4 Strain Blend

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01
Summary

A randomized, placebo-controlled trial explored the impact of this 4-strain probiotic delivered via a liquid barley extract at 1 ml/kg/day over 12 weeks. The study, which was of reasonable quality and included a sufficiently large population, reported beneficial effects on bowel habits, global IBS symptoms, and pain, as measured by the IBS Symptom Severity Score (IBS-SSS). However, the effect sizes for these improvements were mostly small to moderate. No significant changes were observed for bloating or IBS-related quality of life.

Key Takeaway

This 4-strain probiotic blend may offer slight improvements in IBS symptoms related to bowel habits, overall IBS symptoms, and pain, according to evidence from one clinical trial. However, it does not appear to significantly impact bloating or the quality of life for IBS sufferers.

 

Dosing: 

Most Effective Dose (s)
  • 1 mL/kg per day (200 million CFU per mL)
  • Take each morning on an empty stomach
Form Liquid barley extract 
Suggested Minimum 

Trial Duration

 12 weeks

 

Reference:

Sisson G, Ayis S, Sherwood RA, Bjarnason I. Randomised clinical trial: A liquid multi-strain probiotic vs. placebo in the irritable bowel syndrome–a 12 week double-blind study. Aliment Pharmacol Ther 2014 Jul;40(1):51-62. [doi: 10.1111/apt.12787]

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A randomized, placebo-controlled trial explored the impact of this 4-strain probiotic delivered via a liquid barley extract at 1 ml/kg/day over 12 weeks. The study, which was of reasonable quality and included a sufficiently large population, reported beneficial effects on bowel habits, global IBS symptoms, and pain, as measured by the IBS Symptom Severity Score (IBS-SSS). However, the effect sizes for these improvements were mostly small to moderate. No significant changes were observed for bloating or IBS-related quality of life.

Key Takeaway

This 4-strain probiotic blend may offer slight improvements in IBS symptoms related to bowel habits, overall IBS symptoms, and pain, according to evidence from one clinical trial. However, it does not appear to significantly impact bloating or the quality of life for IBS sufferers.

 

Dosing: 

Most Effective Dose (s)
  • 1 mL/kg per day (200 million CFU per mL)
  • Take each morning on an empty stomach
Form Liquid barley extract 
Suggested Minimum 

Trial Duration

 12 weeks

 

Reference:

Sisson G, Ayis S, Sherwood RA, Bjarnason I. Randomised clinical trial: A liquid multi-strain probiotic vs. placebo in the irritable bowel syndrome–a 12 week double-blind study. Aliment Pharmacol Ther 2014 Jul;40(1):51-62. [doi: 10.1111/apt.12787]

Read More…
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A randomized, placebo-controlled trial explored the impact of this 4-strain probiotic delivered via a liquid barley extract at 1 ml/kg/day over 12 weeks. The study, which was of reasonable quality and included a sufficiently large population, reported beneficial effects on bowel habits, global IBS symptoms, and pain, as measured by the IBS Symptom Severity Score (IBS-SSS). However, the effect sizes for these improvements were mostly small to moderate. No significant changes were observed for bloating or IBS-related quality of life.

Key Takeaway

This 4-strain probiotic blend may offer slight improvements in IBS symptoms related to bowel habits, overall IBS symptoms, and pain, according to evidence from one clinical trial. However, it does not appear to significantly impact bloating or the quality of life for IBS sufferers.

 

Dosing: 

Most Effective Dose (s)
  • 1 mL/kg per day (200 million CFU per mL)
  • Take each morning on an empty stomach
Form Liquid barley extract 
Suggested Minimum 

Trial Duration

 12 weeks

 

Reference:

Sisson G, Ayis S, Sherwood RA, Bjarnason I. Randomised clinical trial: A liquid multi-strain probiotic vs. placebo in the irritable bowel syndrome–a 12 week double-blind study. Aliment Pharmacol Ther 2014 Jul;40(1):51-62. [doi: 10.1111/apt.12787]

02
Results
Overall evidence quality grade
81%

This probiotic has higher quality studies in IBS populations supporting it. View our evidence evaluation framework to learn how we assess the quality of studies.

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03
Patient Handout
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04
Clinical Studies
  • #
  • Study
  • Year
  • Author(s)
  • Journal
  • Reference
  • Daily Dose
  • Duration of Intervention
  • Form
  • Study Design
  • Age
  • Participants
    • Study #1

    • Randomised clinical trial: A liquid multi-strain probiotic vs. placebo in the irritable bowel syndrome–a 12 week double-blind study

    • 2014
    • Sisson G, Ayis S, Sherwood RA, Bjarnason I.

    • Aliment Pharmacol Ther 2014 Jul;40(1):51-62

    • DOI: 10.1111/apt.12787
    • 1 mL/kg per day (200 million CFU per mL)
    • 12 weeks
    • Liquid barley extract delivery vehicle
      • RANDOMIZED
      • DOUBLE-BLIND
      • PLACEBO-CONTROLLED
      • SINGLE-CENTER

    • ADULTS

    • ITT,PP (total) n=186,152
      ITT,PP (probiotic) n=124,100
      ITT,PP (placebo) n=62,52
05
Findings from studies

#

  • Diarrhea
  • Constipation
  • Bowel Habits
  • Global IBS Symptoms
  • Abdominal Pain / Discomfort
  • Bloating / Distention
  • Gas / Flatulence
  • Nausea / Vomiting
  • Mental Health
  • Quality of Life
  • Miscellaneous Symptoms
  • Notes

  • Study #1

    • Diarrhea

      • No data

    • Constipation

      • No data

    • Bowel Habits

      • The probiotic group experienced a mean reduction in IBS-SSS bowel habit scores of −15.0 (SD 22.63). The mean difference compared to placebo (95% CI) was −10.4 (−17.71, −3.16), with a p-value of 0.01.

      • We calculated an effect size of 0.52 for this parameter, which is at the threshold for being classified as a moderate degree of effect.

    • Global IBS Symptoms

      • The mean change in IBS-SSS was −63.3 for the probiotic group compared to −28.3 for the placebo group. The mean difference in IBS-SSS was statistically significant [−35.0 (95% CI; −62.03, −7.87); p=0.01].

      • We calculated an effect size of 0.37 for this parameter, classifying the improvements in global IBS symptoms as having the lowest degree of effect.

    • Abdominal Pain / Discomfort

      • The probiotic group experienced a mean reduction in pain score on the IBS-SSS of -28.0 (SD 47.49). The mean difference compared to placebo (95% CI) was −19.2 (−36.77, −1.62), with a p-value of 0.03.

      • We calculated an effect size of 0.32 for this parameter, classifying the improvements in pain score as having the lowest degree of effect.

    • Bloating / Distention

      • There was no statistically significant improvement in bloating compared to the placebo group (p=0.23).

    • Gas / Flatulence

      • No data

    • Nausea / Vomiting

      • No data

    • Mental Health

      • No data

    • Quality of Life

      • There were no significant improvements for IBS-QOL.

    • Miscellaneous Symptoms

      • No data

    • Notes

      • The sample size was very good, but some of the effects detected were extremely small.