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Objectives: Patients with stroke are prone to disability due to muscle hypercatabolism. We aim to review this concept based on available data on benefits of amino acid supplementation in post-stroke rehabilitation.Method: The search was performed on Medline and Embase in January 2019. Randomized controlled studies, observational studies and case reports conducted in the last 15 years on the supplementation of amino acids in post-stroke rehabilitation patients were included.Result: Amino acids prevent muscle hypercatabolism in post stroke patients by suppressing myofibrillar protein and skeletal muscle degradation. Stroke patients supplemented with amino acids led to an improvement of functional and physical performance.Discussion: Muscle protein hypercatabolism and sequestration of amino acids from skeletal muscles occur cyclically in post-stroke patients to counter each other. There is a resultant deficit of amino acids which is unmet. Amino acids have antiproteolytic effect. Its supplementation prevents muscle wasting and improves rehabilitation by promoting physical performance, muscle strength, mass, and function.

The symptoms of irritable bowel syndrome (IBS) lead to considerable impairment of health-related quality of life and high health care costs. Available therapies are not efficient in treating the symptoms of IBS. Studies have shown the beneficial effects of Saccharomyces cerevisiae CNCM I-3856. Therefore, this study was done to evaluate the efficacy and safety of S. cerevisiae CNCM I-3856 in the treatment of IBS.

This was a prospective, randomized, placebo-controlled study. One hundred newly diagnosed subjects with IBS were subgrouped into IBS-D, IBS-C, and IBS-M and then randomized to the S. cerevisiae CNCM I-3856 and placebo groups. Saccharomyces cerevisiae/placebo was administered in addition to standard treatment for a period of 8 weeks. Subjects were assessed for improvement of abdominal pain and change in stool consistency using a 7-point Likert scale and Bristol stool scale respectively.

The mean reduction of abdominal pain score in the S. cerevisiae CNCM I-3856 group was statistically significant when compared with the placebo group (p < 0.001). Similar improvement was also seen in the subgroups. Improvement in stool consistency in IBS-D subgroup at the end of treatment period was found to be statistically significant in S. cerevisiae group when compared to that of placebo (p < 0.001). A similar improvement was seen in the IBS-C and IBS-M subgroups. No serious adverse events were recorded in both groups.

The use of Saccharomyces cerevisiae CNCM I-3856 in IBS at a dose of 2 billion CFU twice daily for 8 weeks has shown to have an improvement in abdominal pain and stool consistency due to its analgesic and anti-inflammatory activity in subjects with IBS.

Digestive symptoms are common affecting more than 60% of the elderly people. Digestive enzyme deficiency and dysbiosis in the gastric fluid microbiota are the major contributors in the pathophysiology of indigestion. Therefore, therapeutic strategy targeting the gastric microbiota and digestive enzymes has the potential to treat indigestion. This study was conducted to evaluate the efficacy and tolerability of probiotic Bacillus coagulans GBI30,6086 along with digestive enzymes in improving indigestion in geriatric population.

An open-labelled, randomized, prospective study was conducted in geriatric patients with complaints of indigestion. The study group (n = 25) received 5 ml of reconstituted probiotic syrup containing Bacillus coagulans GBI-30, 6086, and digestive enzymes daily and the control group (n = 25) received 5 ml of placebo syrup twice daily for 5 days and followed-up after 7 days.

Reduction in Modified Glasgow dyspepsia severity score from baseline to follow up was statistically significant in the study group when compared to the control group (P < 0.0001). Improvement in indigestion, abdominal pain, and flatulence was also greater in the study group compared to the control group.

Bacillus coagulans along with digestive enzymes are effective in treating indigestion in geriatric patients. It is well tolerated and safe to be used in geriatric patients without any major adverse effects.