ORLANDO — The daily consumption of homemade yogurt can lead to a complete resolution of symptoms in patients with irritable bowel syndrome, a prospective study shows.

"We were surprised by the response. We had 189 patients in the study, and 169 had remission within 6 months," said Manju Girish Chandran, MBBS, from the Mary Breckinridge ARH Hospital in Hyden, Kentucky.

And some of the participants had lived with symptoms of irritable bowel syndrome for 9 or 10 years, she reported here at the World Congress of Gastroenterology.

"Our study is based on the fact that there is an internal gut–brain microbiome axis," Dr Chandran told Medscape Medical News. "If you modulate the intestinal microbiome, you can actually achieve remission in some cases."

Medication does not adequately treat the symptoms of irritable bowel syndrome for many people, she said. As a result, "they just live with it."

That is one of the reasons Dr Chandran and her colleagues wanted to assess the potential of homemade yogurt with Lactobacilli to influence the gut microbiome.

Part of a Regular Diet

For their study, the team enrolled 189 consecutive patients diagnosed with irritable bowel syndrome at one of two medical centers in Eastern Kentucky.

Patients were instructed to consume 2 to 3 cups of yogurt every day and record their symptoms in a chart. Their responses were assessed every 2 months for 6 months.

Complete remission — defined as the relief of pre-existing irritable bowel syndrome symptoms and one or two normal bowel movements daily — was achieved by 89% of the study participants.

The yogurt is inexpensive and easy to make. First, boil a gallon of milk for 5 minutes and let it cool to lukewarm. Next, mix in 1 cup of Dannon plain yogurt, which is used as a starter and source of Lactobacilli. Place in an oven with the light on overnight (do not turn the oven on), and then refrigerate the next morning. Save 1 cup from each batch to use as a starter for the next batch.

"You can make enough yogurt for 1 week, and it's pretty cheap," Dr Chandran pointed out. "And it doesn't have to be eaten as plain yogurt." Because it can be mixed with fruit or used in a smoothie, it doesn't "feel like it's a medicine; it is part of a regular diet."

Results Difficult to Interpret

The study design makes the results difficult to interpret, which is disappointing, said William Heizer, MD, a gastroenterologist in private practice in Chapel Hill, North Carolina.

"At the very least, the consenting patients should have been randomly assigned to either a treatment or control group," Dr Heizer told Medscape Medical News. Also, "review of the self-reported charts should have been done by individuals blinded to which group the patient was in."

This was a pilot study, Dr Chandran explained. The next step will be to study the effectiveness of the homemade yogurt in patients with different subtypes of irritable bowel syndrome — constipation or diarrhea — and to randomize some participants to a control group.

This is the first study to show "that yogurt — even though it's homemade — is usable in IBS," said Ronnie Fass, MD, from the MetroHealth Medical Center in Cleveland.

"In traditional diets, we recommend that people with IBS be careful with milk-related products," he told Medscape Medical News. "This study suggests what we thought all along is not so clear cut."

"The homemade yogurt with Lactobacillus was very effective at controlling symptoms of belly pain and alterations in bowel movements. It did both, to my surprise," Dr Fass said. "This is the kind of study that could change standard of care, although more work is needed."

Dr Chandran, Dr Heizer, and Dr Fass have disclosed no relevant financial relationships.

The World Congress of Gastroenterology at the ACG 2017: Abstract P1152. Presented October 16, 2017.

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