IsBacillus coagulanssupplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management?

Purpose The aim of this study was to assess the superiority of low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet plusBacillus coagulanssupplementation to low FODMAP diet alone in the reduction of irritable bowel syndrome (IBS) symptoms. Methods In this randomized clinical trial, fifty IBS patients who met Rome IV criteria for IBS were randomly assigned to receive a low FODMAP diet plus either a probiotic or a placebo capsule for 8 weeks. Probiotic capsules contained 10(9)B. coagulansspores and 400 mg inulin, while placebo capsules consisted of 500 mg rice starch. Results Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001). Moreover, the frequency of patients with clinical improvement in IBS-symptom severity scale (IBS-SSS) was significantly more in probiotic group compared to placebo group (P = 0.038). Conclusion Our results indicate that the addition of probiotic supplement containingB. coagulansto the low FODMAP diet might be superior to low FODMAP diet in alleviating IBS symptoms.