Probiotics and IBS
If you are going to try any sort of supplement, always discuss with your doctor and nutrition professional first. This post is for general information purposes only, is not meant to diagnose or treat, and is in no way a replacement for consulting a medical professional.
What are probiotics?
Our gut is home to millions and millions of bacteria – in fact the number of bacteria in your gut is higher than the number of cells in the human body! The total weight of them can even come to 1.5kg / 4lbs. It’s generally agreed that there are about 500-1000 different types of bacteria in our gut, and for a healthy individual we have a harmonious relationship with these guys.
These bacteria are vital to our health; they help maintain the health of the cells in the gut lining, they support our immune function in the gastrointestinal tract (which is where the bulk of our immune system is located!), they aid in the digestion and absorption of key nutrients, and they even produce some nutrients that our body cannot produce itself – making these available for us.
Probiotics are essentially supplements of specific types of the “good guy” bacteria. The idea is that in taking them, you may be boosting the population of the good bacteria, which would help if your body’s balance of bacteria in the gut is off.
You can also find natural sources of probiotics in certain foods, namely fermented foods, like yogurt, kombucha, kefir, sauerkraut, kimchi, miso, and other pickled vegetables.
When it comes to supplementation specifically, most research has centered on two main families of bacteria: lactobacillus and Bifidobacterium. However, the specific strains/sub-strains of bacteria are going to vary from product to product. Some supplements will just be one specific strain, some may be a mix, and the overall quantity of bacteria can also vary.
Should I be supplementing with probiotics for IBS?
One theory is that symptoms of IBS such as gas, may develop due to an imbalance of “good vs. bad” bacteria in the gut. However, actual clinical results have been mixed and largely inconclusive as to whether probiotics are effective in reducing IBS symptoms.
When it comes to our gut microbiome, in general the composition of it is fairly similar between healthy individuals. But when it comes to an unbalanced microbiome, every person’s tends to be unique. Therefore, it’s difficult to judge whether or not a probiotic will be effective.
Since the bacteria in the probiotic are meant to be alive, it’s also difficult to say how many – if any – actually make it through the digestive system and to the large intestine still alive. And a small study done on off-the-shelf probiotic supplements found that 50% of those tested were actually already dead even before use! Since there’s very little regulation in the industry, whether you’re getting what you paid for can be questionable.
The American Gastroenterological Association has recently come out with revised recommendations stating that there is insufficient evidence to recommend probiotics for IBS.
However, a low-FODMAP diet for as little as 4 weeks has been seen to already impact the balance of bacteria in the gut in a negative direction. But research done at King’s College in the UK has shown that taking a probiotic may help rebalance the gut microbiome after following a low-FODMAP diet.
Overall, if you’re going to try supplementing with a probiotic, keep your expectations realistic and only expect a mild improvement, if any.
Considerations for supplementing with probiotics for IBS
Start with the natural sources in fermented foods! Ease into it over time, as going for a too-large portion size right away could cause digestive distress. Keep in mind that some probiotic-rich foods could be high in FODMAPs.
If you try a supplement, you can also ease into in it by starting with lower amounts. Research suggests that it is more beneficial to focus on one specific strain of bacteria at first, rather than choosing one with many different types.
Give yourself at least a month (one full female hormone cycle) to judge whether or not they are making a difference. They should be taken just before or during a meal (of course always follow the label’s instructions).
If you don’t see an improvement – stop taking them! You don’t want to be wasting your money. You could also try switching to a different strain of bacteria.
As always, consult your doctor before taking any sort of supplement! If you have a known immune deficiency, have cancer or are undergoing cancer treatment, or have short gut syndrome, you shouldn’t be taking probiotics.
There is no research on long-term probiotic use, so taking them for a longer period isn’t recommended.
There is no magical pill that replaces doing the work – and this includes probiotics!
Any supplementation should generally be a second line of support after working with a professional on establishing a healthy, balanced diet and making positive lifestyle changes to address your specific IBS symptom triggers. Always discuss diet and lifestyle changes, as well as supplementation, with your doctor prior to starting.
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Lacy, Brian E.. Making Sense of IBS (A Johns Hopkins Press Health Book) . JHUP. Kindle Edition.