Probiotics are live microorganisms in your digestive tract, such as bacteria and yeasts.
They are often referred to as “good” or “helpful” bacteria because they function to maintain the natural balance of organisms in your intestines. Probiotics are found in certain foods and supplements.
For people with irritable bowel syndrome (IBS), probiotics may help improve symptoms like abdominal pain, bloating, gas, constipation, or diarrhea by altering the gut microbiome and reducing inflammation.
Several studies have found certain probiotics may ease IBS symptoms. A review of 19 randomized controlled trials found that in general, probiotic use was associated with improvement in pain/discomfort, bloating/distention, and bowel movement frequency in people with IBS. The most beneficial probiotic strains were Bifidobacterium breve, Bifidobacterium longum, Lactobacillus casei, Lactobacillus plantarum, and Saccharomyces boulardii.
Probiotics are thought to help IBS through several mechanisms:
Rebalance the gut bacteria. IBS may involve changes in the gut microbiota with higher numbers of pathogenic bacteria and lower amounts of beneficial bacteria. Probiotics may help shift the bacterial composition towards a healthier balance.
- They have anti-inflammatory effects. Probiotics may help decrease inflammation in the gut, which is linked to IBS symptoms. Less inflammation may lead to less pain, cramping, and gut hypersensitivity.
Improve gut barrier integrity. Probiotics can enhance the gut barrier and decrease intestinal permeability. A stronger gut barrier may prevent certain substances from entering the bloodstream, triggering an immune response leading to inflammation and IBS symptoms.
Influence gut-brain interactions. The gut and brain communicate closely through neural, hormonal, and bacterial mechanisms. Probiotics may help regulate signaling between the gut and brain to reduce transmission of pain impulses and ease anxiety or distress that can worsen IBS.
Soften stool and regulate bowel movements. For some with IBS-C, probiotics may help speed up GI transit time and induce more frequent, complete bowel movements. For those with IBS-D, probiotics may help solidify stool consistency and reduce the number of unformed stools. The effects will depend on the types and doses of probiotics used.
Probiotic supplements come in capsule, tablet, powder and liquid forms. The number of colony-forming units (CFUs) indicates the number of live microorganisms in a product. For IBS, aim for a product with at least 10 to 15 billion CFUs per serving of a mixture of strains. It may take 4 to 8 weeks of use to experience the benefits. Probiotics can be combined with prebiotics, such as inulin or fructooligosaccharide, which provide food for good bacteria.
Always check with your doctor before using probiotics to determine proper dosing and to ensure there are no contraindications with any medications you are on. Probiotics may not be suitable or effective for all people with IBS. They appear most useful when combined with diet, lifestyle changes, and conventional treatments. For many with IBS though, probiotics and other approaches offer a safe, natural way to improve daily functioning and quality of life significantly.
- Are there any risks to taking probiotics? For most adults, probiotics are considered safe with no serious side effects. However, some people may experience increased gas, bloating, cramps or diarrhea after starting probiotics. rarely, probiotics could contribute to infection or other adverse effects in people with compromised immune systems. It is best to check with your doctor before using probiotics.
- Do I need to take probiotics every day? For the best results, it is recommended to take probiotics daily and consistently. Do not stop and start. It takes time for the probiotics to establish themselves and make changes to the gut microbiota. Missings doses or stopping use will disrupt this process and reduce benefits. For maintenance, you may be able to lower the dose, but daily consumption is ideal.
- How long does it take for probiotics to start working? It can take weeks or months of continuous use to experience the full effects of probiotics. Some people notice better digestive health or improved IBS symptoms within a few weeks. For others, it may take 6 to 8 weeks for significant improvements to be felt. Much depends on the strains and potency used as well as the severity of your symptoms. Patience is key, and the longer you use probiotics, the better the results over time.
- Can I take probiotics with my IBS medications? In most cases, it is fine to take probiotics with IBS medications as directed by your doctor. However, some antibiotics could interact with probiotics. Always follow instructions from your physician and check for any contraindications listed for your prescriptions. As a general rule, take probiotics at least 2 hours apart from antibiotics and other medications. Never stop or change prescription medications without consulting your doctor first.
- Do I need to take probiotics with food? It is recommended you take probiotics with food, especially a meal containing fats or oils. Taking probiotics with food helps ensure the bacteria survive the harsh, acidic environment of the stomach so they can reach your intestines. If stomach upset occurs, taking with food may help minimize discomfort. However, capsule form probiotics may be enteric coated so can be taken without food. Check directions for your specific product.
In summary, probiotics show significant potential for helping to manage IBS symptoms like pain, bloating, and abnormal bowel habits. The types and amounts of probiotics needed will differ for each individual. Patience and experimentation may be required to find the right probiotic for your needs. Always talk to your doctor before starting probiotics or making changes to your IBS treatment plan. Used properly under guidance, probiotics are a promising way to approach IBS naturally and holistically.