How probiotics can help fight IBS

Probiotics are a hot topic at this time, especially for people with irritable bowel syndrome (IBS).

IBS is a chronic disease that causes abdominal pain and changes in bowel habits.

Many people take probiotics in the hope that the balance of their intestinal bacteria improves their symptoms.

This article discusses the latest research on probiotics for IBS, including strains and specific symptoms.

What is IBS?

Yogurt with raspberries and blueberries

Irritable bowel syndrome is a chronic disease characterized by abdominal pain or discomfort, as well as bloating, gas, constipation and diarrhea (1).

It affects 7-21% of people worldwide and is three times more frequent in women than in men in the West, although the difference is not as great in Asia (1, 2, 3).

The exact causes of IBS are unknown. However, some of the suggested causes include changes in digestive motility, infections, intestinal interactions, excessive growth of bacteria, sensitivity to food, carbohydrate malabsorption and intestinal inflammation (3, 4).

Eating certain foods can trigger symptoms and stress can make them worse (3, 5).

IBS is diagnosed when you have abdominal pain at least one day per week for three months, plus at least two of the following symptoms: pain related to defecation, a change in the frequency of bowel movements or a change in the appearance of stool (6)

In addition, there are four subtypes of IBS, which are related to the type of bowel movement that is experienced more frequently (6):

  • IBS-D: Predominant diarrhea

  • IBS-C: Predominant constipation

  • IBS-M: Alternating between diarrhea and constipation.

  • IBS-U: Not specified, for people who do not fit in one of the previous categories

Another subtype, known as "infectious" IBS has also been suggested for people who develop the disease after an infection. This subtype can be applied to up to 25% of people with IBS (3).

Treatment for all subtypes includes medications, improvements in diet and lifestyle, the elimination of FODMAP and lactose and the use of probiotics (3).

FODMAP are types of poorly digested carbohydrate molecules that are found naturally in many foods. They can cause gastrointestinal symptoms such as gas and bloating, which can exacerbate IBS.

Summary Irritable bowel syndrome (IBS) is a chronic disease characterized by abdominal pain and changes in bowel movements. Its causes are not yet known, but may be related to brain interactions, excessive bacterial growth, infection, inflammation and sensitivity.

What are probiotics?

Your digestive system is full of beneficial bacteria known as intestinal flora and play a fundamental role in your health (7, 8).

However, for various reasons, the intestinal flora sometimes becomes unbalanced, which allows harmful bacteria to proliferate (7).

Probiotics are live bacteria or yeasts that are found in foods and supplements. They are safe, similar to the natural intestinal flora and provide health benefits (8).

People use them to promote a healthy and balanced intestinal flora. They can provide a series of health benefits, such as supporting weight loss, improving heart health, improving digestion and stimulating the immune system (8, 9).

Some common probiotic foods include yogurt, sauerkraut, tempeh, kimchi and other fermented foods.

In addition, common probiotic strains found in supplements include Lactobacillus Y Bifidobacterium (8).

Summary Probiotics are live bacteria and yeasts that people can consume to support and help balance the natural bacteria in the body. Common sources include yogurt, fermented foods and supplements.

How do probiotics work with IBS?

A significant amount of recent research has investigated how probiotics could be used to treat and manage IBS.

The symptoms of IBS have been related to certain changes in the intestinal flora. For example, people with IBS have lower amounts of Lactobacillus Y Bifidobacterium In its bowels, and higher levels of harmful. Streptococcus, E. coli Y Clostridium (7, 9).

In addition, up to 84% of patients with IBS experience an excessive growth of bacteria in their small intestine, which can cause many of their symptoms (7).

However, it is uncertain whether this change is a cause or result of IBS. In addition, certain medications used to treat IBS symptoms can damage healthy bacteria living in the intestine (7, 10).

Changes in the intestinal flora may influence the symptoms of IBS by increasing inflammation, increasing gas sensitivity in the intestine, reducing immune function, and changing digestive motility (7, 11).

Probiotics have been proposed to improve symptoms by (10):

  • Inhibit the growth of bacteria that cause diseases.

  • Improve the barrier functions of the immune system.

  • Helping to fight inflammation.

  • Slow down the bowel movements

  • Reduce gas production by balancing the intestinal flora.

  • Reducing the sensitivity of the intestine to the accumulation of gas.

However, not all probiotics are the same. In fact, the term "probiotic" covers many different strains and types of bacteria and yeasts. Its effects on health vary according to type.

Summary Imbalances of the intestinal flora may contribute to the symptoms of IBS. Probiotics help restore balance in several ways, including by inhibiting the growth of harmful bacteria, reducing inflammation, and slowing down the digestive system.

Can probiotics improve IBS symptoms?

A comprehensive review of 2016 concluded that it is not clear how effective probiotics are in treating IBS. He cited small study sizes and lack of consistent data (11).

However, several studies have shown that specific probiotics may have the potential to target specific symptoms. Probiotics of the Bifidobacterium, Lactobacillus Y Saccharomyces Families have shown a particular promise (10, 11).

General improvement of symptoms

In a review conducted by the British Dietetic Association (BDA), 29 studies evaluated the overall improvements in symptoms, and 14 of them showed a positive result for 10 different probiotics (11).

For example, one study treated 214 patients with IBS with the probiotic L. plantarum 299v. After four weeks, 78% of the patients rated the probiotic as good or excellent to improve symptoms, particularly for pain and swelling (12).

These findings were supported by another study in Poland. However, two other smaller studies on the same probiotic strain did not find a positive effect (13, 14, 15).

A German study of a probiotic fluid of two strains known as Pro-Symbioflor also had promising results. In this study, 297 patients were treated for eight weeks and experienced a 50% decrease in general symptoms, including abdominal pain (16).

Meanwhile, Symprove is a four-strain probiotic that was tested on 186 patients in the United Kingdom. It was found to reduce the overall severity of symptoms after 12 weeks of treatment (17).

Bifidobacterium infantis 35624 It has also been shown that capsules marginally reduce pain, swelling and problems with bowel habits in all subtypes of IBS (3).

While some of these results are promising, there is some inconsistency between the studies. In addition, most strains have only one study that demonstrates their effectiveness. Therefore, more research is needed to confirm the results.

Summary Preliminary research has found 10 probiotic strains that can help improve the general symptoms of IBS. However, the results have been inconsistent, and most strains have only a small study behind them. Additional research is required.

Abdominal pain

Abdominal pain is one of the key symptoms of IBS. It is often found in the lower or entire abdomen and disappears after a bowel movement (18).

Seven types of probiotics have been associated with improvements in the symptoms of abdominal pain (11).

The tension L. plantarum it was found that both the frequency and the severity of abdominal pain decreased, compared to a placebo (12).

One study investigated the yeast. S. cerevisiae, also known as Lesaffre. After eight weeks of treatment, 63% of the people in the test group and 47% of the people in the placebo group reported significant reductions in pain (19).

In another study, participants drank a probiotic solution consisting of B. bifidum, B. lactis, L. acidophilus Y L. casei for eight weeks Her pain was reduced by 64% in the probiotic group and by 38% in the placebo group (20).

While this research is positive, most studies on probiotics have not found a beneficial effect on pain. More studies are needed to confirm the findings of these strains.

It is also interesting to see how much impact the placebo effect had in these studies. The placebo effect occurs when people experience a positive effect during a study, even when they are only taking a placebo. This is commonly observed in the SII research (21).

Summary Abdominal pain is the main symptom of IBS. Seven probiotic strains have been found that help reduce pain. However, more research is needed to confirm the results.

Swelling and gas

Excess gas production and increased sensitivity can cause uncomfortable swelling and gas in the IBS (22).

In the 2016 BDA review, only two studies found that probiotics specifically reduced swelling and only one found that they reduced gas (11).

The tension L. plantarum it was found that the frequency and severity of swelling symptoms decreased, compared to a placebo (12).

Another study treated patients with a rose hip drink mixed with a fermented oatmeal soup with L. plantarum. The test group experienced significant reductions in gas, and both the test and placebo groups experienced reductions in abdominal pain (14).

An additional study found that participants with IBS experienced a reduction in abdominal swelling after four weeks of treatment with a supplement of four strains that contained B. lactis, L. acidophilus, L. bulgaricus Y S. thermophilus (2. 3).

If excess gas and bloating is your main problem with IBS, then one of these probiotics can improve your symptoms. However, more studies are needed.

Summary The tension L. plantarum It has been found to reduce both abdominal swelling and gas. Another mixed strain supplement has also resulted in gas reductions. However, in general, few studies have shown that probiotics improve gas and bloating.


Approximately 15% of people with IBS experience the predominant form of diarrhea (24).

While much research has been done on probiotics for diarrhea related to infection, less is known about the effects of probiotics on noninfectious types, such as IBS.

A probiotic known as Bacillus coagulans It has been found to improve multiple symptoms, including diarrhea and the frequency of bowel movements. However, studies to date have only been small, so more research is needed (25, 26).

The probiotic yeast Saccharomyces boulardii It has also been investigated for the treatment of IBS with predominant diarrhea. However, although one study found that intestinal habits improved and inflammation decreased, another study found no improvement (27, 28).

A multi-strain probiotic known as VSL # 3 was tested in people with IBS and found to slow the bowels and reduce gas. However, in a study specifically in people with IBS with predominant diarrhea, it was not found to improve bowel movements (29, 30).

Another probiotic of multiple strains called Duolac 7 was tested in 50 patients for eight weeks. It was found that the stool consistency significantly improved compared to the placebo group, and there was a general improvement in symptoms (31).

In general, it seems that the use of probiotics to treat diarrhea in IBS is not very effective, since only a few small-scale studies have shown improvement.

Summary While the use of probiotics for the treatment of infectious diarrhea is well documented, there is less evidence of use in IBD diarrhea. B. coagulans Y S. boulardii, In addition to some preparations of multiple strains, it may have a positive effect, but more studies are needed.


The most common form of IBS is the predominant type of constipation, which affects almost half of all people with the disease (24).

Studies on IBS with predominant constipation have sought to determine if probiotics can increase the frequency of bowel movements and alleviate associated symptoms.

One study gave participants one of two probiotics from multiple strains, one that contained L. acidophilus Y L. reuteri and the other one that contains L. plantarum, L. rhamnosus Y L. lactis.

Treatment with these probiotics resulted in more frequent bowel movements and an improvement in consistency (32).

In a study on children with IBS, treatment with probiotic. B. lactis and the prebiotic inulin reduces constipation, bloating and feelings of fullness. However, it should be noted that in some patients with IBS, inulin may worsen the symptoms (11, 33).

Additionally, S. cerevisiae It has been found to reduce symptoms of abdominal pain and bloating for IBS with constipation. However, more studies are needed to confirm this (34).

As with most of the other symptoms discussed, while some of these results are promising, studies to date have been small. There has not been enough research to confirm whether probiotics really benefit people with constipation in IBS.

Summary IBS with predominance of constipation is the most common form of the disease. B. lactis, S. cerevisiae and some probiotics from multiple strains have shown positive effects. However, more studies are needed.

Should you take probiotics if you have IBS?

Despite some promising research, it is too early to make general recommendations about the use of probiotics for IBS.

While it has been shown that some strains have benefits for one or two symptoms, it is unlikely that most probiotics cause improvements.

However, probiotics are safe and a relatively cheap potential treatment option for IBS. In addition, they have worked for some people, especially those with specific symptoms.

If you are interested in trying a probiotic, there is an excellent selection on Amazon.

Here are some key tips when making your selection:

  • Choose a probiotic based on the evidence: Select a probiotic that has an investigation that supports it.

  • Select a probiotic according to its symptoms: Choose strains that work for your problems.

  • Take the correct dose: Use the dose recommended by the manufacturer.

  • Stick with a type: Try a variety for at least four weeks and control your symptoms

Keep in mind that some probiotic supplements contain ingredients that could worsen your symptoms. These include oats, inulin, lactose, fructose, sorbitol and xylitol. If your symptoms are triggered by any of these, look for a probiotic that does not contain them.

By taking the time to select a probiotic that best suits your needs, you may discover that they are an effective complementary treatment for your IBS symptoms.

Even if you do not experience significant improvements, probiotics still offer other great health benefits and can be a valuable component of a healthy lifestyle.

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