Irritable bowel syndrome (IBS) is a chronic disease characterized by a group of symptoms which include abdominal pain, diarrhea, constipation, bloating and discrepancies in bowel movements. About 10 – 25% of people in western (developed) countries suffer from IBS. The exact cause of IBS is not clear. It is believed due to a disturbance in the gut-brain axis. Other causes include infections, SIBO (small intestine bacterial overgrowth), genetic factors, GIT disorders and food sensitivity. The usual onset of IBS is 45 years and is more prevalent in women. Probiotics for IBS have promising results in reducing these symptoms (1).
IBS can be briefly summarized as hypersensitivity of viscera with disturbed motility of GIT. Based on predominant symptoms, Irritable Bowel Syndrome (IBS) is classified into four types:
|IBS – C||Constipation|
|IBS – D||Diarrhea|
|IBS – M (Formerly IBS – A)||Pain and diarrhea|
|IBS – U||Unspecified|
|IBS – PI||Post infectious IBS or Acute IBS|
Post-infectious IBS (IBS – PI) is an acute condition with intensified symptoms of diarrhea, vomiting, and fever.
Causes of Irritable Bowel Syndrome
The most common cause of IBS is the immune response in the gut post to an infection. Opportunistic pathogens such as E. coli and helminth parasites trigger symptoms of IBS. This, in turn, prolongs the symptoms of IBS – PI. Use of antibiotics during these infections will increase the risk of incidence of IBS.
Another major cause of IBS is the disruption in gut motility. Gut motility is strongly influenced by serotonin (5 – HT). When serotonin receptors are disrupted it severely affects the gut motility and secretion resulting in varied symptoms of IBS.
Foods like gluten can worsen the symptoms of IBS. Fermented oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are also triggering factors of IBS. Although IBS is a group of symptoms, it is well documented that patients with IBS have a poor quality of life.
In 1849 Cummings reported, “The bowels are constipated and are at lax at one time. How this disease has two opposite symptoms, I do not profess to explain”. (2).
The psychological factors also play a prominent role in predisposing IBS. It can be attributed to the gut-brain axis. The exact mechanism is still unknown. But it is also believed that the cause of IBS is not purely psychological as the gut-brain effects are mutual (vice-versa). For example, disrupted gut motility can lead to mood disorders but mood disorders need not cause IBS.
There are many theories suggested by researchers regarding the causes of IBS. But it is still uncertain about the exact cause. This can be related to the varying symptoms and underlying complexities. Not every abdominal pain/constipation/diarrhea can be IBS. It can be diagnosed as IBS if you are suffering from abdominal pain or diarrhea for more than one week and if you are above 49 years old (citation needed). Other diseases such as giardiasis, thyroid disorders and cancer of colon will have similar symptoms. GIT infections, lactose intolerance must be ruled out. Imbalance in probiotic microbiota can also cause IBS (3).
Probiotics for IBS are extensively studied regarding their mechanism of action and how exactly they help in reducing the symptoms.
What are probiotics?
Our body harbors trillions of bacterial colonies. There are both friendly and harmful bacteria in our body. A friendly bacterium which does not cause any harm to our body isn’t necessarily a probiotic. A probiotic is a bacterial (or yeast) strain that produces a healthy effect on the human body.
“Probiotics are live microorganisms when administered in adequate amounts confer a health benefit on the host” (4).
Our gut, skin and vaginal tissue in women have an ample number of probiotics. But it is the gut that hosts more numbers. They help in digestion, diabetes, immune response, hormone response, prevent urinary tract infections (in women), maintain the pH of vaginal fluids, leaky gut and helps in alleviating mood disorders. The most common probiotics are different species of Lactobacillus and Bifidobacterium.
These probiotics are periodically destroyed by gut juices and antibiotics (when consumed). They must be replaced regularly either by eating probiotic-rich foods (fermented foods) or by taking probiotic supplements. Once these probiotics reach the lower part of the gut and colonize, they will exert the healthy benefits.
How probiotics for IBS work?
People with IBS have a significant reduction in probiotic strains in the gut. They are also known to have excess bacterial overgrowth in the small intestine (SIBO). But whether IBS causes SIBO or SIBO causes IBS is yet unknown. It is well established that the disturbance in gut microbiome will aggravate the symptoms of IBS.
Probiotics reduce the symptoms of IBS by:
- Forming a physical barrier that prevents the hyperpermeability of the gut.
- Enhance digestion by secreting digestive enzymes.
- Help tight junction proteins in preventing toxins from entering the bloodstream (strengthens the lining of the gut).
- Fights opportunistic pathogens
- Reduces SIBO.
- Reduces the hypermotility of the gut.
Though the exact mechanism, how probiotics for IBS work is unknown, several case studies highlighted their importance in reducing the symptoms. Research is still going on to find out the mystery behind their action.
Probiotic strains such as Lactobacillus, Bifidobacterium, and Saccharomyces are excellent in reducing the symptoms of IBS (5).
Lactobacillus plantarum 299V was effective in reducing abdominal pain. It also reduced the frequency and severity of abdominal pain compared to placebo group of patients with IBS (6). L. plantarum showed significant improvements in patients with IBS flatulence (7). Bifidobacterium infantis 35624 also reduced abdominal pain and bloating.
In a case study, a combination of Bifidobacterium bifidum BGN4, Lactobacillus acidophilus AD031 and other species reduced abdominal pain. A case study conducted on Korean adults with IBS, probiotic strains Bifidobacterium (bifidum and lactis) Lactobacillus (acidophilus and casei) decreased abdominal pain by 64% (8).
The action of Lactobacillus plantarum, L. acidophilus, L. bulgaricus and Bifidobacterium lactis were tested in Iranian adults with IBS. After 4 weeks of treatment with these multiple strains, 80% of the patients reported a significant reduction in bloating and abdominal pain (9).
After abdominal pain, diarrhea is another major symptom in people with IBS. In a case study (10), B. coagulans MTCC 5856 was very effective in reducing the frequency of diarrhea in IBS – D patients.
VSL#3, a mixture of 8 different probiotics was tested on patients with IBS and bloating. After four weeks of treatment, VSL#3 reduced the symptoms of flatulence, bloating and reduced colonic transit (11).
Fifty patients with IBS – D were treated with a probiotic mixture of Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus rhamnosus, Bifidobacterium breve, Bifidobacterium lactis, Bifidobacterium longum, and Streptococcus thermophilus 1.0×10 CFU (12). After 8 weeks of treatment the result was very satisfactory. Patients showed adequate relief (AR) of overall symptoms. Patients with IBS – D showed consistency in the stool.
Bifidobacterium lactis and Saccharomyces cerevisiae are effective in reducing the symptoms of constipation. Multi-strain probiotic supplements which include L. acidophilus, L. plantarum, L.reuteri, L. rhamnosus and L. lactis decreased the symptoms of constipation (13).
The case studies prove to reduce various symptoms of IBS. But it is unknown how exactly they work. Some suggest that they reduce symptoms of IBS by their anti-inflammatory action. It is still early to judge that probiotics for IBS are the ultimate cure.
Should I Take Probiotics For IBS?
As stated earlier, treating ibs with probiotics greatly reduce the symptoms but the exact mechanism is unknown. The mysterious action of probiotics on health benefits must be well established. The complex mechanism of gut-brain axis and the immune system makes it difficult to document the mechanism of action of probiotics. So, it is very negligent to say that probiotics for IBS will work without fail. But, it always good to have probiotics in your daily diet besides there is no harm in taking them. And, considering so many case studies which prove that probiotics can confer to various health benefits, it is usually suggested to include them in your diet chart. There is a great increase in consumption of probiotics nowadays and exponential growth in research.
Consuming fermented foods such as kefir, kombucha, kimchi, and sauerkraut will confer to health in many ways as these foods contain a diverse amount of probiotic strains. You can prepare them at home very easily. If you cannot prepare fermented foods at home there are reputed online stores which sell fermented foods online (Kevita, Goodbelly Probiotics, and Cultured food life).
If you want to buy supplements (not fermented foods) make sure the manufacturer provides the following details on its label:
- Probiotic strains included
- Shelf life
- Number of colony forming units (CFU)
- Efficacious dose
The term ‘alive and probiotic’ does not make it probiotic. The manufacturer must mention the different probiotic strains included in their products. Make sure that these supplements do not contain ingredients that worsen your symptoms.
The results after consuming probiotics may be time-consuming. You just need a lot of patience and you must consume them on a daily basis. Once these probiotics reach the lower part of the gut (which takes a great amount of time), you can reap the health benefits.
Here are some of the best probiotics for IBS (supplements) selected for you.
- A BREAKTHROUGH DIGESTIVE SUPPLEMENT - Zenwise Health's Advanced Digestive Enzymes are formulated with the combination of plant based enzymes, Inulin Prebiotic and 1 Billion CFU of multi strain probiotics to promote daily intestinal health. Label designs may vary.
- GAS, BLOATING & STOMACH DISCOMFORT - This supplement features enzyme ingredients such as Papain and Amylase, along with Lactase, Protease and Lactase to support in easing discomfort.
- BETTER NUTRIENT DIGESTION - Digestive Enzymes can help your body digest fats, fiber, protein, cellulose, and gluten. This formula also contains Turmeric, which may provide additional support to promote digestive motility.
- ENERGIZE YOUR BODY - These Advanced Digestive Enzyme supplements are ideal pills for individuals who lead active lifestyles or are embarking on a new weight loss and fitness journey to feel their best.
- ESSENTIAL FOR WHOLE FAMILY - Each vegetarian capsule may help improve digestive flora health against foods and liquids that upset the stomach for men and women.
- Vitamin Bounty's Pro 50 offers an potent, 50 Billion organisms per serving, making it one of the most effective probiotics on the market.
- Unlike other probiotics that only contain 1 or 2 strains of probiotic, Pro-50 has 13 probiotic strains, ensuring you will get the support you need for your overall digestive health.
- Pro-50 uses a patented delayed release capsule, that protects the live organisms in the capsule from stomach acid, delivering more cultures and ensuring maximum efficacy.
- The capsule itself is a delayed-release vegetable capsule, developed and tested in a NSF certified facility. The potency and purity is guaranteed.
- Strains Include: Saccharomyces boulardii, Lactobacillus plantarum, Lactobacillus acidophilus, Bifidobacterium lactis, Lactobacillus brevis, Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus salivarius, Lactobacillus paracasei, Lactobacillus bulgaricus, Bifidobacterium bifidum, Bifidobacterium brevis, Bifidobacterium longum
- Promotes long term digestive and immune health with continued use
- Defends against occasional gas, bloating, abdominal discomfort and diarrhea
- BC30, the probiotic in Digestive Advantage, survives stomach acid 100x better than leading probiotics and yogurts
- No artificial flavors. Guaranteed for purity, freshness and labeled potency
- Each capsule contains 1 billion viable cells of BC30 probiotic
- MORE POTENT SOURCE OF DIGESTIVE ENZYMES - If you are looking for digestive enzyme supplements that maximize the benefits, look no further! Divine Bounty offers one of the most effective and powerful plant based digestive enzyme formulas available for men or women. Our extra strength formula has a powerful 500mg of digestive enzymes in just one capsule, with high activity units to ensure maximum benefit.
- ADDED PREBIOTICS & PROBIOTICS - We have crafted our formula very carefully to create a complete and effective formula. Not only is it one of the most potent digestive enzymes formula, we have taken it a step further and also included prebiotics and probiotics, fortified with 6 essential vitamins. Our multi strain probiotics are 2 Billion total CFU, so you know you're getting high quality ingredients and the best value for money.
- HIGHEST QUALITY INGREDIENTS - Our formula is made up of only pure ingredients with no harmful additives. Powerful digestive enzymes with only the best probiotics, prebiotics and super vitamins. Don't put other nasty ingredients into your body. Our digestive enzyme capsules are GMO free, soy free, gluten free and have no preservatives, stearates, silicone dioxide or artificial ingredients. Suitable for vegetarian and vegan diets. A pure, safe formula.
- OPTIMIZE DIGESTION, RECLAIM ENERGY & ENJOY EATING - Our highly active digestive enzyme and probiotic supplement aids the body's own digestive capabilities. Each capsule provides the body with natural enzymes and flora designed to optimize your digestion of fats, oils, proteins, carbohydrates, and dairy, saving you energy in the process. Alpha-Galactosidase and Beta-Glucanase help break down vegetables, beans and grains, while Glucoamylase and Invertase aid in the digestion of sugars.
- A SUPPLEMENT YOU CAN TAKE WITH CONFIDENCE - Digestive enzymes can also be found in the form of pills, tablets, and powder. But none are as convenient as Divine Bounty capsules. Divine Bounty is proudly made in the USA in an FDA inspected facility. We stand behind our Digestive Enzyme blend and are proud to have the best formula on the market. If it doesn't work for you, let us know. We care about your results.
- 112.5 billion live lactic acid bacteria per capsule
- Highest available concentration of beneficial bacteria
Dr.Shashikanth Vydyula is founder of Pocket Reviewer. He is a vivid health enthusiast with a passion for beauty, wellness and nutrition.
Buy his Gigs.
Last update on 2018-09-19 at 05:44 / Affiliate links / Images from Amazon Product Advertising API