According to a systematic review from 2019 and our own clinical practice, probiotics can effectively treat the symptoms of irritable bowel syndrome (IBS) with a few caveats:
- Probiotics are not usually recommended for patients with small intestine bacterial overgrowth (SIBO).
- Single-strain probiotics seem to be more effective than multi-strain probiotics at reducing IBS symptoms.
As long as a patient tests negative for SIBO, probiotics are one of my first go-to treatments to address IBS. Probiotics (specific strains of “good bacteria”) repopulate the colonies of beneficial bacteria in the lower digestive system and typically lead to a healthier microbiome.
Read on to find out how probiotics can help treat IBS, what health benefits they offer, and when not to take them for your IBS.
At PrimeHealth, we diagnose your symptoms to their root cause. Then, we make an individualized plan to cure your IBS. Colorado residents, schedule a free consultation today!
5 Benefits of Probiotics for IBS
The evidence-based beneficial effects of probiotics for IBS are clear, and that’s why we recommend them to patients we believe will experience improvements to their condition. 5 benefits of taking probiotics may include:
1. Fighting Inflammation
This 2021 study found that probiotics can have a pivotal effect on the modulation of immune and inflammatory mechanisms.
Another study found that using two probiotic strains (Lactobacillus and Bifidobacterium) led to a significant improvement in symptoms of irritable bowel syndrome. They work by normalizing the ratio of anti-inflammatory and pro-inflammatory cytokines, leading to reduced inflammation.
2. Slowing the Growth of Bad Bacteria
Probiotics have been shown to inhibit the growth of pathogenic bacteria more than placebo groups.
When good bacteria adhere to your intestinal cells, it prevents pathogenic bacteria from growing and causing problems.
3. Boosting Your Immune System
Not only do probiotics regulate inflammation (which is great for your immune system), they can strengthen your gut barrier.
Leaky gut syndrome occurs when you have an overgrowth of harmful gut bacteria, weakening the barrier between the gut and the bloodstream. Leaky gut syndrome leads to a weaker immune system because foreign bodies can more easily enter the bloodstream.
Probiotics treat leaky gut, meaning they may strengthen your immune system.
One randomized study showed that probiotics prevented the invasion of Salmonella bacteria by strengthening barrier function in the gut.
4. Controlling Bowel Movement Speed
Probiotics may regulate stool frequency and bowel movement speed for patients with IBS, particularly if bloating is a dominant symptom.
A large number of animal studies have shown probiotics regulate bowel motility.
Controlling bowel movement speed is vital for IBS-D sufferers.
5. Decreasing Gas Production
When you increase beneficial bacteria in your large intestine, such as Lactobacillus and Bifidobacterium strains, gas production decreases.
Probiotics May Worsen SIBO
An IBS patient who also suffers from SIBO (small intestine bacterial overgrowth) should most often not take probiotics. Probiotics can worsen bacterial overgrowth in SIBO patients.
Can probiotics make IBS worse? Probiotics can make IBS worse if your IBS is triggered by SIBO, especially if it is methane-predominant SIBO. If you have SIBO, probiotics can get trapped in your small intestine and worsen your symptoms. Take a breath test to test for SIBO before treating IBS with probiotics.
Other studies have shown a decrease in hydrogen gas production with the use of probiotics, so they may actually helpful in hydrogen-predominant SIBO.
A large number of IBS patients also suffer from SIBO, so it’s worth getting tested for this first. The most common test for SIBO is a 2- to 3-hour hydrogen breath test.
When you have SIBO, the good bacteria that belong in your large intestine populate in your small intestine. In your small intestine, those beneficial microbes aren’t providing the much-needed benefits to your gut health. As your small intestine tries to get them out, SIBO symptoms emerge.
There are a few exceptions to the rule for some people. Here are a few probiotic strains that may help treat SIBO:
- Lactobacillus casei: This strain has been studied for its potential to reduce bacterial overgrowth in the small intestine.
- Bifidobacterium infantis: Some research suggests that B. infantis can help restore a healthy balance of gut bacteria in individuals with SIBO.
- Lactobacillus plantarum: This strain may have antimicrobial properties that could be beneficial in SIBO management.
- Saccharomyces boulardii: While not a bacteria but a yeast, S. boulardii has been explored for its potential in addressing SIBO-related issues.
Treat SIBO before treating IBS. In fact, SIBO might be the only root cause of IBS — meaning if you successfully treat your SIBO, your IBS might disappear, too.
Choosing IBS Probiotics
Lactobacillus and Bifidobacterium strains are the most common probiotics in dietary supplements and probiotic foods.
Different strains can have different effects on the body. For this reason, it’s important to refer to each individual strain by its name rather than using the overly general term “probiotics.”
Which probiotics are best for IBS? Lactobacillus and Bifidobacterium probiotics are among the best probiotic strains to take for IBS. Look for a gluten-free brand with a high number of colony-forming units (CFU) for best results.
Another strain, S. boulardii, is a beneficial strain that is a yeast. It is most helpful for IBS-D sufferers, and is used to help protect people from infections during antibiotic use.
The Role of Fermented Foods
Fermented foods are foods transformed by beneficial bacteria through a natural process known as fermentation. This age-old formulation not only enhances the flavor and preservation of foods but also introduces a wealth of live bacteria.
Boost your gut health with these probiotic-rich foods:
- Yogurt: Yogurt is a well-known probiotic-rich food packed with beneficial live cultures like Lactobacillus and Bifidobacterium.
- Kefir: Kefir is a fermented milk drink that offers a diverse range of probiotics and is easy to incorporate into your diet.
- Sauerkraut: This fermented cabbage dish is a great source of probiotics, thanks to the lactic acid bacteria involved in the fermentation process.
- Kimchi: A traditional Korean side dish made from fermented vegetables, primarily cabbage and spices, which is rich in probiotics.
- Miso: Miso is a Japanese seasoning made by fermenting soybeans or other grains with salt and koji fungus, providing probiotics and a unique umami flavor.
- Tempeh: Tempeh is a soy-based product that is fermented, offering a variety of probiotics and a nutty flavor.
- Pickles: Fermented pickles, not the vinegar-preserved kind, are loaded with probiotics and can be a tasty addition to your meals.
- Buttermilk: Buttermilk contains live cultures that can support gut health, and it’s often used in cooking and baking.
- Natto: Natto is a traditional Japanese dish made from fermented soybeans, rich in probiotics and vitamin K2.
- Traditional Greek Yogurt: Greek yogurt made from quality ingredients and live cultures is a fantastic source of probiotics.
(Side note: Don’t just add probiotic food and neglect to avoid certain foods when you have IBS. Your diet is the most important part of reversing your symptoms!)
Common Probiotic Strains Found in Food
Probiotics can be found in various foods, and the strains of probiotics can vary. However, some of the specific probiotic strains found in foods include:
- Lactobacillus acidophilus: This strain is frequently found in yogurt, fermented milk, and some fermented vegetables. It’s known for promoting gut health and aiding digestion.
- Bifidobacterium bifidum: Often found in dairy products like yogurt, B. bifidum supports gut health and may help regulate bowel movements.
- Lactobacillus casei: This probiotic is found in yogurt, fermented milk, and some cheese. It can contribute to a balanced gut microbiome.
- Lactobacillus plantarum: Commonly found in fermented foods like sauerkraut and kimchi, L. plantarum may help with digestion and support a healthy gut.
- Bifidobacterium longum: Present in dairy products, B. longum is associated with digestive health and may have immune-boosting properties.
- Saccharomyces boulardii: This yeast-based probiotic can be found in certain fermented foods and supplements. It’s known for its ability to support gut health and alleviate diarrhea.
- Lactobacillus rhamnosus: Often present in yogurt and other dairy products, L. rhamnosus is associated with gut health and may help reduce symptoms of irritable bowel syndrome (IBS).
- Streptococcus thermophilus: Commonly found in yogurt and cheese, this probiotic strain aids in the digestion of lactose and supports gut health.
What Are Probiotics?
Probiotics are beneficial bacteria, like the 100 trillion benevolent microorganisms in and on your body right now. If you’re talking about “taking probiotics,” this is usually in reference to taking a dietary supplement containing probiotics.
You may also enrich your diet with probiotic-containing foods and beverages like kimchi or kombucha.
Probiotics have also been studied in neuro-cognitive conditions, such as Parkinson’s disease, obsessive-compulsive disorder, depression, and many more, and may even be beneficial for weight loss.
There are countless strains of beneficial bacteria. Different probiotics contain different strains of these helpful microorganisms.
What is the difference between probiotics and prebiotics? Probiotics are good bacteria. Prebiotics are fermentable plant fibers that feed probiotics. Both are beneficial (under the right circumstances).
What are the side effects of probiotics? There are very few or no side effects of probiotics for most patients. It’s rare to experience them, but here are some side effects that may occur:
- Abdominal distress
- Allergy flare-ups
- Headaches
- Infection
Probiotics aren’t the only treatment for the overall symptoms of IBS. Other helpful methods for addressing IBS exist, such as:
- A low-FODMAP diet
- Stress relief
- Gut-healing supplements
- Targeted medication
- Abstention from alcohol and caffeine
- Avoiding antibiotics
- Regular exercise
- Quality sleep
When treating IBS, you first need to know the underlying cause. Talk with an integrative specialist about diagnosing the root cause of your IBS, which could be parasites, low vagal tone, hormone imbalance, or even food poisoning.
Proactive IBS treatment is better than reactive treatment. If you have IBS now, you’re statistically more likely to experience it again, even if you treat it. It’s wise to establish a maintenance plan for preventing IBS, which may include taking probiotic supplements.
At PrimeHealth, we help people with IBS to overcome their gastrointestinal disorders for good by discussing, diagnosing, and treating each individual’s root cause. Colorado residents, schedule a free consultation today!
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