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Therap Adv Gastroenterol. 2017 Jan;10(1):74-88. doi: 10.1177/1756283X16670075. Epub 2016 Oct 10.

Systematic review and meta-analysis: the effects of fermented milk with Bifidobacterium lactis CNCM I-2494 and lactic acid bacteria on gastrointestinal discomfort in the general adult population.

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York Health Economics Consortium, University of York, Heslington, York, UK.
Monash University, Alfred Hospital, Melbourne, Australia.
Wythenshawe Hospital, Manchester, UK.
University of Sydney, Royal North Shore Hospital, Sydney, Australia.
Quantics Consulting Ltd, Edinburgh, Scotland.
York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York YO10 5NQ, UK.



It has been suggested that probiotics may improve gastrointestinal discomfort. Not all probiotics exhibit the same effects and consequently meta-analyses on probiotics should be confined to well-defined strains or strain combinations. The aim of this study was to evaluate the effectiveness of a probiotic fermented milk (PFM) that includes Bifidobacterium lactis (B. lactis) CNCM I-2494 and lactic acid bacteria on gastrointestinal discomfort in the general adult population.


Double-blind randomized controlled trials in the general adult population comparing PFM with a control dairy product for at least 4 weeks were searched from multiple literature databases (up to February 2015). Meta-analyses using random-effects models, with individual participant data were undertaken to calculate an odds ratio (OR) or standard mean difference (SMD), with a 95% confidence interval (CI).


The search strategy identified 12,439 documents. Overall, three trials with a total of 598 adults (female = 96.5%) met the inclusion criteria. Consumption of the PFM product was associated with a significant improvement in overall gastrointestinal discomfort compared with the control product (OR = 1.48; 95% CI 1.07-2.05), with a number needed to treat (NNT) of 10.24 (95% CI 5.64-55.93). PFM was also superior to the control in reducing digestive symptoms, as measured using a composite score (SMD = -0.21; 95% CI -0.37 to -0.05). Sensitivity analyses produced similar results, and the heterogeneity between studies was minimal.


This meta-analysis shows that the consumption of PFM with B. lactis CNCM I-2494 and lactic acid bacteria is associated with a modest but consistent and significant improvement of outcomes related to gastrointestinal discomfort in healthy adults.


Bifidobacterium lactis; digestive symptoms; gastrointestinal discomfort; meta-analysis; probiotic; systematic review

Conflict of interest statement

Conflict of interest statement: Danone commissioned York Health Economics Consortium (YHEC) Ltd. (an independent research organization) and Quantics Consulting (a statistical consultancy) to carry out this systematic review and meta-analysis. Dr Jacqui Eales (YHEC) served as a researcher on this review. Dr Eales has previously received funding from Danone Institute International (DII) to deliver a conference presentation of the outcome of another systematic review commissioned by DII and undertaken by YHEC. Dr Peter Gibson has served as a consultant or advisory board member for Abbvie, Ferring, Janssen, Merck, Nestle Health Science, Danone, Allergan and Takeda. His institution has received speaking honoraria from Abbvie, Janssen, Ferring, Takeda, Fresenius Kabi and Pfizer. He has received research grants for investigator-driven studies from Abbvie, Janssen, Falk Pharma, Danone and A2 Milk Company. His department financially benefits from the sales of a digital application and booklets on the low FODMAP diet. He has published an educational/recipe book on diet. Dr Peter Whorwell has acted as a consultant for, or received research grant support from, the following companies in the last 5 years: Almirall Pharma, Boehringer-Ingelheim, Chr. Hansen, Danone Research, Ironwood Pharmaceuticals, Salix, Shire UK, Sucampo Pharmaceuticals and Allergan. Dr John Kellow is a Board member of the Rome Foundation and is on the Advisory Board of Danone Australia. Dr Ann Yellowlees is a Director of Quantics, and declares no additional personal interests. Dr Richard Perry (Quantics) declares no additional personal interests. Mary Edwards, Dr Sarah King, Hannah Wood and Julie Glanville are employed by YHEC, and declare no additional personal interests.

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