The Best Probiotic Supplements for IBS

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Probiotic supplements
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As more attention is being given to the role of gut bacteria in the onset and maintenance of irritable bowel syndrome (IBS), scientists are looking to probiotic supplements for their potential in reducing IBS symptoms. Here you will learn why probiotics might be of help and how to choose a supplement that is right for you.

Overview

Probiotics are sometimes called "friendly" bacteria, as they are thought to support our immune systems and enhance our health by keeping the numbers of "unfriendly" bacteria within our digestive systems in check.

Your large intestine is filled with thousands of strains of bacteria - all a part of our gut flora. Optimal health calls for a favorable balance among all of these various strains. When unfriendly bacteria predominate - a condition known as intestinal dysbiosis - we may experience an inflammatory state that results in physical symptoms.

Taking a probiotic supplement is thought to help us to maintain a favorable balance of bacteria, which sets the stage for optimal health and may help to quiet your IBS symptoms.

Symptoms

Although research on the use of probiotics for IBS is complicated due to the difficulty of making comparisons of the many strains that are tested, for the most part, studies have shown a positive effect of probiotics on the variety of symptoms that make up IBS. Just as promising is the fact that most studies have not shown any negative effect on IBS symptoms from taking probiotics.

 In a variety of studies, probiotic supplements have been found to:

  • Decrease bloating
  • Decrease flatulence
  • Improve overall IBS symptoms
  • Normalize the frequency of bowel movements
  • Reduce abdominal pain

Why They Help

Taking a probiotic supplement, and thereby increasing the number of friendly bacteria within the large intestine, is thought to reduce the symptoms of IBS through some or all of the following effects:

  • Eradicating small intestinal bacterial overgrowth (SIBO)
  • Reducing the number of unfriendly bacteria
  • Strengthening the lining of the intestines
  • Reducing reduce intestinal permeability (leaky gut)
  • Normalizing motility
  • Reducing visceral hypersensitivity
  • Reducing pain through helpful effects on nerve receptors found in the intestinal lining

What Type Is Best?

One of the challenges for researchers is trying to come to firm conclusions as to which strains are the most effective for easing IBS symptoms. As of now, there is some limited evidence that the following strains can be effective in easing IBS symptoms:

  • Lactobacillus strains, (such as L. acidophilus, L. plantarum, L. rhamnosus)
  • Bifidobacterium strains, (such as B. infantis (Align), B. longum, B. bifidum)

Manufacturers have been busy developing various probiotic formulations and assessing their effectiveness. One such mixed strain formulation that has some research support for effectiveness is VSL#3. This type of attention by supplement manufacturers bodes well for a promising future for more safe and effective product choices.

As you make your choice, be sure that the supplement you choose contains live strains of bacteria. At home, be sure to store the supplement according to manufacturer's suggestions.

Some formulations requre refrigeration, while others can be stored in a cool, dry place.

Probiotics in Food

Certain foods contain probiotics as a result of how they are prepared. Probiotic-containing foods are foods that have undergone a process of fermentation which results in the production of varied and numerous strains of probiotic bacteria. Some examples of fermented, probiotic-containing foods include yogurt, traditionally prepared sauerkraut, and the Korean dish kimchi. Fermented foods have long been thought to promote overall and digestive health, but there is little actual research on the subject.

It is also unknown if fermented foods would be helpful for IBS symptoms. According to Monash University testing, the process of fermenting can increase the FODMAP content of some foods. If you choose to add fermented foods into your diet, be sure to start with small doses to assess your ability to tolerate these foods without worsening symptoms.

The Bottom Line

With the hope of a positive benefit, and minimal risk of side effects, probiotics may well be worth trying for your IBS. But as with any over-the-counter product, before you try probiotics remember to check with your doctor. (Probiotics may be harmful to individuals who have weakened immune systems or those who suffer from serious chronic illness.)

The British Dietetic Association recommends that you try a probiotic supplement for a period of four weeks to see if it has any effect on your symptoms. If not, they recommend that you try a different product with a different strain or strains of probiotic bacteria. 

Sources:

Dai, C., et. al. "Probiotics and irritable bowel syndrome" World Journal of Gastroenterology 2013 28 19:5973–5980.

Didari T, Mozaffari S, Nikfar S, Abdollahi M. "Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis." World Journal of Gastroenterology 2015;21(10):3072-3084.

Gallo A, Passaro G, Gasbarrini A, Landolfi R, Montalto M. "Modulation of microbiota as treatment for intestinal inflammatory disorders: An uptodate." World Journal of Gastroenterology 2016;22(32):7186-7202.

McKenzie YA, Alder A, Anderson W, Wills A, Goddard L, Gulia P, Jankovich E, Mutch P, Reeves LB, Singer A, Lomer MCE. "British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults" Journal of Human Nutrition and Dietetics 2012 25:20-274.

Weber S. "Fermented foods and FODMAPS" Monash University January 2017.

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