If you suffer from Irritable bowel syndrome (IBS), you’re not alone. It’s estimated that 3-25% of the general population has IBS. That’s between 10 to 80 million people in the U.S. alone! Most people don’t seek medical attention since only a small number of people have severe symptoms. The symptoms include abdominal pain, cramping, bloating, gas, diarrhea and constipation. Some people control their symptoms by managing stress, diet and lifestyle while others seek treatment.
Scientists don’t know what causes IBS but it’s likely that a number of factors play a role. The cramping pain is caused by abnormal contractions in the muscles surrounding the intestine. The enteric nervous system also plays a role (if you’re interested in learning more about the enteric nervous system (ENS) and how the gut microbiotia interacts with the ENS, check out my previous blog called Moods, Microbes and Digestion).
There is currently no cure and conventional therapy is aimed at reducing symptoms. Dietary changes may be helpful for some people and include eliminating food that cause gas, eliminating gluten, and elimination of certain types of carbohydrates such as fructose, lactose and others (i.e., so-called FODMAPs). Medications include fiber supplements, anti-diarrheal medications, antidepressants (i.e., since some patients suffer from depression), medicines that reduce painful bowel spasms, and others. Your healthcare provider should be able to assess your needs and design a treatment plan.
For more information on the diagnosis and management of IBS, checkout the article by Agrawal, et. al.
Some experts believe that probiotics may provide an attractive and safe alternative to assist in the treatment of IBS.
The use of probiotics for the treatment of IBS has been extensively studied. One meta-analysis (a meta-analysis is a systematic review of many selected studies in order to develop a single conclusion that has greater statistical power) involving 43 randomized controlled trials showed that probiotics had beneficial but modest effects on IBS symptoms including abdominal pain, bloating and gas. The authors conclude that “probiotics are effective treatments for IBS, although which individual species and strains are the most beneficial remains unclear.”
Meta-analysis performed by Hoveyda, et. al., McFarland, et. al., and Kikfer, et. al., come to similar conclusions that probiotics may alleviate some IBS symptoms but that we should be cautious because of insufficient data.
Probiotics are known to be safe. Since we do not have a probiotic supplement that works in all cases of IBS to alleviate all symptoms, the question is, if probiotics are effective, which species and strains (and combination of species/strains) work best for you? Currently there is no test or diagnostic that can pinpoint the perfect probiotic formulation for your individual needs. Consequently, if you have IBS and you are interested in probiotics, talk to your healthcare provider. They should have an opinion on which product to try. You may have to test-drive several formulas until you settle on one that works best.
In the meantime, I recommend that you skim through the reviews that I provide above and check out the table below. The table provides a short list of some of the species and strains that have received the most attention in clinical studies. A word of caution; some of the clinical studies listed in the table did not show a clinical benefit and so I suggest that you refer to the individual studies in the reference section for more details. The links will bring you to a summary page; simply skim down to the conclusions to learn the outcomes of the study.
It’s important to be knowledgeable about the supplements and medications that you take. After all, it’s your health and what you put into your body can make all the difference in the world.
If you find this information to be helpful, drop me a note in the comments section below and give me a thumbs up.
|Top 10 Studied Probiotics for Irritable Bowel Disease|
|Probiotic Strain||References||Dose Per Day||Duration||Strains|
|Lactobacillus acidophilus||1, 2, 3, 4, 5, 6, 7, 8||4 - 10 billion||1 - 6 months||NA, La5, LA-102, SDC 2012, 2013|
|Lactobacillus paracasei||1, 4, 5, 6, 8||20 - 90 billion||1 - 6 months||NA, F19|
|Bifidobacterium lactis||1, 3, 6, 8, 9||10 million - 26 billion||2 - 6 months||NA, Bb12|
|Bifidobacterium infantis||4, 5, 10||100 million - 900 billion||1 - 2 months||NA, 35624|
|Bifidobacterium longum||2, 4, 5||10 - 900 billion||1 - 2 months||NA, LA-101|
|Lactobacillus plantarum||4, 5, 11||10 - 900 billion||1 - 2 months||NA, 299v DSM 9843|
|Streptococcus thermophilus||2, 5, 4||10 - 900 billion||1 - 2 months||NA, LA-104|
|Bifidobacterium bifidum||3, 12||1 - 20 billion||1 - 2 months||NA, MIMBb75|
|Lactobacillus rhamnosus||9||10 million / day||5 months||GG, Lc705|
|Bifidobacterium breve||4, 5||450 - 900 billion||1 - 2 months||NA|
About the author:
Douglas Toal, Ph.D. is a medical microbiologist with extensive knowledge and expertise in clinical and environmental microbiology with additional training in biochemistry, metabolism and anti-aging medicine. Dr. Toal is founder of Liberty Bion, Inc. You can connect with Dr. Toal on his blog or on Twitter @DrDougToal.
Douglas Toal, PhD is a medical microbiologist with extensive knowledge and expertise in clinical and environmental microbiology with additional training in biochemistry, metabolism and anti-aging medicine. He is board-certified in Medical & Public Health Microbiology and has performed extensive research in the cell-to-cell signaling strategies that bacteria use to communicate. His current interests include validating innovative diagnostic methods for the identification of clinical disease. He frequently blogs about the application of probiotics in human health, recent discoveries in gut microbiota function and trends in anti-aging medicine and wellness.