Bacillus Coagulans as potent intervention for irritable bowel syndrome: A systematic review and meta-analysis of randomized control trials

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Abstract Introduction: Irritable bowel syndrome (IBS) is the most common functional GIT disorder. Bacillus coagulans (BC) is a potent spore-forming probiotic that has been proposed as a potent supplement that can improve GIT dysbiosis and relieve IBS symptoms. We aim to assess the effect of BC on different IBS symptoms. Methods: We searched seven databases for RCTs that compare the use of BC versus placebo in the management of IBS symptoms. Results: Our search finally retrieved seven RCTs after extensive screening. Our analysis revealed that BC significantly improved the severity of IBS symptoms such as urgency {MD: -1.05, 95% CI: -1.33; -0.77}, bowel habit satisfaction {MD: -1.40, 95% CI: -1.68; -1.13}, straining {MD: -1. 22, 95% CI: -1.61; -0.82}, the passage of gas {MD: -1.25, 95% CI: -1.51; -0.99}, incomplete evacuation {MD: -1.06, 95% CI: -1.55; -0.57}, and the total score of symptom severity {MD: -10.13, 95% CI: -11.61; -8.66, (P < 0.00001)}. We also found a significant improvement in the physician’s global assessment score at 8 weeks {MD: 1.61, 95% CI: 0.61; 2.60, (P = 0.002)}; however, results were not significant at 4 weeks (P = 0.48). Moreover, our results indicate a significant decrease in the discomfort score after 4 and 8 weeks, the bloating score after 2, 4, 8, and 11 weeks and the vomiting score. Regarding abdominal pain, BC significantly lowered pain score after 2, 4, 8, and (11-13) weeks. Conclusion: BC is a very effective probiotic in reducing the severity of IBS symptoms and abdominal pain with no serious adverse events. Future studies are needed to assess the use of BC as a long-term regimen and compare different subspecies of BC.

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