Irritable bowel syndrome (IBS) is a very common digestive disorder experienced by an estimated 7-16% of people in the United States, primarily women and young people. It is a chronic condition that affects the intestines and stomach, causing a wide range of symptoms that require long-term management.
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One of the most frequently used tools for helping relieve IBS symptoms is probiotics. These can help restore the healthy balance of good gut bacteria in the gastrointestinal tract that may be due to IBS. Probiotics are naturally found in some, but not all, fermented foods, as well as in supplemental form.
Let’s examine the basics of IBS, how probiotics can help, factors to consider when choosing a probiotic, and some of the best ones on the market.
Understanding IBS and Probiotics
IBS is a chronic condition that can affect everyone differently. It can manifest with mild to severe symptoms that may go from periods of being manageable to being disruptive to daily activities.
Some of the most common IBS symptoms include:
- Abdominal pain
- Changes in bowel pattern
- Diarrhea and/or constipation
- Increased mucus in stool
Depending on the types of symptoms experienced, there are four categories of IBS generally diagnosed:
- IBS-D: Diarrhea-predominant
- IBS-C: Constipation-predominant
- IBS-M: Alternating between diarrhea and constipation
- IBS-U: Unspecified, for people who do not fit into one of the above categories
The exact cause of IBS is unknown but is likely a combination of multiple factors. Some theories of what may lead to IBS include a severe viral or bacterial infection that causes gut inflammation, significant stress experienced in early childhood, changes in gut bacteria, muscle contractions in the intestinal tract, and disrupted signals between your brain and gut.
How Probiotics Can Help
Probiotics are a common approach to IBS because they are thought to help improve symptoms of the condition through a couple different ways:
- They help balance the ratio of healthy versus unhealthy gut bacteria. This matters because IBS symptoms have been linked to certain alterations in the gut flora, such as lower levels of Lactobacillus and Bifidobacterium.
- They strengthen the intestinal barrier by promoting the production of tight junction proteins, reducing gut permeability, and preventing the translocation of harmful bacteria.
- They influence your immune response, which may help reduce the low-grade inflammation and immune dysregulation that are often present in IBS.
- They promote beneficial metabolites, like short-chain fatty acids (SCFAs), which play a crucial role in gut health by providing energy to the cells lining the colon, offering anti-inflammatory activity, and helping promote a healthy gut microbiome.
- They help influence the gut-brain axis, helping to reduce hypersensitivity and heightened pain perception, commonly reported by people with IBS.
Choosing Probiotics for IBS
Now that you understand how probiotics can benefit IBS management, you’re probably wondering how to choose the best one for this condition.
There are a variety of probiotics and they work best when aligned with their specific uses. In other words, it’s important to understand strain specificity when selecting a probiotic. A probiotic designed to support reproductive health is unlikely to be very effective in supporting IBS.
Colony-forming units (CFU) will be listed on the bottle. This tells you how many bacteria are present in any given amount of cells. The higher the CFU, the more live microorganisms there are within each capsule, and presumably, the more effective it may be for its purpose. If you’re new to probiotics, look for ones that contain at least 1 billion CFUs, but ideally at least 15 billion for specific conditions.
It’s also relevant to consider product quality, viability, shelf stability, and brand reputation when perusing the probiotic aisle. Pay attention to the storage requirements, including whether they need to be refrigerated as this may affect how easy they are to transport or travel with while protecting viability. Check the expiration date to make sure you will use it up in that amount of time.
Additionally, look for supplement brands that have gone the extra mile to obtain third-party testing and certification for quality, purity, and safety. This might include labels from NSF International, Consumer Lab, or USP.
Finally, if you have any known allergens or potential sensitivities to certain probiotic strains, be sure to determine whether the probiotic you’re considering contains these and avoid them.
Top Probiotic Strains for IBS
There are so many probiotics available that may come as individual or combination strains. Which are the best probiotics for IBS? Here are a couple of the more popular strains and what the research says about them.
Lactobacillus acidophilus is a type of bacteria that is naturally found in your body, including your digestive tract. It’s also a common supplemental probiotic thought to help balance gut bacteria in and prevent harmful strains from flourishing.
In one 2015 review of six randomized, placebo-controlled clinical trials, L. acidophilus was found to be significantly more effective for reducing IBS symptoms than a placebo. Another older review found that this strain may help reduce abdominal discomfort and pain among people suffering from IBS, although the evidence is mixed. And in a 2020 randomized controlled trial, researchers found that it helped reduce abdominal pain and severity related to IBS more than a placebo.
Bifidobacterium infantis is a type of lactic acid bacteria naturally found in your mouth and digestive tract.
In a 2020 review of five studies, researchers concluded that probiotic supplements containing B. infantis may be effective for IBS symptom management without significant negative effects. Another 2009 review found that B.infantis 35624 showed significant improvement in reported abdominal discomfort, bloating, and difficult bowel movements.
Bacillus coagulans are a shelf-stable spore-forming probiotic that can withstand the acidity in your stomach. This bacteria can produce lactic acid in the colon which is beneficial for its health.
One strain in particular, B.coagulans Unique IS2, has been researched for IBS. This probiotic has been linked to helping improve abdominal pain associated with constipation along with helping increase frequency of bowel movements. In a 2022 review this strain was found to help alleviate straining with bowel movements.
Streptococcus thermophilus is a type of good bacteria in the gut that produces lactic acid. It’s thought to modulate the immune response, support healthy gut bacterial balance, reduce inflammation, improve gut integrity, and reduce perceived pain related to IBS symptoms.
Some research has found S. thermophilus to be effective in reducing gassiness and bloating while improving the quality of life among people with IBS.
Other Considerations for IBS Management
Adding probiotic strains designed for IBS management is a simple intervention that many people find beneficial. Of course, this isn’t the only thing you can do — making other positive lifestyle changes are also important.
First, enjoy a healthy, balanced diet rich in minimally processed, nutrient-dense foods. This includes things like fruits, vegetables, legumes, nuts, seeds, grains, and lean proteins. It also means minimizing ultra-processed foods that may promote inflammation.
Following a low-FODMAP diet — which excludes Fermentable Oligo-, Di-, Mono-saccharides, And Polyols found in foods like onions, garlic, oranges, berries, potatoes, eggplant, oats, and more — is also often recommended under the supervision of a dietitian.
A low-FODMAP diet is an elimination diet that can be helpful in identifying trigger foods for flare-ups and designing a way of eating that meets nutritional needs while minimizing IBS symptoms. As with any elimination diet there needs to be a reintroduction of foods because long term elimination of foods can hurt your gut in the long run.
Getting regular physical activity may also help support IBS symptom management. Staying active can also help support a positive mood, improving quality of life.
IBS is a very individualized condition and therefore it’s important to be under the care of a knowledgeable healthcare provider for personalized management.
Using Probiotics for IBS
IBS is a common condition and can have a number of symptoms that come and go. While the specific cause of IBS is unknown, there are several management approaches that have been proven effective for many people. One of the most frequent interventions for IBS is the use of probiotics, which is a simple way to help support a healthy gut microbiome.
Probiotics may help improve gut integrity, reduce inflammation, modulate the immune response, and rebalance the ratio of good bacteria. IBS continues to be studied and more research is needed to determine the best ways to manage this condition. Reach out for more support in developing an individualized plan and choosing the most suitable probiotic for your unique needs.
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Amanda is a pizza loving registered dietitian nutritionist specializing in mindfulness and gut health. She quickly realized that gut health goes beyond the gut; it is also about honoring our gut feelings. She is the creator of The Mindful Gut™ which uses science and strategy to help people improve their gut health.