Probiotics and IBS - what you need to know

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that affects the digestive system, including the small and large intestine (bowel). People with IBS commonly suffer from symptoms such as bloating, abdominal pain, cramping, gas, diarrhea, and constipation. To help manage their symptoms, many people make dietary changes. Some are also turning to probiotics in the hope that they may also help.

What are probiotics?

Probiotics are defined as ‘live microorganisms that, when administered in adequate amounts, confer a health benefit on the host’, according to the International Scientific Association for Probiotics and Prebiotics (ISAPP).

Our gastrointestinal system is home to many microorganisms, including viruses, fungi, and more than 1000 species of bacteria. These microorganisms are collectively known as our microbiota (also known as our microbiome or intestinal microflora).

The gut microbiota plays a key role in maintaining good health and keeps the gastrointestinal system working efficiently. An imbalance in the types or strains of microorganisms in the gut is thought to be one factor that contributes to the development of IBS symptoms.

When taken in adequate amounts probiotics can support the existing microorganisms in your body and help to restore the microbiota back to a healthy state after an imbalance has occurred. Probiotics are found naturally in some foods and beverages, as well as in supplements.

Why take probiotics for irritable bowel syndrome?

In addition to the makeup of the gut microbiota, a range of other factors can also contribute to the development of IBS symptoms including diet and the action of endocrine cells in the gut, which secrete the hormones that regulate gut movement.

The effects of probiotics are thought to be limited, but significant, in people with gastrointestinal disorders such as IBS. Probiotics can help people with IBS because they:

• Help restore and maintain a healthy balance of microorganisms in the body
• Improve the body’s immune system response
• Strengthen the bowel wall, improving its ability to act as a barrier against germs
• Aid gut communication by improving short-chain fatty acid and neurotransmitter production
• Reduce the secretion of intestinal cytokines, which are substances that can lead to inflammation and diarrhea
• Reduce IBS symptoms

Probiotic products can contain many different strains of microorganisms that each have their own effect on IBS symptoms.

Which probiotics work best for irritable bowel syndrome?

Below is a list of some of the most commonly studied probiotic species and subspecies that have been shown to help people with IBS.

Probiotics tend to contain multiple strains or combinations of these microorganisms. Multi-strain probiotics are thought to be better for managing IBS symptoms compare with those that just contain a single microorganism.

Sources of probiotics

Probiotics can be found in fermented food and dietary supplements and are usually taken or eaten regularly to gain maximum health benefits. It is recommended that probiotics be taken for a least four weeks and according to the manufacturer's instructions.

Fermented foods

Fermented foods and beverages are a source of probiotics. When consumed they help improve the balance of good and bad gut flora. Fermented foods can help reduce some symptoms of IBS such as gas and abdominal pain, and also have other health benefits too.

Dietary supplements

Supplements containing probiotics are also available. Probiotics are available in different forms, such as powders, capsules, and liquids. They often contain a mix of live microorganisms, rather than a single strain. Probiotics should preferably contain a dose of greater than 10 billion CFU/g (colony-forming units per gram). CFU is a measure of the amount of live or viable microorganisms in the product.

It is important that the microorganisms in the probiotics are live in order to provide health benefits. One possible issue with supplements to be aware of is that the microorganisms may die during the shelf life of the product. Look for products that have the expected CFU number displayed at the end of the shelf life and not at the time of manufacture.

Bottom line

• Probiotics appear to be beneficial for overall IBS symptoms. In particular, they appear to help with abdominal pain and flatulence or gas. The evidence supporting their use in managing other symptoms, such as bloating, is less clear.
• Check labeling to make sure your probiotic supplement does not contain an ingredient that may trigger your IBS symptoms such as lactose, fructose, oats, sorbitol, and xylitol. Also, avoid fermented foods and beverages if they increase your IBS symptoms.
• More research needs to be done to identify the best combinations of microorganisms to include in probiotic products that are used to manage IBS symptoms.
• Some strains of microorganisms appear to be more effective than others. The beneficial effects that probiotics have appear to be strain-specific.
• What dose to take and for how long also requires further investigation. The higher the amount doesn’t necessarily mean it will increase the health benefits.
• Consult your healthcare professional if you have any concerns about introducing probiotics to your diet, especially if you have an underlying condition.