Do Probiotics Help IBS? 7 Facts From Research.

✅ Evidence-Based.

✅ By Dr. Farahat.

Your IBS is ruining your life every day. And you’re constantly reading many claims about the “magic of probiotics in IBS” 

Me too, but in a world of Marketing and finance, we always get confused about too many health claims for everything that is “buyable”. 

So, today, I researched for YOU with a single question in mind: Can Probiotics help your IBS? 

(1) After doing some research, Here are my takeaways: – 

Till this moment, The Food & Drug Administration (FDA) doesn’t regulate The manufacturing and distribution of probiotics.

And this is because no study about probiotics for IBS provided clear evidence about its efficacy.

Most of the research work has limitations such as:

  • Most studies don’t follow up patients for long periods.
  • The small number of study participants.
  • Poor study design affects the quality of results.
  • Many studies have contradicting results (no single probiotic provided consistent results in different studies)

BUT…

That doesn’t mean probiotics are ineffective in IBS. Probiotic research is still evolving and some studies provide promising results. 

Also, probiotics have proven death benefits in many other gut diseases such as: –

  • Inflammatory Bowel disease.
  • Antibiotic-associated diarrhea.
  • Clostridium Difficile Colitis.
  • Infectious diarrhea.
  • Allergic diseases.

Regarding IBS, the big health authorities such as: 

  • FDA (Food and Drug Administration), 
  • AGA (American Gastroenterology Association), 
  • ACG (American College of Gastroenterology), 
  • and EFSA ( The European Food Safety Authority)

These authorities don’t currently recommend specific types of probiotic strains or combinations for the treatment of irritable bowel syndrome. Although uncertain about its role in IBS, a trial of a probiotic intake is recommended by many gastroenterologists and many health authorities such as the UK NHS (National Health Service).

Probiotics, under some circumstances, do help with your IBS. but before you put expectation and hopes about it for your IBS, you should be aware of the following facts about probiotics and your IBS:

  • What works for others doesn’t necessarily work for you.
  • The type, dose, and duration of probiotic intake play a role in your response.
  • Some have side effects and may make your IBS worse
  • You have to experiment with different doses and different strains to obtain maximum benefits.

(2) How do probiotics help IBS?

Your gut teams with bacteria inside to maintain its function and aid in proper digestion. Several studies related IBS to disturbance of the balance between good and bad bacteria inside your colon.

Good bacteria inside your Intestine helps with:

  • fighting bad Bacteria & other pathogens: They simply fight for Their position inside your gut, and you obtain protection from harmful invaders.

Overgrowth of bad bacteria can cause IBS symptoms such as diarrhea, Gas, Bloating, and abdominal pain.

  • Strengthen the Intestinal immunity: probiotic bacteria augments The cell junctions of your intestine lining. Probiotics help “tightening” the cell fence that acts as a “barrier” against toxins and microbes.
  • Decreases intestinal inflammation: probiotic bacteria decreases the production of a substance that mediates inflammation called (cytokines).
  • Decreases your intestine hypersensitivity: probiotics play a role in “pain sensation” trough adjustment of the production of neurotransmitters (pain mediators) and pain receptors inside your gut.
  • Aids in digestion & absorption: good bacteria help your colon to Break down and absorb Certain foods such as vitamins. This helps the reduction of maldigestion symptoms such as bloating and distension.

do probiotics help IBS

An Interesting story from research about probiotics and IBS:

In 2013, Dr. L. Couzet and his research team in France did an interesting experiment on rats. They transferred fecal microbiota from humans with IBS into rats, and interestingly, rats developed IBS symptoms unlike another group of rats that received fecal microbiota from humans who don’t have IBS. 

This experiment is eye-opening about the role of microbes inside your colon in IBS. although we don’t have the optimum probiotics for IBS, targeting this type of treatment can be the future of IBS treatments

Restoring the balance of your intestinal ecosystem of microbes can be the key to improve your IBS symptoms. And probiotic is one of its applications.
So, Probiotics can Help your IBS in many ways:

  • Improving abdominal pain and gut sensitivity.
  • Decreases intestinal inflammation.
  • Improving Gas and bloating (help digest and fight gas-producing microbes).
  • Improving diarrhea (& sometimes, Constipation).

(3) How effective they are?

To help you understand what to expect when taking probiotics for IBS, I did small research for the last updated review studies on PubMed.

The most recent review study was a 2019 paper titled “Probiotics In Irritable Bowel Syndrome: An UP-To-Date Systematic Review”.

what a “review” study does is collecting and analyzing the results of other research work on a specific topic.

This review study found That 63.6% of the included clinical trials reported “significant” improvement in IBS symptoms with probiotics”. The remaining 36.4 % found No improvement of IBS symptoms. Even some reported worsened IBS symptoms with probiotics.

Worth mentioning, The same review study found That probiotics Containing multiple strains improved IBS symptoms more Than single-strain probiotics.

Another recent meta-analysis promoted by The “American College Of Gastroenterology” Concluded That

  • Overall, probiotics can decrease IBS symptoms By 19% (Relative Risk: 0.81)
  • Better results with certain strains such as Lactobacillus Plantarum, Bifidobacterium infantis, Streptococcus Faecium, & some E. coli species.
  • No significant side effects of probiotics.
  • Results are inconsistent, and the meta-analysis could not provide a definitive recommendation about its efficacy.

However, the “World Gastroenterology organization” global guidelines on probiotics Indicate That They may reduce overall IBS symptoms, especially abdominal pain, Bloating, and distention.

TAKEAWAY

Evidence exists that probiotics can help your IBS, However, they seem to be partially effective for IBS, and No probiotic can fit all types of IBS patients.

(4) what are the predictors of a good response to probiotics?

This interesting 2018 review about probiotics in Irritable bowel Syndrome mentioned some predictors. When found, they raise the odds of your response to probiotics: –

  • Being female.
  • previously responded to a low FODMAP diet.
  • Having diarrhea or mixed type of IBS (although probiotics are also effective in IBS-C, it seems to be far less other types of IBS)
  • Using probiotics containing multiple strains.

(5) what probiotic strains help with specific IBS symptoms.

I did a little research again to determine what type of probiotic can help you according to your main complaint or IBS subtype.

The main 4 IBS subtypes ane:

  1. Diarrhea-predominant IBS
  2. Constipation-predominant IBS.
  3. Mixed type. (Alternating diarrhea and constipation).
  4. Unspecified type: normal motion or occasional diarrhea or constipation.

To make it easy for you, I gathered the best probiotic strains to go for according to your predominant symptom.

IBS Subtype or prominent symptomPossible probiotic strains that can help
IBS Diarrhea.

Saccharomyces Boulardii (yeast) (ref)

Lactobacillus Plantarum CECT 7484 (ref)

Lactobacillus Plantarum CECT 7485 (ref)

Pediococcus Acidilactici CECT 7483 (ref).

IBS-Constipation.Bifidobacterium lactis BB-12 (ref)
Gas and BloatingLactobacillus Plantarum (DSM 9843) (ref)
Best overall, mixed, or unspecified types of IBS

Combination of Lactobacillus acidophilus NCFM® and Bifidobacterium lactis Bi-07 (ref)

Bifidobacterium lactis HN019 (ref)

Tips on Selecting the best probiotics for your IBS
  • Results are not typical, Trial & Errors is The Best strategy.
  • Select multi-strain probiotics containing combinations of the above according to your main complaint.
  • Stick to one type at least 4 weeks Before experimenting with another type.
  • Note: we didn’t include abdominal pain Because it is a fundamental symptom of IBS & it is present across all types.

(6) Can probiotics cure IBS, Completely?

There is no evidence from the literature that probiotics provided a permanent cure from IBS. To date, probiotics can ‘improve” but can not permanently cure your IBS symptoms such as abdominal pain, diarrhea, and bloating.

The research in IBS & probiotic e is still evolving, and No consistent data was found to support its regular use as a treatment for IBS, but some health authorities such as The NHS recommend a trial of probiotic for one month. My advice to you is to experiment with it for your IBS.

(7) Can probiotics make your IBS worse?

Most of The time, taking a probiotic will not make your IBS worse. However, some clinical trials found That probiotics may cause IBS flare-ups, especially in people with IBS-Cret]. Another overlooked cause of IBS-flare ups

is The use of inappropriate types of probiotics;

  • Not made specifically for IBS.
  • Containing The wrong strains.
  • Or, having additives that are harmful to your IBS Such as sugar and lactose.

So, carefully select your Probiotic and make sure it’s made specifically for IBS patients.

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