Anti-inflammatory-antioxidant modifications and synbiotics improved health-related conditions in patients with progressive forms of multiple sclerosis: A single-center, randomized clinical trial

There is growing evidence that dietary modification can improve clinical manifestations in multiple sclerosis (MS) patients. This study aimed to assess the impact of synbiotics and anti-inflammatory-antioxidant-rich diet on fatigue, pain, gut and bladder status, and sexual function in patients with progressive forms of MS. In this single-center, single-blind, randomized, controlled clinical trial, seventy participants with three forms of progressive MS (primary-progressive, secondary-progressive, and progressive-relapsing) were randomly assigned to receive either synbiotics supplement and anti-inflammatory-antioxidant-rich diet or a placebo along with their usual diet for a duration of four months. Modified fatigue impact scale (MFIS), global pain scale (GPS), bladder control scale (BLCS), bowel control scale (BWCS), and sexual satisfaction scale (SSS) were assessed at baseline and at the end of the trial. Sixty-nine participants successfully completed the trial, resulting in a 98% adherence rate to the diet, and no reports of serious side effects. Significant mean changes were observed in fatigue (Δ for experimental group = −10.5 ± 10.8 vs. Δ for control group = −0.08 ± 4.1; P < 0.001), pain (−14.1 ± 19.0 vs. 0.9 ± 10.3; P < 0.001), bladder (−0.76 ± 2.1 vs. 0.3 ± 1.1; P = 0.013) and bowel (−6.6 ± 3.2 vs. −0.05 ± 2.3; P < 0.001) control, as well as sexual function (−1.0 ± 2.3 vs. 0.51 ± 0.21; P < 0.001). The anti-inflammatory-antioxidant-rich diet and synbiotics co-supplementation demonstrated improvements in fatigue, pain, sexual function, and bowel/bladder status among patients with progressive MS.