The efficacy of synbiotic supplements containing Bacillus coagulans and inulin with low FODMAP diet compared with low FODMAP diet alone on inflammatory factors, clinical outcomes and quality of life in patients with irritable bowel syndrome

Inclusion criteria:

18-65 years Patients with irritable bowel syndrome, according to gastroenterologist diagnosed according to the ROME- IV criteria (1.Improvement with defecation 2.Onset associated with a change in stool frequency 3.Onset associated with a change in stool form (appearance) At least three days a month, three months a year and no pathological findings in the clinical investigating) lack of any organic intestinal disease(diagnosed by last 5 years ago colonoscopy) and intestinal infections(diagnosed by stool culture). No medical history of chronic gastrointestinal and colorectal disease Absence of any major bowel surgery Absence of regular use of laxatives or antidiarrheal drugs No chronic use of antibiotics, corticosteroids and immunosuppressants No usage of drugs that modifying the digestive motility such as metoclopramide, cisapride, diphenoxylate,… No usage of drugs that increased bleeding of intestinal mucosa such as aspirin, warfarin, heparin,… No history of breast cancer in patient or in first-degree relatives of a person Absence of severe mental or behavioral disorder Absence of nicotine and its derivatives use in last 6 monthsNo usage of NSAIDs and aspirin in last week(influence on gut permeability)

Exclusion criteria:

Life threatening symptoms Death Not agree to continue the study

Target sample size: 50

Actual sample size reached: 50