8-strain probiotic formulation promising for bile acid malabsorption

The De Simone formulation 8-strain probiotic appears to induce favourable microbiome and metabolome changes in patients with bile acid malabsorption, as shown in a study.

The study included 22 patients with bile acid malabsorption. These patients were randomly assigned to receive the De Simone formulation 8-strain probiotic (900 billion bacteria) or placebo (maltose), administered three times daily for 3 weeks.

Outcomes of interest were symptoms, serum 7αC4, faecal primary bile acids, intestinal permeability assessed using the ¹³C-mannitol-lactulose test (0.1 and 1 g of the sugars respectively) over 24 h, faecal short chain fatty acids, microbiome, and metabolome. Assessments were conducted at baseline and after the intervention.

Compared with placebo, probiotic supplementation resulted in a significant decrease in the percentage of faecal primary bile acids (chenodeoxycholic acid and cholic acid), with a median change from baseline of −5.7 percent vs 9.8 percent (p=0.012).

Patients in the probiotic group showed a significant shift in faecal microbiome after the intervention, driven by an increase in probiotic-specific species.

Symptoms, intestinal permeability, or faecal short chain fatty acids did not differ between the probiotic and placebo groups. However, the probiotic group showed a numerical decrease in 0–2 h ¹³C-mannitol excretion compared with the placebo group (−1.9 vs 1.0 mg; p=0.084).