Abstract
Treatments that target alterations in gut microbiota may be beneficial for patients with irritable bowel syndrome (IBS). A systematic review and meta-analysis was conducted of randomised clinical trials (RCTs) evaluating the efficacy and safety of probiotics, prebiotics and synbiotics. Factors considered in the analysis included global IBS symptoms and/or abdominal pain, secondary symptoms and the frequency of adverse events. A total of 33 RCTs involving 4,321 patients were identified. Overall, probiotics significantly improved global IBS symptoms compared to placebos (standardised mean difference = −0.32, 95% confidence interval: −0.48 to −0.15; P <0.001), with significant heterogeneity between studies (I2 = 72%; P <0.001). This remained apparent in both single- and multi-strain probiotic interventions as well as synbiotic formulations. However, evidence regarding prebiotics was scarce. There were no significant inter-group differences in terms of the frequency of adverse events. Future RCTs should address methodological limitations, including short follow-up periods and patient adherence.
Publication details
- DOI
- 10.18295/squmj.2020.20.01.003
- Journal
- Sultan Qaboos University Medical Journal, 20(1), e13-24
- Publisher
- Sultan Qaboos University
- Open access
- Gold open access
- License
- CC BY-ND 4.0
Cite this article
APA 7
Asha, M. Z., & Khalil, S. F. (2025). Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis. Sultan Qaboos University Medical Journal, 20(1), e13-24. https://doi.org/10.18295/squmj.2020.20.01.003
MLA 9
Asha, Mohammad Z., and Sundos FH Khalil. "Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis." Sultan Qaboos University Medical Journal, vol. 20, no. 1, 2025, pp. e13-24. https://doi.org/10.18295/squmj.2020.20.01.003.
Chicago (author–date)
Asha, Mohammad Z., and Sundos FH Khalil. 2025. "Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis." Sultan Qaboos University Medical Journal 20 (1): e13-24. https://doi.org/10.18295/squmj.2020.20.01.003.
Harvard
Asha, M. Z. and Khalil, S. F. (2025) 'Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis', Sultan Qaboos University Medical Journal, 20(1), pp. e13-24. doi:10.18295/squmj.2020.20.01.003.
Vancouver
Asha MZ, Khalil SF. Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis. Sultan Qaboos University Medical Journal. 2025;20(1):e13-24. doi:10.18295/squmj.2020.20.01.003
IEEE
M. Z. Asha, and S. F. Khalil, "Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis," Sultan Qaboos University Medical Journal, vol. 20, no. 1, pp. e13-24, 2025, doi: 10.18295/squmj.2020.20.01.003.