Decoding Probiotics for IBS
In this lesson we'll be looking at the evidence for using Probiotics in IBS and giving tips on choosing a probiotic wisely
What are Probiotics?
Probiotics are live, helpful bacteria like the helpful bacteria living in your gut. If consumed in large enough quantities, they can provide health benefits. Probiotics can be used to treat diarrhoea caused by antibiotics. They also help relieve digestive symptoms.
How Do They Work?
Probiotics can impact the gut microbiome by
- increasing the numbers or activity of our own beneficial bacteria.
- slow or stop the growth of harmful microbes
- support the lining of the gut and reduce inflammation.
But, it’s important to remember that probiotics won’t have the same effect on everyone. Your response will be impacted by your diet, the balance of microbes you already have, and your general health.
What effect do probiotics have on IBS?
Some studies show probiotics can reduce bloating, tummy pain, and wind in people with IBS. But other studies have found little or no effect. This might be due to differences in the methods used. These studies were carried out over different periods of time too. This makes it difficult to compare results.
Even experts have different opinions on their effectiveness. The American Gastroenterology Association states that there is insufficient high-quality evidence. As a result, they don't make recommendations about using probiotics to help manage IBS symptoms.
But the World Gastroenterology Guidelines on Probiotics report that a reduction in abdominal bloating and wind as a result of probiotic treatments is a consistent finding in published studies. They recommend choosing the strain of probiotic with the best evidence for the symptom/s you want relief from.
What’s a Probiotic Strain?
Think of bacteria like different types of cars. Just like there are various car models with unique features, bacteria come in different "models" too.
One model or type of bacteria is a "strain." So, a bacterial strain is a specific version of bacteria. Each bacterial strain has its own characteristics and benefits that make it different from others.
Selecting a strain or a combination of strains that have proven benefits for your specific symptoms increases the chance of getting positive results.
What Strains are Good for IBS?
The World Gastroenterology Guidelines provide a list of probiotic strains shown to have positive results in people with IBS.
The list is too long to publish here, but we’ve included a few suggestions of strains and products that are available in the UK, with relevant brand names.
Single strain
- Lactobacillus plantarum 299v (DSM 9843) - tummy pain and bloating
- Bifidobacterium infantis 35624 – improvement in overall IBS symptoms. Brand name: Aflorex.
Multi strain
- Lactobacillus rhamnosus NCIMB 30174, L. plantarum NCIMB 30173, L. acidophilus NCIMB 30175 and Enterococcus faecium NCIMB 30176 – Brand name: Symprove
- Bacillus subtilis PXN 21, Bifidobacterium bifidum PXN 23, B. breve PXN 25, B. infantis PXN 27, B. longum PXN 30, Lactobacillus acidophilus PXN 35, L. delbrueckii spp. bulgaricus PXN39, L. casei PXN 37, L. plantarum PXN 47, L. rhamnosus PXN 54, L. helveticus PXN 45, L. salivarius PXN 57, Lactococcus lactis PXN 63, and Streptococcus thermophilus PXN 66 Brand name: Biokult
Tips for choosing and using a probiotic supplement
- Choose a probiotic that researchers have shown to help with IBS. Select one that targets your specific symptom profile, like bloating or constipation.
- Try one probiotic at a time and track symptoms
- Take it between 4 and 12 weeks (about 3 months) to see if it impacts your symptoms. If you haven’t seen any benefit by then, you can choose to try a different strain, or combination of strains.
- Take the probiotic at the dose or servings that has been shown to be beneficial. You'll need to take most probiotics daily for best results - so try to be consistent
- Check added ingredients for FODMAPS. Avoid any products with FODMAP ingredients like: chicory, inulin or fructo-oligosaccharides (FOS). These can aggravate gas and bloating in IBS-sensitive tummies