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.
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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.
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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 reduce gas and bloating, according to multiple studies.
Related reading: Colon Cleansing: Types, Benefits, Dangers & FAQs
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.
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Note: This is nuanced, as some probiotics can actually help treat SIBO as well, so discuss this with your provider.
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.
Remember that the effectiveness of probiotics can vary from person to person. It’s crucial to consult with a healthcare professional who can recommend the right probiotic strains and dosages based on your specific condition and needs.
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.
How do I know if IBS probiotics are working? You know if IBS probiotics are working if your IBS symptoms begin to decrease. Symptoms may fade in a few days, but randomized controlled trials suggest you should see the greatest benefit after 4 to 8 weeks of taking IBS probiotics.
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.
To maximize the probiotic benefit of fermented foods, it’s essential to incorporate them into your diet consistently. Whether as a side dish or a refreshing beverage, the regular consumption of these foods can complement probiotic supplements in managing IBS.
(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.
Examples of harmful bacteria that may cause infection from foods include Clostridium, E. coli, most Streptococcus strains, and Rhinobatos. Obviously, we don’t count these in the use of probiotics.
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.
In the human body, probiotics are vital. They are essential for both your oral microbiome and your gut microbiome (or gut microbiota). In dietary supplements, probiotics may help with various issues, including digestive health, autoimmune diseases, and even IBS.
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
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Other Treatments For IBS
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
Proactive IBS Treatment
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.
Latest Research on Probiotics and IBS
If you’re dealing with IBS, there’s some good news—recent research shows probiotics can really help with managing symptoms. Certain strains, like Lactobacillus plantarum, Bifidobacterium infantis, and Saccharomyces boulardii, have been shown to ease common issues like bloating, abdominal pain, and irregular bowel movements. Out of these, Bifidobacterium infantis stands out for its ability to balance gut bacteria and calm inflammation, which is often the root of IBS discomfort.
There’s also exciting progress with newer strains like Akkermansia muciniphila and Faecalibacterium prausnitzii. A 2022 study shows that these might help strengthen your gut lining and reduce inflammation, giving hope for tackling IBS at its core.
While probiotics aren’t a cure, using the right ones regularly could make a big difference in your daily life and help you feel a bit more in control.
Probiotics for IBS in Clinical Practice
Gastroenterologists play a big role in helping patients find relief from IBS, and probiotics are often a key part of their approach. They know that IBS symptoms can manifest differently from person to person, so their treatment plans are usually tailored to each patient.
When suggesting probiotics, gastroenterologists focus on factors such as:
- the right dosage (usually 1-10 billion CFUs per day)
- how long to take them (at least 4-8 weeks to see results)
- the correct strains that match a patient’s specific symptoms
These recommendations are backed by research and clinical guidelines to make sure they’re effective and safe. For example, a 2021 study in the Nutrients journal found that patients with diarrhea-dominant IBS noticed improvements in their quality of life after using probiotics consistently for about eight weeks.
Doctors also check in to see how patients are responding since not every probiotic works for everyone. This step-by-step, thoughtful approach combines the latest science with a deep understanding of each person’s needs, creating a plan that’s sustainable and effective over time.
Probiotics and Combination Therapies
Probiotics can work even better when combined with other therapies, creating a well-rounded approach to managing IBS. Our team of functional medicine practitioners recommends pairing probiotics with dietary changes, like trying a low-FODMAP diet.
This diet, known as the go-to for IBS management, helps reduce gut irritants while probiotics restore balance to your microbiome. In fact, research shows that using probiotics alongside a low-FODMAP diet can bring greater relief than either option alone.
Probiotics are also often combined with other gut-friendly strategies, like adding more fiber for better regularity or practicing stress-reducing activities like yoga or mindfulness. Since stress is a major IBS trigger, probiotics that target the gut-brain connection can make a real difference. Together, these approaches tackle both the physical and emotional challenges of IBS, giving you a more balanced path to feeling better.
New Probiotic Supplements for IBS in 2024
If you’re looking for ways to manage IBS, 2024 has introduced some amazing advancements in probiotic supplements. These options are thoughtfully designed to help with the unique challenges IBS brings.
Here are the top 5 probiotics making a big impact right now, chosen for their effectiveness, strain mix, and CFU count:
Daily Probiotic 30C – A Boost for Gut Health and Immunity
Daily Probiotic 30C supports gut health and immunity with 100 billion CFU† per capsule, combining four carefully selected, research-backed probiotic strains like Bifidobacterium lactis HN019®. Vegetarian, gluten-free, and dairy-free, it uses DRcaps™ and nitrogen-sealed blister packs to protect potency and ensure delivery to the small intestine.
Benefits include:
- improved digestion
- immune support
- better bowel regularity
- and assistance with lactose digestion.
Mega Probiotic ND 120 Capsules
Mega Probiotic™ ND is a dairy-free probiotic blend containing 9 unique strains of good bacteria and prebiotic fiber to support digestion and regularity. Formulated with FOS, this natural supplement is crafted to promote optimal digestive health and a balanced gut.
SYMBIOFLOR® Irritable Bowel
Packed with bacterial concentrate with Escherichia coli bacteria (DSM 17252), SYMBIOFLOR® Irritable Bowel has shown promising results in clinical trials, reducing bloating and abdominal pain. With a hefty 1.5-4.5 x 10 billion CFU count in each dose, it’s ideal for tackling moderate to severe IBS symptoms head-on.
VSL4™ Gut Capsules
VSL4™ Gut Capsules are a mix of probiotic strains that help rebuild gut flora, decreasing inflammation and supporting a strong gut lining. Each capsule contains 30 billion CFUs per serving, making it the most potent probiotic on this list.
Culturelle® Digestive Daily Probiotic Capsules
With the clinically studied probiotic strain Lactobacillus rhamnosus GG, Culturelle® Digestive Daily Probiotic Capsules are great for easing occasional digestive issues like gas, bloating, and diarrhea. These probiotics work naturally with your body to support better digestion and boost your immune system.
Long-Term Efficacy of Probiotics in IBS: What the Data Shows
Research into probiotics and their long-term effects on managing IBS symptoms is showing some really encouraging results. Studies have followed patients for years to see how probiotics impact gut health over time.
For example, a 2021 meta-analysis found that regular probiotic use significantly reduced abdominal pain and bloating in IBS patients, with benefits lasting up to a year after treatment. These findings suggest that probiotics can be key in supporting gut health by reducing inflammation and strengthening the gut barrier, offering long-term relief from IBS symptoms.
That said, everyone’s body is different, and factors like diet, lifestyle, and specific probiotic strains can influence how well they work for you. It’s all about finding what works best for your unique needs.
The Role of Maintenance Therapy in IBS
Managing IBS symptoms long-term often comes down to consistency, and that’s where maintenance therapy steps in. While probiotics can work wonders for short-term relief, sticking with a lower, ongoing dose may help keep symptoms from creeping back. A study shows that patients with ulcerative colitis on maintenance therapy saw a significant reduction in flare-ups and improved gut health. By adding probiotics to your daily routine, you can maintain that balance and feel better long-term.
So, what’s the secret? Maintenance therapy helps keep your gut bacteria in balance, which is key to preventing IBS flare-ups. And no, this doesn’t mean you’re stuck taking probiotics forever. It’s more about finding the right rhythm and pairing probiotics with a healthy gut routine—like eating enough fiber and managing stress. Over time, this balanced approach can even reduce your reliance on supplements.
Probiotics and IBS in Special Populations
For pregnant women and kids, probiotics can help with IBS symptoms too. Here’s what you need to know:
Probiotics for IBS in Pregnant Women
Pregnancy brings a lot of changes, both physically and emotionally, and for some moms-to-be, dealing with IBS can make things even trickier. The good news? Probiotics might help manage IBS symptoms safely during pregnancy. Probiotics have been shown to ease common pregnancy-related issues such as nausea, vomiting, and constipation.
Research shows that probiotics can be a big help for pregnant women, not just during pregnancy but also postpartum. They’ve been linked to weight management, reducing the risk of gestational diabetes, keeping insulin levels steady, and even lowering the chances of preeclampsia.
While this makes probiotics a promising option for managing IBS and supporting gut health during pregnancy, it’s always important to check with a healthcare provider first. Every pregnancy is different, and what works for one person might not be the best fit for another. With the right guidance, probiotics can be part of a larger plan to keep IBS in check and help moms-to-be feel a bit more comfortable.
Children with IBS: A Unique Approach to Probiotic Therapy
Helping kids manage IBS can be tough. Their growing bodies and sensitive digestive tract need a gentler, more personalized approach—and that’s where probiotics can help. Research shows that probiotics can ease symptoms like tummy pain, irregular bowel movements, and general gut discomfort in children with IBS.
That said, it’s important to work with a pediatrician or gastroenterologist when trying probiotics. Strain selection, dosage, and how long they’re used should all be tailored to your child’s specific needs. Probiotics also tend to work best when combined with other strategies, like dietary changes, stress management, and supportive therapies.
Final Thoughts
Managing irritable bowel syndrome symptoms can be a long and challenging journey, but probiotics can definitely help ease the burden. From research-backed evidence to real-life success stories, there’s plenty of promise surrounding these tiny gut helpers. As always, it’s important to work with a functional medical doctor to find the best approach for you and your unique needs.
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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