The possibility of Bacillus probiotic use in patients with post-infectious irritable bowel syndrome after COVID-19 infection

Abstract

Background. In Ukraine, one of the most rapidly gro­wing problems of family medicine and gastroenterology is irritable bowel syndrome (IBS). The coronavirus disease 2019 (COVID-19) pandemic and the beginning of a large-scale military invasion of Ukraine contributed to this. Aim: to optimize the treatment of patients with post-infectious irritable bowel syndrome after COVID-19 infection with the use of Bacillus probiotics in the comprehensive treatment. Materials and methods. A simple randomized clinical trial was conducted to study the effectiveness and safety of а 5-strain Bacillus probiotic in patients with post-COVID IBS. A total of 42 patients (26 women and 16 men) aged 26 to 48 years (average of (32 ± 11) years) were examined. The diagnosis of post-infectious IBS was established according to the Rome IV criteria. The severity was assessed using the IBS Symptom Severity Scale. All patients underwent a comprehensive laboratory and instrumental examination, which included general clinical and biochemical blood tests (liver tests, serological tests for infectious markers), stool tests for calprotectin, worm eggs, parasites, and abdominal ultrasonography. Results. In the dynamics of observation, a certain decrease was noted in the severity of clinical symptoms in both groups. But at the same time, after 2 weeks of treatment, there was a tendency to a faster decrease in the severity of symptoms such as abdominal pain, intestinal motility disorders, and flatulence in patients who received the probiotic, although this trend was significant only for flatulence (p 0.05). After 4 weeks of treatment, significantly better indicators regarding the severity of all studied symptoms were found in the group of patients receiving the probiotic (p < 0.05). This difference persisted even 1 month after the end of treatment. Characteristically, during the first two weeks of observation, the number of days per week during which patients did not need to take antispasmodics and/or regulators of intestinal motility significantly decreased in the second group (3.1 ± 0.4 vs 6.7 ± 0.9 in the comparison group, p < 0.05). This difference was even more pronounced after 4 weeks of treatment. It is extremely important that the patients who received the probiotic practically did not need to take symptomatic therapy to eliminate the manifestations of abdominal pain and intestinal motility disorders. The indicated changes and trends persisted one month after the end of treatment. Conclusions. The use of Bacillus probiotic has shown positive results in the treatment of patients with IBS after COVID-19 infection. Its administration contributed to a significantly faster disappearance of the symptoms of post-infectious IBS, such as abdominal pain, flatulence, normali­zed intestinal motility (p < 0.05 compared to the control group), and also dramatically reduced the need for symptomatic therapy (p < 0.05).

Keywords

• irritable bowel syndrome
• post-infectious irritable bowel syndrome
• covid-19
• probiotics
• bacillus