Effect Of Colonscopic Probiotics Adminstration On Symptoms Of Irritable Bowel Syndrome:A Feasibility Study

Objective:To analyze the effect of colonscopic probiotics administration on symptoms of irritable bowel syndrome(IBS),and to investigate its feasibility and potential adverse events.Methods: During November 2016 to April 2017,consecutive outpatients with diarrhea and constipation referring to colonscopy were selected at single gastroenterology clinic in the First Affiliated Hospital of Fujian Medical University.Among the patients met IBS Roma IV diagnostic criteria,only those with informed consent were enrolled.A dose of 100 m L of Bifidobacterium,Lactobacillus acidophilus and Enterococcus faecalis triple suspension(33.6mg/m L)was sprayed into right hemicolon during colonscopy.The Bristol stool scale,abdominal Visual Analogue Score(VAS),colon symptom score and IBS severity scoring system(IBS-SSS)were performed 0,2 and 4 weeks after treatment,while Hospital Anxiety and Depression Scale(HADS)was evaluated at 0 and 4 week.Results: A total of 18 patients were finally enrolled,including 5 cases of IBS with predominant constipation(IBS-C)and 13 cases of IBS with predominant diarrhea(IBS-D).The average age and male:female ratio in IBS-C group and IBS-D group were 49.4±10.0 years and 1:0.66,and 36.1±8.9 years and 3.3:1,respectively.All questionaires were retrieved.Two IBS-C patient improvement no change after 2 week and 4 week.Three participants enrolling in IBS-C group was terminated early since the symptom scales and Bristol stool scale at 2 week follow-up showed no difference when compared to that at baseline.In IBS-D group,the Composite efficacy index was 69.2%,while the scores of stool character,stool urgency,distension,Bristol stool scale,abdominal VAS and IBS-SSS at 2 and 4 week follow-up were decreased when compared to that at baseline(P<0.05),while the decrease of frequency of abdominal pain score was found at 4 week follow-up.However,the mucous stool and HADS score showed no difference(P>0.05).No serious adverse events was reported.The total cost of colonscopic adminstration was 1/6 of that of oral probiotics administration(3 weeks).Conclusion: A single-dose probiotics administration via colonscopy improved the symptoms in IBS-D,but not in IBS-C patients.The presenting new method could be considered as a therapeutic choice for IBS-D patients.