*, Ingvar Bjarnason

Background: Irritable bowel syndrome (IBS) is a common and burdensome functional gastrointestinal disorder of unknown etiology. Due to its complex and multifactorial nature, the delivery of effective management approaches is challenging, with modestly effective therapies and limited efficacy for many conventional drug treatments. To date, some probiotics have shown efficacy in IBS management in randomised clinical trials. The stringent inclusion criteria may not, however, be representative of the wider clinical population. The present study aimed to evaluate the effect of a multi-strain water-based probiotic (Symprove) on participant-reported change in IBS or IBS-like symptoms, and quality of life in a real-life situation. Methods: From 6th February to 31st March 2020, real world evidence data were collected from a total of 2301 individuals who retrospectively completed an online questionnaire, of which 1246 (54%) were trialling for IBS or IBS-like symptoms (medically- or self-diagnosed). P values were calculated using proportions Z tests and Mann-Whitney U tests (non-parametric equivalent). Differences are stated as statistically significant where P ≤ .05. Results: Of the 1246, 58% (n=717) entered the medically-diagnosed pathway and 40% (n=501) entered the self-diagnosed pathway, 2% (n=28) were omitted from the final analysis. Of the final 1218, over 90% of participants in both IBS cohorts reported improvements (‘completely resolved’ or ‘some positive difference’) in IBS or IBS-like symptoms after 4 or more weeks of Symprove, including abdominal pain (p<0.001) bloating (p<0.001), urgency (p<0.001) and bowel habit satisfaction (p<0.001), in addition to quality of life (p<0.001). Conclusions: Trialling Symprove for 4 or more weeks was associated with improvements in IBS or IBS-like symptoms, in addition to quality of life. These results support the effectiveness of Symprove in patients with IBS or IBS-like symptoms and may be considered a potentially useful adjunct for patients in primary and secondary care.