Probiotics can effectively treat the symptoms of irritable bowel syndrome (IBS) unless you also suffer from small intestine bacterial overgrowth (SIBO). If you have SIBO, probiotics may worsen your digestive discomfort.
If you test negative for SIBO, probiotics are an excellent treatment option for IBS. Probiotics (or “good bacteria”) repopulate the colonies of beneficial bacteria in your lower digestive system and lead to a healthier microbiome.
Which probiotics should I take for IBS? Lactobacillus and Bifidobacterium are the best probiotic strains to take for IBS. Look for a probiotic brand made in the United States if possible, as the regulations are more stringent.
Read on to find out how probiotics can help treat IBS, what health benefits probiotics possess, and when not to take probiotics.
Done letting your gut issues rule your life? Join PrimeHealth’s Gut Health Group Visits and find lasting relief with a community of others who understand.
Sign up today — only a few spots remain for the next group beginning on Sept 20!
Irritable Bowel Syndrome (IBS)
IBS is a set of gastrointestinal symptoms that can be triggered by a variety of unrelated root causes. Up to 21% of Americans have IBS, which is twice as common in women as in men.
This condition may be diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), or mixed between the two (IBS-M). A fourth subtype, IBS-U, describes when your IBS symptoms do not fit into any of the other subtypes.
Common symptoms of IBS include:
- Abdominal pain
- Loose stool
- Undesired weight loss
- Urgency to go to the restroom
- Rectal bleeding
- Constipation or diarrhea
Many conventional healthcare professionals call IBS “incurable,” even though there are plenty of treatments. They call it this because there are multiple possible root causes for the same set of symptoms — and conventional medicine often struggles to address these underlying issues.
Unfortunately, many of these conventional “treatments” merely mask symptoms, while not treating the root cause.
Integrative doctors, however, accept that multiple separate underlying causes can trigger the same set of symptoms. We diagnose your individual cause then treat it to cure your IBS.
Should IBS sufferers take probiotics? Yes, IBS sufferers should take probiotics in most cases. The exception is if they also suffer from SIBO, a common IBS trigger. Probiotics can worsen bacterial overgrowth in SIBO patients.Otherwise, probiotics are a beneficial option for IBS sufferers.
However, this is rather nuanced, as some probiotics can actually help treat SIBO as well, so discuss this with your provider.
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 usually refers to a dietary supplement containing probiotics, or a probiotic-containing food like kombucha or kimchi.
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. It’s more helpful to mention specific strains by name, but it is admittedly harder to understand.
Here are the most common strains of probiotics found in foods and dietary supplements:
- Lactobacillus acidophilus
- Lactobacillus plantarum
- Lactobacillus rhamnosus
- Lactobacillus casei
- Bifidobacterium lactis
- Bifidobacterium bifidum
- Bifidobacterium infantis
- Bifidobacterium animalis
- Some specific Streptococcus strains
Examples of harmful bacteria include Clostridium, E. coli, most Streptococcus strains, and Rhinobatos.
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). Like taking a probiotic supplement, if you suffer from SIBO, supplemental fiber will also likely make you feel worse until the condition is treated.
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 of the most common ones:
- Abdominal distress
- Allergy flare-ups
Can probiotics make IBS worse? Probiotics can make IBS worse if your IBS is triggered by 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.
5 Benefits Of Probiotics For IBS
Check out these beneficial effects of probiotics for IBS, complete with links to clinical trials and recent studies.
What are the benefits of taking probiotics? The benefits of taking probiotics may include:
- Fighting inflammation
- Slowing the growth of harmful bacteria
- Boosting your immune system
- Controlling bowel movement speed
- Decreasing gas production
This 2021 study says, “Studies on animals and humans show that probiotics can have a pivotal effect on the modulation of immune and inflammatory mechanisms.”
One study found that the use of probiotics led to a significant improvement in symptoms of irritable bowel syndrome, largely due to their ability to reduce inflammation. Probiotics normalized the ratio of anti-inflammatory and pro-inflammatory cytokines.
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.
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 gut and 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.
Also, an older animal study showed that probiotics prevented the invasion of Salmonella bacteria by strengthening barrier function in the gut.
Controlling bowel movement speed
Probiotics may regulate bowel movement speed for patients with IBS, particularly if bloating is a dominant symptom.
A large number of animal studies have shown probiotics affect bowel motility.
Controlling bowel movement speed is vital for IBS-D sufferers.
Decreasing gas production
When you increase beneficial bacteria in your large intestine, such as Lactobacillus and Bifidobacterium strains, gas production is decreased.
Probiotics reduce gas and bloating, according to multiple studies.
Choosing IBS Probiotics
Lactobacillus and Bifidobacterium strains are the most common probiotics in dietary supplements and probiotic foods. They’re often included in supplements because they are the most beneficial bacteria, according to the sum of our current scientific knowledge.
Science is moving toward referring to each individual probiotic strain — because different strains can have a different effect on the body — instead of using the overly general term “probiotics.” However, we are not there yet.
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.
Patients With SIBO
If you have SIBO (small intestine bacterial overgrowth), do not take probiotics for IBS. 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.
If you take a probiotic supplement when you have SIBO, many of the good bacteria within the supplement get trapped in your small intestine, likely worsening your SIBO symptoms.
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.
Other Treatments For IBS
Probiotics are far from the only treatment that’s effective for IBS symptoms. 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
Proactive IBS treatment is better than reactive treatment. If you have IBS now, you’re statistically more likely to experience it again. Yes, 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 in the short term and for good. We discuss, diagnose, and treat according to an individualized plan that you and your PrimeHealth doctor organize ahead of time.
Stop Googling and finally get to the root of your gut issues.
Our gut health group visits begin Sept 20, 2022. Don’t miss out — sign up today!
Medically Reviewed September 30, 2021
- McKenzie, Y. A., Bowyer, R. K., Leach, H., Gulia, P., Horobin, J., O’Sullivan, N. A., … & (IBS Dietetic Guideline Review Group on behalf of Gastroenterology Specialist Group of the British Dietetic Association). (2016). British Dietetic Association systematic review and evidence‐based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update). Journal of Human Nutrition and Dietetics, 29(5), 549-575.
- Patel, N., & Shackelford, K. S. (2018). Irritable Bowel Syndrome.
- Shreiner, A. B., Kao, J. Y., & Young, V. B. (2015). The gut microbiome in health and in disease. Current opinion in gastroenterology, 31(1), 69.
- Chen, X., D’Souza, R., & Hong, S. T. (2013). The role of gut microbiota in the gut-brain axis: current challenges and perspectives. Protein & cell, 4(6), 403-414. Abstract: https://pubmed.ncbi.nlm.nih.gov/23686721/
- Williams, N. T. (2010). Probiotics. American Journal of Health-System Pharmacy, 67(6), 449-458.
- Ortolani, C., & Pastorello, E. A. (2006). Food allergies and food intolerances. Best Practice & Research Clinical Gastroenterology, 20(3), 467-483.
- Cristofori, F., Dargenio, V. N., Dargenio, C., Miniello, V. L., Barone, M., & Francavilla, R. (2021). Anti-inflammatory and immunomodulatory effects of probiotics in gut inflammation: a door to the body. Frontiers in Immunology, 12, 178.
- O’Mahony, L., McCarthy, J., Kelly, P., Hurley, G., Luo, F., Chen, K., … & Quigley, E. M. (2005). Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology, 128(3), 541-551.
- Dai, C., Zheng, C. Q., Jiang, M., Ma, X. Y., & Jiang, L. J. (2013). Probiotics and irritable bowel syndrome. World Journal of Gastroenterology: WJG, 19(36), 5973.
- Ahrne, S., Nobaek, S., Jeppsson, B., Adlerberth, I., Wold, A. E., & Molin, G. (1998). The normal Lactobacillus flora of healthy human rectal and oral mucosa. Journal of applied microbiology, 85(1), 88-94.
- Krishna Rao, R., & Samak, G. (2013). Protection and restitution of gut barrier by probiotics: nutritional and clinical implications. Current Nutrition & Food Science, 9(2), 99-107.
- Madsen, K., Cornish, A., Soper, P., McKaigney, C., Jijon, H., Yachimec, C., … & De Simone, C. (2001). Probiotic bacteria enhance murine and human intestinal epithelial barrier function. Gastroenterology, 121(3), 580-591.
- Dimidi, E., Christodoulides, S., Scott, S. M., & Whelan, K. (2017). Mechanisms of action of probiotics and the gastrointestinal microbiota on gut motility and constipation. Advances in nutrition, 8(3), 484-494.
- Didari, T., Mozaffari, S., Nikfar, S., & Abdollahi, M. (2015). Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World journal of gastroenterology: WJG, 21(10), 3072.
- Choi, C. H., Jo, S. Y., Park, H. J., Chang, S. K., Byeon, J. S., & Myung, S. J. (2011). A randomized, double-blind, placebo-controlled multicenter trial of Saccharomyces boulardii in irritable bowel syndrome: effect on quality of life. Journal of clinical gastroenterology, 45(8), 679-683.
- Dale, H. F., Rasmussen, S. H., Asiller, Ö. Ö., & Lied, G. A. (2019). Probiotics in irritable bowel syndrome: an up-to-date systematic review. Nutrients, 11(9), 2048.
- Reding, K. W., Cain, K. C., Jarrett, M. E., Eugenio, M. D., & Heitkemper, M. M. (2013). Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome. The American journal of gastroenterology, 108(2), 270.
- Jadallah, K. A., Nimri, L. F., & Ghanem, R. A. (2017). Protozoan parasites in irritable bowel syndrome: a case-control study. World journal of gastrointestinal pharmacology and therapeutics, 8(4), 201.
- Bonaz, B., Bazin, T., & Pellissier, S. (2018). The vagus nerve at the interface of the microbiota-gut-brain axis. Frontiers in neuroscience, 12, 49.
- Chen, C., Gong, X., Yang, X., Shang, X., Du, Q., Liao, Q., … & Xu, J. (2019). The roles of estrogen and estrogen receptors in gastrointestinal disease. Oncology letters, 18(6), 5673-5680.