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Irritable Bowel Syndrome (IBS)BIO-IBSNCT07584278

Probiotics and Biomarkers in Irritable Bowel Syndrome

A study testing Probiotic Supplementation (Lactobacillus Reuteri) in people with Irritable Bowel Syndrome (IBS), run by Sahlgrenska University Hospital at 1 site in Sweden.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this double-blind parallel-arm randomized controlled trial is to learn if a probiotic supplement (containing a new strain derived from L. reuteri) alters outcomes related to symptom severity and transit time in adults with irritable bowel syndrome (IBS). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Irritable Bowel Syndrome (IBS)
What is being tested?
Probiotic Supplementation (Lactobacillus Reuteri)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
252 participants
Where
1 siteSweden
Study dates
28 Apr 2026to May 2031
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosed with IBS according to ROME V criteria
  • IBS-SSS greater than or equal to 75
  • Adult over 18 years old
  • BMI 18.5-35 kg/m2
  • Able to understand the participant information sheet and willing to comply with the study protocol
  • Able to give informed consent
  • Able to complete the Swedish questionnaires

Who cannot join

  • History of any gastroenterology disease including coeliac disease, heart, liver, neurological, or current psychiatric disease, diabetes, any surgery to the abdomen that affects intestinal function (not including cholecystectomy, appendectomy, ceasarean section).
  • The use of opioids 1 month prior to screening and throughout the study
  • The use of probiotic supplements from 14days before randomization and during the study (not including foods with probiotic components)
  • Consumption of antibiotics 3 months prior to screening and throughout the study
  • The start of any new drugs that affect the gastrointestinal tract or symptoms within the last month before the start of the study. As well as the start of new diets of psychological therapy as treatment for IBS symptoms.
  • Participation in any medical research during the last month
Show all 11Show fewer
  • Clinically relevant lab abnormalities at the time of screening (fecal calprotectin greater than or equal to 150 ug/g as absolute cutoff. If calprotectin is between 50 - 150ug/g the decision is made on clinical judgement)
  • Pregnancy, plan to become pregnant during the study, breastfeeding
  • alcohol consumption >14 units per week
  • Use of recreational active drugs during 1 month before screening or during the study
  • Use of medication that primarily affects bowel function, transit time, stool consistency 2 weeks before the intervention or during the 12 week intervention period

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Magnus Simren, MD, PhD contact

0046313428107

magnus.simren@medicine.gu.se

Sweden1 site, 1 recruiting
  • Mag-tarmlab, Sahlgrenska University Hospital

    Gothenburg, 413 45

    MagTarmlab, +46 31 342 81 07, magtarmlab.se@vgregion.se

    Recruiting

Other trials in Sweden

About this study

Official title: The Impact of Probiotics on Biomarkers and Symptom Severity in Irritable Bowel Syndrome

The goal of this double-blind parallel-arm randomized controlled trial is to learn if a probiotic supplement (containing a new strain derived from L. reuteri) alters outcomes related to symptom severity and transit time in adults with irritable bowel syndrome (IBS). The main question it aims to answer is:

Does the probiotic alter IBS symptom severity?

Read more

Researchers will compare the probiotic to a placebo (a lookalike substance that contains no probiotic) to see if the probiotic works to alter outcomes.

Participants will:

Be randomized to either take the probiotic supplement or placebo supplement daily for 12 weeks.

Visit the lab for 4 study visits (visit 1: screening and informed consent; visit 2: randomization, data collection, beginning the intervention; visit 3: end of intervention and data collection; visit 4: 3 month post intervention follow up and data collection).

Provide biological samples (blood, stool, saliva, urine) Complete questionnaires

Read the detailed description

The BIO-IBS study is a double-blind, randomized, placebo-controlled clinical trial investigating whether a combination probiotic improves symptoms in adults with irritable bowel syndrome (IBS). The trial also explores biological mechanisms and predictors of treatment response.

Background \& Rationale IBS is a common disorder of gut-brain interaction (~4% prevalence in Sweden). Current treatments include dietary, pharmacological, and psychological approaches. Increasing evidence suggests the gut microbiome plays a key role, prompting interest in probiotics.

Aims

  1. Evaluate effect of probiotic combination on IBS symptoms. 2, Identify predictors of response. 3. Investigate IBS pathophysiology and biomarkers.

Study Design

Type: Double-blind, randomized, placebo-controlled, parallel-group Participants: 252 adults with IBS Randomization: 1:1 (probiotic vs placebo) Treatment duration: 12 weeks Follow-up: 3 months post-treatment Timeline: Recruitment starting April 2026 lasting ~3 years

Participants Inclusion Criteria

Adult (≥18 years), IBS (Rome IV criteria) IBS-SSS > 75 BMI 18.5-35 Able to consent and complete Swedish questionnaires

Key Exclusion Criteria

Significant gastrointestinal or systemic disease Recent antibiotics (within 3 months) or probiotics (within 2 weeks) Opioid use Pregnancy/breastfeeding Significant lab abnormalities (e.g., high fecal calprotectin) Major lifestyle/treatment changes

Intervention

Active treatment: Tablet containing both L. reuteri strains Placebo: Identical without bacteria Dose: 1 tablet twice daily Duration: 12 weeks Compliance ≥80% required for per-protocol analysis.

Outcomes Primary Outcome

Change in IBS symptom severity (IBS-SSS) from baseline to 12 weeks (intervention vs placebo)

Secondary Outcomes

Proportion achieving ≥50 or ≥100 point IBS-SSS reduction Gastrointestinal symptoms (GSRS-IBS) Pain reduction Quality of life (IBSQOL) Work productivity (WPAI:IBS) Transit time (gut motility) Adverse events Sustainability of effects (3-month follow-up)

Exploratory Outcomes

Stool consistency/frequency Biomarkers (microbiome, immune, metabolomics, etc.) Psychological and lifestyle factors Dietary influences Mechanistic insights into IBS

Study Procedures Visits Screening (2-8 weeks before randomization Consent, questionnaires, biological samples, diaries

Randomization (Day 0) Baseline assessments and start of treatment

During intervention Regular symptom tracking Phone follow-up at week 6

End of treatment (12 weeks) Repeat assessments and samples

Follow-up (3 months later) Long-term outcomes

Optional (Facultative) Assessments Rectal sensitivity (barostat) Sigmoidoscopy ± confocal endomicroscopy MRI (motility and colonic volume)

Measurements

Questionnaires: IBS-SSS, GSRS-IBS, HADS, PHQ-15, IBSQOL, stress, work productivity Biological samples: blood, stool, urine, saliva Gut function: transit time (radiopaque markers and sweetcorn method) Diet: food frequency and recall diaries

Statistical Considerations Sample size: 252 participants (powered to detect clinically meaningful IBS-SSS difference)

Populations:

Intention-to-treat (all randomized) Per-protocol (≥80% compliance, no major deviations) Analysis plan: Defined in a Statistical Analysis Plan No interim analysis

Safety Probiotics considered safe with minimal risk (mainly transient flatulence). Adverse events will be recorded and classified by severity and causality. IBS symptom fluctuations are not counted as adverse events unless worsened.

Ethics \& Data Handling Conducted according to Declaration of Helsinki and ICH-GCP. Participants give informed consent and can withdraw anytime. Data are pseudonymized and securely stored (REDCap)

Risk-Benefit Assessment Low risk due to established safety of L. reuteri strains Moderate participant burden (questionnaires, sample collection) Optional procedures may cause discomfort but are controlled and voluntary Potential benefit: improved IBS symptoms and better understanding of disease mechanisms

Key Strengths Large sample size Rigorous randomized controlled design Comprehensive symptom, biological, and mechanistic assessment Long follow-up

Conclusion This study aims to determine whether a novel probiotic combination improves IBS symptoms and to identify biological and clinical predictors of response, contributing to more personalized treatment strategies in IBS.

Being tested
Probiotic Supplementation (Lactobacillus Reuteri), Placebo Supplementation
Keywords
probiotic, irritable bowel syndome, ibs symptom severity, oro-anal transit time, randomized controlled trial
Medical subject headings
Irritable Bowel Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Probiotic Supplementation (Lactobacillus Reuteri)Other

    Probiotic using a new strain derived from L. reuteri.

  • Placebo SupplementationOther

    A placebo supplement that is identical to the probiotic in formulation and packaging except that the probiotic bacteria is not present.

Study groups in NCT07584278
Study groupRoleWhat they receive
InterventionExperimentalAdults with IBS who have been randomized to receive the intervention
Receives: Other: Probiotic Supplementation (Lactobacillus Reuteri)
ControlPlacebo comparatorAdults with IBS who have been randomized to receive the placebo
Receives: Other: Placebo Supplementation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. IBS symptom severity (IBS-Symptom-Severity-Score)

    • Between group differences (intervention vs control) in mean IBS-SSS scores from baseline to end of intervention.
    • Proportion of responders (decrease in IBS-SSS over greater than or equal to 50 points from baseline to end of intervention) between arms
    • Proportion of greater responders (decrease in IBS-SSS scores greater than or equal to 100 points from baseline to end of intervention) between arms

    Measured: Screening (15-60 days pre-intervention), baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84), 3 month follow up post intervention

Secondary outcomes (9)
  1. Gastrointestinal Symptom Rating Scale- IBS (GSRS-IBS)

    Change in Gastrointestinal Symptom Rating Scale- IBS (GSRS-IBS) scores over time between arms

    The GSRS uses a 7- point Likert scale. Total scores can range from 15 - 105 with higher scores indicating worse symptom rating

    Measured: Screening (15-60 days pre-intervention), baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84), 3 month follow up post intervention

  2. General global assessment: satisfactory adequate relief of symptoms from baseline to end of intervention between arms

    The proportion of individuals with greater or equal to 50% of assessments with an adequate relief of symptoms

    Measured: During intervention (days 14, 28, 42, 56, 70), end of intervention (day 84)

  3. General global assessment: worst pain over the last 24 hours, intervention group vs placebo group reduced between baseline and end of intervention between arms

    The proportion of individuals with greater or equal to 50% of assessments between baseline and end of intervention, and a greater than or equal to 30% decrease in worst pain during the last 24 hours compared to baseline

    Measured: During intervention (days 14, 28, 42, 56, 70), end of intervention (day 84)

  4. IBS-quality of life (IBS-QoL)

    Change in IBS-quality of life (IBS-QoL) scores over time between arms

    The IBS-QoL is a 34-item scale that uses a 5-point Likert scale with total scores ranging from 0-100, where higher scores indicate better quality of life

    Measured: Baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84), 3 month follow up post intervention

  5. Work Productivity and Activity Impairment:IBS (WPAI:IBS)

    Change in Work Productivity and Activity Impairment:IBS (WPAI:IBS) scores over time between arms

    The WPAI:IBS consists of 6 items regarding employment status, hours of work missed because of IBS, hours missed because of other reasons, hours actually worked, how much IBS affected productivity of working (VAS of 0 to 10), how much IBS affected regular activities (VAS of 0 to 10). Total scores are expressed as percentage of impairment/productivity lost with higher scores indicating greater impairment

    Measured: Baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84), 3 month follow up post intervention

  6. Change in oro-anal transit time from baseline to end of intervention between groups: Radiopaque markers

    Participants will take oral tablets that are radiopaque markers following a specific protocol beginning from 7 days prior to attending the study visit. Each day they will swallow one set of radiopaque markers with water, then on day 7 a nurse will conduct an X-ray of the abdomen to show the location of the markers in the bowel.

    Measured: Baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84)

  7. Change in oro-anal transit time from baseline to end of intervention between groups: sweetcorn

    Sweetcorn oro-anal transit time will be measured using a specific protocol. 7 days before attending the study visit the participants will be advised to eat 100g of sweetcorn at 0800 with minimal chewing. Following this, each time they open their bowel for the next 6 days they will be advised to visually inspect the stool for sweetcorn and record whether or not they see the sweetcorn in a diary.

    Measured: Baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84)

  8. Hospital Anxiety and Depression Scale (HADS)

    Change in Hospital Anxiety and Depression Scale (HADS) scores over time between groups.

    The HADS is a 14-item questionnaire (with 2 subscales: HADS-Depression (7 items) and HADS-Anxiety (7 items), with each item rated on a 4 point Likert scale. Total scores range from 0 - 21. Higher scores indicate worse symptoms for anxiety and depression

    Measured: Baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84), 3 month follow up post intervention

  9. Patient Health Questionnaire (PHQ)

    Change in Patient Health Questionnaire (PHQ) scores over time between groups

    The PHQ is a 15-item questionnaire with each item rated on a 3-point Likert scale. Total scores range from 0-30 with higher scores indicating greater somatic symptom burden

    Measured: Baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84), 3 month follow up post intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 May 2026
  2. Study start28 Apr 2026
  3. Primary completionApr 2031 (estimated)
  4. Study completionMay 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
252 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07584278
Sponsor's protocol ID
BIO-IBS 2025-04788-01-805801
Acronym
BIO-IBS
Status last verified
May 2026
First submitted
22 Apr 2026
Last updated
1 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Probiotic Supplementation (Lactobacillus Reuteri) in people with Irritable Bowel Syndrome (IBS), run by Sahlgrenska University Hospital at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 1 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Magnus Simren, MD, PhD (0046313428107, magnus.simren@medicine.gu.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

IBS symptom severity (IBS-Symptom-Severity-Score) (time frame: Screening (15-60 days pre-intervention), baseline (day 0 of intervention), during intervention (days 14, 28, 42, 56, 70), end of intervention (day 84), 3 month follow up post intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Jun 2026.

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