Perceived gastrointestinal symptoms in people with cystic fibrosis before and after a 12-week course of a multistrain probiotic

Abstract

Objectives: Gut dysbiosis is common in people with cystic fibrosis (PwCF)1. Probiotics may improve the gut microbial profile and intestinal motility, and reduce pro-inflammatory cytokines2. SymproveTM is a 4 strain probiotic containing 109 CFUs per 70 ml dose of Lactobacillus rhamnosus, Enterococcus faecium, Lactobacillus acidophilus and Lactiplantibacillus plantarum. Randomised controlled trials (RCTs) have demonstrated benefit of SymproveTM in Irritable Bowel Syndrome (IBS)3 and Inflammatory Bowel Disease (IBD)4. We sought to evaluate Gastro-Intestinal (GI) symptoms, using the GI Symptom Rating Scale (GSRS), before and after a 12-week course of SymproveTM. The GSRS validity in CF has been previously demonstrated5. Method(s): PwCF at a UK adult CF centre who reported the following GI symptoms between 2021 and 2024 were recommended a 12-week course of 70 ml SymproveTM: known GI dysmotility not resolved with prokinetics, prolonged course of IV/oral antibiotics (>6 weeks), diagnosis of IBS/Small Intestinal Bacterial Overgrowth (SIBO). The GSRS was completed before starting SymproveTM and following the completion of the 12-week course. Result(s): A total of 21 PwCF (8 male) started SymproveTM, 3 did not complete the course, 13 completed both questionnaires. Two presented with SIBO, 3 had diarrhoea associated with >6 weeks oral antibiotics, 4 reported bloating, 5 had constipation, 2 alternating constipation and diarrhoea and 5 had diarrhoea and/or urgency. Change in GSRS scores were analysed using Wilcoxon's signed rank test or paired t-test in SPSS version 29. Conclusion(s): A significant reduction in GI symptoms, specifically abdominal pain and indigestion (predominately bloating and flatus), was reported by PwCF following a 12-week course of SymproveTM probiotics. There was an insufficient sample size for a subgroup analysis of scores according to probiotic indication. A RCT should be considered to exclude placebo bias. Copyright © 2025