6 Reasons Why VSL#3 is Ideal for Irritable Bowel Syndrome

Key Points

• VSL#3, a blend of beneficial bacteria, has shown promise in treating IBS in both children and adults.
• The VSL#3 probiotic has a positive impact on the gut microbiome, potentially alleviating IBS symptoms.
• Studies suggest that VSL#3 may alter gut microbial composition, replacing or modifying bacteria in the gut.
• The link between VSL#3 and improvements in gastrointestinal permeability is a notable area of study.
• Larger randomized trials are needed to validate the potential benefits of VSL#3 in managing IBS symptoms.
• The study provides crucial insights into the intricate relationship between probiotics, the gut microbiome, and IBS symptoms.

Probiotics in the Treatment of Irritable Bowel Syndrome

Irritable bowel syndrome  affects individuals across all age groups, significantly impacting their quality of life

The understanding of IBS has significantly evolved over the past few decades.

Initially thought to be caused by abnormalities in gut smooth muscle and central nervous system hypervigilance, recent research has expanded to include both central and peripheral mechanisms in the pathophysiology of IBS ^{1 2}.

This includes factors such as abnormal colonic transit, intestinal irritants, changes in the gut microbiome, enteroendocrine cell dysfunction, and bile acid malabsorption ^{3 4}.

A notable area of study in IBS treatment is the alteration in gut microbiome composition and the metabolites produced by microbial metabolism, such as bile acids ⁵⁶.

Probiotics have shown promise in treating IBS in both children and adults, with VSL#3 being a specific probiotic with evidence of efficacy based on randomized trials ^{7 8}.

However, the exact mechanism by which probiotics benefit IBS patients remains unclear.

Some studies suggest that probiotics alter the gut microbial composition, essentially replacing or modifying the bacteria in the gut⁹.

Other studies have reported varying results regarding the effects of VSL#3 on gut microbiota composition, potentially due to differences in treatment duration or other factors ¹⁰.

Additionally, increased gut permeability may be related to abdominal pain in some IBS patients, but it is unknown if VSL#3 affects gut permeability ^{11 12}.

While probiotics are generally considered safe, the risk/benefit ratio of using probiotics to treat IBS has been questioned ¹³.

No study has specifically focused on the potential side effects of VSL#3 in adult IBS patients.

In previous clinical trials, the reporting of adverse events was unclear ^{14 15}

, although no significant adverse events were reported when the related probiotic VisBiome was administered to autistic children with functional gastrointestinal disorders ¹⁶.

This article aims to examine the impact of VSL#3 on adults with IBS.

A Closer Look at VSL#3

The VSL#3 probiotic is a powerhouse blend of beneficial bacteria, including four strains of Lactobacillus, three strains of Bifidobacterium, one strain of Streptococcus thermophilus, and starch ¹⁷.

In a clinical trial, participants took two packets daily, equivalent to 900 billion CFU, for either 4 or 8 weeks.

This potent mix was consumed mixed in cold food or a non-carbonated beverage.

Notably, B. infantis and B. longum, previously classified as separate species, are now considered subspecies of the same organism, and Lactobacillus bulgaricus in VSL#3 has been reclassified as L. helveticus ¹⁸.

VSL#3 Probiotics on Irritable Bowel Syndrome: A Comprehensive Study

Introduction

A study conducted between January 2011 and January 2014, with 77 individuals screened and 21 enrolled, investigated the safety and impact of the VSL#3 probiotic on individuals with Irritable Bowel Syndrome ¹⁹.

Pain and Stool Diaries

The study analyzed the number of pain episodes, mean pain rating, and maximum pain rating per day, both before and after VSL#3 administration.

The results showed significant decreases in the number of pain episodes and maximum pain rating, demonstrating the potential benefits of VSL#3 in alleviating pain associated with IBS.

Microbiome Analysis

The microbiome analysis revealed that the VSL#3 probiotic, composed of various bacterial strains, positively impacted the gut microbiome.

Whole Genome Shotgun Sequencing was used to analyze the presence and abundance of VSL#3 bacterial strains in participants’ stool samples.

The results showed an increase in the relative abundance of several VSL#3-related species after treatment, with B. animalis and S. thermophilus being highly enriched.

Gastrointestinal Permeability

Colonic permeability, measured as percent sucralose recovery, showed a positive trend with the number of pain episodes, although statistical significance was not achieved.

However, colonic permeability decreased significantly after 8 weeks of VSL#3 treatment, suggesting a potential link between probiotic treatment duration and improvements in gastrointestinal permeability.

Bile Acids

While bile acid profiles did not show significant changes post-probiotic treatment, the study identified trends that warrant further exploration.

Notably, unconjugated secondary bile acids were negatively associated with colonic permeability, whereas primary bile acids were positively associated with stool type.

Adverse Events

The study reported no deaths, infections, or unscheduled IBS-related healthcare visits during the trial.

A total of 88 adverse events were reported, with bloating being the most common. However, all AEs were rated as not serious and were deemed unrelated to VSL#3.

Serious Adverse Events

Two serious adverse events were reported on the same subject, both unrelated to the VSL#3 probiotic.

The SAEs were due to vaginal bleeding caused by uterine fibroids.

The study highlights the potential benefits of VSL#3 in alleviating pain associated with IBS and improving gastrointestinal permeability.

The positive impact on the gut microbiome further supports the use of probiotics in managing IBS symptoms.

However, larger randomized trials are needed to validate these findings and explore the identified trends in more detail.

Probiotics and Irritable Bowel Syndrome : Insights from VSL#3

The study delves into the intricate relationship between probiotics and the gut microbiome of individuals suffering from IBS, with a focus on the effects of VSL#3.

This probiotic has previously demonstrated efficacy in ameliorating IBS symptoms in both adults and children through double-blind, randomized trials ²⁰.

Key Findings

Microbiome Analysis

The comprehensive analysis utilized Whole Genome Shotgun Sequencing to decipher the intricate dynamics of the gut microbiome post-VSL#3 administration.

This approach revealed significant correlations between certain probiotic species, such as L. plantarum, L. casei subsp. paracasei, B. animalis, and S. thermophilus, and a reduction in the frequency of pain episodes.

These species also exhibited trends towards reduced colonic permeability ^{21 22}.

Gastrointestinal Permeability

The study marks a significant stride in understanding the potential link between probiotics and gastrointestinal permeability, a connection that has remained largely unexplored in adults with IBS.

Animal studies have suggested that VSL#3 administration may reduce gut permeability, possibly through various molecular mechanisms ^{23 24} .

Bile Acids and Abdominal Pain

These findings underscore the possible role of bile acids in modulating abdominal pain and colonic permeability in IBS patients.

While the study did not yield statistically significant results, it did reveal trends that warrant further exploration in larger trials.

Bile acids, particularly taurochenodeoxycholic acid, were associated with increased abdominal pain and colonic permeability, indicating a potential protective mechanism of VSL#3 in mitigating these symptoms ²⁵.

The study, albeit limited by its sample size and open trial design, provides crucial insights into the potential benefits of VSL#3 in managing IBS symptoms.

The correlation between the abundance of probiotic organisms and the alleviation of abdominal pain is a promising avenue for future research.

The findings lay the groundwork for more rigorous, double-blind randomized controlled trials to further validate the therapeutic potential of VSL#3 in treating IBS, while controlling for placebo effects commonly observed in IBS patients ²⁶.

Discussion

• VSL#3 has demonstrated promise in treating IBS symptoms in both children and adults.
• The probiotic has a positive impact on the gut microbiome, potentially leading to symptom relief.
• Studies suggest that VSL#3 may alter the gut microbial composition, replacing or modifying bacteria.
• There is a potential link between VSL#3 and improvements in gastrointestinal permeability.
• Larger randomized trials are necessary to validate the benefits of VSL#3 in managing IBS symptoms.

Conclusion

• The study provides valuable insights into the relationship between probiotics, the gut microbiome, and IBS symptoms.
• The potential benefits of VSL#3 in alleviating IBS symptoms are promising, but further research is needed.
• The findings lay the groundwork for more rigorous, double-blind randomized controlled trials to validate the therapeutic potential of VSL#3 in treating IBS.
• The correlation between the abundance of probiotic organisms and the alleviation of abdominal pain is a promising avenue for future research.