USING BREWER’S YEAST AND GINGER IN THE MANAGEMENT OF CONSTIPATION-PREDOMINANT IRRITABLE BOWEL SYNDROME: A RANDOMIZED DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL
Objective: The objective of the present study is to confirm and/or prove the beneficial outcomes from using Brewer’s yeast and Ginger in constipation-predominant irritable bowel syndrome (IBS-C) subjects compared to placebo.
Methods: A total of 45 patients suffering from IBS-C were enrolled in a double-blind placebo-controlled study as defined by Rome III criteria. Parallel groups were randomly assigned in this study: A placebo group, Brewer’s yeast group, and ginger group, taken daily for 20 days. IBS severity scale and visual analog scale for IBS (VAS-IBS) were used to assess the severity of pain, abdominal distention, and constipation (IBS-C) subjects. The data were measured at 3 times: At 0 time (T0), after 10 days of treatment (T10), and after 20 days of treatment (T20) for the three treatment groups.
Results: Intragroup analysis showed a clinically significant reduction in the symptoms of abdominal pain, distention, and constipation, in the Brewer’s yeast group compared to placebo after the 20 days of the study. There was also a significant reduction of abdominal distention and constipation symptoms in the ginger group throughout the study.
Conclusion: This study reveals the beneficial effects of Brewer’s yeast and ginger in reducing troublesome gastrointestinal symptoms in subjects with IBS-C and holds the promise to use them in IBS-C patient.
2. Grundmann O, Yoon SL. Irritable bowel syndrome: Epidemiology, diagnosis and treatment: An update for health-care practitioners. J Gastroenterol Hepatol 2010;25:691-9.
3. American College of Gastroenterology Task Force on Irritable Bowel Syndrome, Brandt LJ, Chey WD, Foxx-Orenstein AE, Schiller LR, Schoenfeld PS, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol 2009;104 Suppl 1:S1-35.
4. Katsinelos P, Lazaraki G, Kountouras J, Paroutoglou G, Oikonomidou I, Mimidis K, et al. Prevalence, bowel habit subtypes and medical care-seeking behaviour of patients with irritable bowel syndrome in northern Greece. Eur J Gastroenterol Hepatol 2009;21:183-9.
5. Park JM, Choi MG, Kim YS, Choi CH, Choi SC, Hong SJ, et al. Quality of life of patients with irritable bowel syndrome in Korea. Qual Life Res 2009;18:435-46.
6. Shen YH, Nahas R. Complementary and alternative medicine for treatment of irritable bowel syndrome. Can Fam Physician 2009;55:143-8.
7. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC, et al. Functional bowel disorders. Gastroenterology 2006;130:1480-91.
8. Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: A meta-analysis. Clin Gastroenterol Hepatol 2012;10:712-210000.
9. Hungin AP, Whorwell PJ, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: An international survey of 40,000 subjects. Aliment Pharmacol Ther 2003;17:643-50.
10. DiBonaventura M, Sun SX, Bolge SC, Wagner JS, Mody R. Health-related quality of life, work productivity and health care resource use associated with constipation predominant irritable bowel syndrome. Curr Med Res Opin 2011;27:2213-22.
11. Dibonaventura MD, Prior M, Prieto P, Fortea J. Burden of constipation-predominant irritable bowel syndrome (IBS-C) in France, Italy, and the United Kingdom. Clin Exp Gastroenterol 2012;5:203-12.
12. Fortea J, Prior M. Irritable bowel syndrome with constipation: A European-focused systematic literature review of disease burden. J Med Econ 2013;16:329-41.
13. Camilleri M, Tack JF. Current medical treatments of dyspepsia and irritable bowel syndrome. Gastroenterol Clin North Am 2010;39:481-93.
14. Jadallah KA, Kullab SM, Sanders DS. Constipation-predominant irritable bowel syndrome: A review of current and emerging drug therapies. World J Gastroenterol 2014;20:8898-909.
15. Moyad MA. Brewer’s/baker’s yeast (Saccharomyces cerevisiae) and preventive medicine: Part II. Urol Nurs 2008;28:73-5.
16. Chilton SN, Burton JP, Reid G. Inclusion of fermented foods in food guides around the world. Nutrients 2015;7:390-404.
17. Nakamura T, Agata K, Mizutani M, Iino H. Effects of brewer’s yeast cell wall on constipation and defecation in experimentally constipated rats. Biosci Biotechnol Biochem 2001;65:774-80.
18. Pineton de Chambrun G, Neut C, Chau A, Cazaubiel M, Pelerin F, Justen P, et al. A randomized clinical trial of Saccharomyces cerevisiae versus placebo in the irritable bowel syndrome. Dig Liver Dis 2015;47:119-24.
19. Pinheiro I, Robinson L, Verhelst A, Marzorati M, Winkens B, den Abbeele PV, et al. A yeast fermentate improves gastrointestinal discomfort and constipation by modulation of the gut microbiome: Results from a randomized double-blind placebo-controlled pilot trial. BMC Complement Altern Med 2017;17:441.
20. Spiller R, Pélerin F, Cayzeele Decherf A, Maudet C, Housez B, Cazaubiel M, et al. Randomized double blind placebo-controlled trial of Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: Improvement in abdominal pain and bloating in those with predominant constipation. United European Gastroenterol J 2016;4:353-62.
21. Ashraf K, Syedadnan A, Shah A, Mujeeb M. Determination of 10-gingerol in Indian ginger by validated hptlc method of samples collected across subcontinent of India. Int J Pharm Pharm Sci 2016;8:190-3.
22. Ashraf K, Sultan S, Shah S. Phychemistry, phytochemical, pharmacological and molecular study of Zingiber officinale Roscoe: A review. Inter J Pharm Pharm Sci 2017;9:8-16.
23. Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids 1997;56:379-84.
24. Ghayur MN, Gilani AH. Ginger lowers blood pressure through blockade of voltage-dependent calcium channels. J Cardiovasc Pharmacol 2005;45:74-80.
25. Maghbooli M, Golipour F, Moghimi Esfandabadi A, Yousefi M. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res 2014;28:412-5.
26. Borrelli F, Capasso R, Aviello G, Pittler MH, Izzo AA. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56.
27. Tianthong W, Phupong V. A randomized, double-blind, placebo-controlled trial on the efficacy of ginger in the prevention of abdominal distention in post cesarean section patients. Sci Rep 2018;8:6835.
28. van Tilburg MA, Palsson OS, Ringel Y, Whitehead WE. Is ginger effective for the treatment of irritable bowel syndrome? A double blind randomized controlled pilot trial. Complement Ther Med 2014;22:17-20.
29. Ghayur MN, Gilani AH. Pharmacological basis for the medicinal use of ginger in gastrointestinal disorders. Dig Dis Sci 2005;50:1889-97.
30. Drossman DA, Chang L, Bellamy N, Gallo-Torres HE, Lembo A, Mearin F, et al. Severity in irritable bowel syndrome: A Rome foundation working team report. Am J Gastroenterol 2011;106:1749-59.
31. Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: A simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 1997;11:395-402.
32. Bengtsson M, Hammar O, Mandl T, Ohlsson B. Evaluation of gastrointestinal symptoms in different patient groups using the visual analogue scale for irritable bowel syndrome (VAS-IBS). BMC Gastroenterol 2011;11:122.
33. Drossman DA, Morris CB, Schneck S, Hu YJ, Norton NJ, Norton WF, et al. International survey of patients with IBS: Symptom features and their severity, health status, treatments, and risk taking to achieve clinical benefit. J Clin Gastroenterol 2009;43:541-50.
34. Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, Stoa JM. Chronic constipation in the elderly. Am J Gastroenterol 2012;107:18-25.
35. De Giorgio R, Ruggeri E, Stanghellini V, Eusebi LH, Bazzoli F, Chiarioni G, et al. Chronic constipation in the elderly: A primer for the gastroenterologist. BMC Gastroenterol 2015;15:130.
36. Pickett-Blakely O. Obesity and irritable bowel syndrome: A comprehensive review. Gastroenterol Hepatol (N Y) 2014;10:411-6.
37. Rey E, Talley NJ. Irritable bowel syndrome: Novel views on the epidemiology and potential risk factors. Dig Liver Dis 2009;41:772-80.
38. El-Salhy M. Irritable bowel syndrome: Diagnosis and pathogenesis. World J Gastroenterol 2012;18:5151-63.
39. O’Malley D, Quigley EM, Dinan TG, Cryan JF. Do interactions between stress and immune responses lead to symptom exacerbations in irritable bowel syndrome? Brain Behav Immun 2011;25:1333-41.
40. Blanchard EB, Lackner JM, Jaccard J, Rowell D, Carosella AM, Powell C, et al. The role of stress in symptom exacerbation among IBS patients. J Psychosom Res 2008;64:119-28.
41. Nakade Y, Fukuda H, Iwa M, Tsukamoto K, Yanagi H, Yamamura T, et al. Restraint stress stimulates colonic motility via central corticotropin-releasing factor and peripheral 5-HT3 receptors in conscious rats. Am J Physiol Gastrointest Liver Physiol 2007;292:G1037-44.
42. Konturek SJ, Brzozowski T, Konturek PC, Zwirska-Korczala K, Reiter RJ. Day/night differences in stress-induced gastric lesions in rats with an intact pineal gland or after pinealectomy. J Pineal Res 2008;44:408-15.
43. Lyte M, Vulchanova L, Brown DR. Stress at the intestinal surface: Catecholamines and mucosa-bacteria interactions. Cell Tissue Res 2011;343:23-32.
44. Sánchez B, Delgado S, Blanco-Míguez A, Lourenço A, Gueimonde M, Margolles A, et al. Probiotics, gut microbiota, and their influence on host health and disease. Mol Nutr Food Res 2017;61: 1-15.
45. Sarkar A, Lehto SM, Harty S, Dinan TG, Cryan JF, Burnet PWJ, et al. Psychobiotics and the manipulation of bacteria-gut-brain signals.Trends Neurosci 2016;39:763-81.
46. Tillisch K, Labus J, Kilpatrick L, Jiang Z, Stains J, Ebrat B, et al. Consumption of fermented milk product with probiotic modulates brain activity. Gastroenterology 2013;144:1394-401, 1401.e1-4.
47. Crouzet L, Gaultier E, Del’Homme C, Cartier C, Delmas E, Dapoigny M, et al. The hypersensitivity to colonic distension of IBS patients can be transferred to rats through their fecal microbiota. Neurogastroenterol Motil 2013;25:e272-82.
48. O’Mahony SM, Marchesi JR, Scully P, Codling C, Ceolho AM, Quigley EM, et al. Early life stress alters behavior, immunity, and microbiota in rats: Implications for irritable bowel syndrome and psychiatric illnesses. Biol Psychiatry 2009;65:263-7.
49. Cayzeele-Decherf A, Pélerin F, Leuillet S, Douillard B, Housez B, Cazaubiel M, et al. Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: An individual subject meta-analysis. World J Gastroenterol 2017;23:336-44.
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.