Even the NHS recommends probiotics for IBS - they are fine to take alongside most prescription and over the counter medications for IBS, and are a safe, natural option to try.

However, if you think you have IBS, you should always have your symptoms diagnosed by a doctor first. But how do probiotics help IBS? Probiotics may help IBS because the condition has been associated with an imbalance in the gut microbiome 5, the name for the populations of live bacteria that live in the gut.

Read more about the gut microbiome in this article: All About the Microbiome. Recent research seems to confirm this, indicating a link between IBS-D symptoms and a harmful bacteria called Brachyspira IBS sufferers often have lower levels of good bacteria e.

Bifidobacterium species, and increased levels of bad bacteria, known as pathogens, with some of the best-known being from the Clostridium species.

Supplementing with a high-quality probiotic may help to reduce IBS symptoms in the following ways:. Read more about the gut-brain connection in this article: The Gut-Brain Axis. When choosing a probiotic supplement for IBS , it is important to select one which is supported by good quality research.

Clinical trials show how the probiotic performs in real people, for typical symptoms of IBS, such as constipation, bloating, or diarrhoea. Different probiotic strains can be beneficial for different symptoms of IBS, as each strain can have unique propertie s. Read on to find out more about these strains, or if you're short on time, why not watch the video below watch my short IBS information video.

I give a brief overview of the best strains to use for the most common types of IBS. Probiotics are natural and well tolerated by the majority of people who take them.

Those who have an extreme imbalance of good and bad bacteria in their gut, also known as dysbiosis , may notice some changes in their digestive system when they first start to take a probiotic supplement.

These side effects should subside within 48 hours in most people while the gut microbiome readjusts, but may last a little longer if the gut is severely imbalanced. If you can, it is worth persevering, either by lowering the dose or coming off for a few days before reintroducing them, once the gut has readjusted the pre and probiotics can start to exert their full benefits.

Probiotic supplements which contain prebiotics may also cause an increase in gas and bloating, especially in those who are sensitive to certain carbohydrates. For those who are on a low FODMAP diet, prebiotic or synbiotic supplementation is generally avoided at this time.

Read more about FODMAPs and prebiotics in What are Prebiotics? Healthcare professionals may wish to read more about this over on our Probiotic Professionals site: Probiotics and Side Effects - an in-depth review.

If your doctor diagnoses you with IBS and your primary symptom is diarrhea, then you have IBS-D. Saccharomyces boulardii is one of the best probiotics for IBS-D symptoms. This unique probiotic is in fact a yeast, the only yeast 'friendly' enough to be called a probiotic. boulardii has over 50 years of research supporting its use, and is recommended in many hospitals worldwide for diarrhoea.

You can find this strain in Optibac Probiotics S. A review of 42 clinical trials confirmed S. boulardii as one of the best probiotic strains for IBS diarrhoea The review showed that S.

boulardii offered significant improvements in abdominal pain and frequency of bowel movements for individuals with IBS-D. As well as IBS-D, S. Healthcare practitioners can read more about probiotics for IBD on the Probiotic Professionals site.

boulardii is a friendly yeast, it has very different properties to friendly bacteria: it's a 'transient' probiotic which means it does not colonise for long in the gut. boulardii as they work together. For this, use one of the probiotic strain recommendations in the IBS-A section.

The probiotic strains Pediococcus acidilactici CECT , Lactobacillus plantarum CECT and Lactobacillus plantarum CECT have also been researched and shown to be good probiotics for IBS-D This trial measured improvements in the quality of life of the participants, in relation to their IBS diarrhoea symptoms, which is thought to be one of the most accurate ways of measuring the effectiveness of the treatment.

However, Saccharomyces boulardii is the primary probiotic recommendation for IBS-D. Healthcare practitioners can read more about S. boulardii and using probiotics for diarrhoea and upset stomachs on the Probiotics Professionals site.

If you have IBS which presents with regularity issues and constipation, this is known as IBS-C. There are a couple of strains which have been particularly researched for constipation: Bifidobacterium lactis BB ® and Bifidobacterium lactis HN Bifidobacteria like to live in the large intestine where the stool is formed, so they tend to be the most researched probiotic for regularity issues.

Bifidobacterium lactis BB ® , is thought to be the most well-researched strain in the whole Bifidobacteria family, and has been particularly researched in those with constipation 3,4. It promotes more regular bowel movements, which are easier to pass, as well as supporting gut health in general.

In one clinical trial, over women with a tendency towards constipation were given a supplement containing Bifidobacterium lactis BB ® and prebiotics Intestinal transit time the time it takes for food to move through the gut decreased significantly.

Those who took the B. lactis BB ® supplement were no longer constipated and had normal bowel movements compared to those who took the placebo. The above illustrated clinical trial used Bifidobacterium lactis BB ® in combination with a prebiotic; however, prebiotics don't suit everyone who suffers from IBS.

Read more about prebiotics and IBS below. The probiotic strain Bifidobacterium lactis HN has been researched for all symptoms of IBS, and more specifically to improve intestinal transit time IBS-C sufferers who prefer to avoid prebiotics may get on better with a supplement containing Bifidobacterium lactis HN without added prebiotics.

Healthcare professionals can learn more about Bifidobacterium lactis HN on the Probiotics Database. Healthcare professionals can learn more about using probiotics for constipation on the Probiotic Professionals site, and read the rest of the research involving Bifidobacterium lactis BB ® and Bifidobacterium lactis HN on the Probiotics Database.

Many people with this type of the condition find they have alternating symptoms of IBS diarrhoea, bloating, pain, and constipation. This form of IBS is known as IBS-A alternating or IBS-M mixed symptoms.

For the relief of this IBS variant, it can be hard to know which symptom to target, but the best first step is to try a high-quality, general, daily probiotic for all-round gut-support, as imbalanced gut flora is thought to be a factor in IBS 5.

Two strains, Lactobacillus acidophilus NCFM ® and Bifidobacterium lactis Bi ® which can be found in Optibac Probiotics Every Day EXTRA have been specifically trialled in those with IBS and found to not only regulate bowel movements 29 but also for the relief of IBS bloating, abdominal distension, and abdominal cramps Even on its own Lactobacillus acidophilus NCFM ® has been shown to be effective in improving various symptoms of patients with IBS 5,6.

Healthcare professionals can read more about Lactobacillus acidophilus NCFM ® and Bifidobacterium lactis Bi ® on the Probiotics Database. Lactobacillus acidophilus NCFM ® and Bifidobacterium lactis Bi ® are the most recommended strains for all-round IBS support, but there a few other probiotic strains which can be considered:.

The probiotic strain Bacillus coagulans Unique IS-2 , is often used in 'gummy' probiotic supplements so is popular with people who find this format easier to take. It can be found in Optibac Probiotics Adult Gummies , and has been researched for the support of IBS symptoms in both adults and children.

acidophilus CUL60 L. acidophilus CUL21 B. bifidum CUL20 B. acidophilus CUL60, L. acidophilus CUL21, B. bifidum CUL20, B. Level II. Strain Specific Probiotic Products Indicated for IBS in Children BioGaia® ProTectis® Drops with Vitamin D.

BioGaia® chew tabs L. reuteri DSM rhamnosus GG. acidophilus SD L. casei SD L. bulgaricus SD L. plantarum SD B longum SD B. infantis SD B. breve SD S. Description of Level of Evidence.

Evidence from well-designed cohort or case-control analytic studies, preferably from more than one center or research group. Evidence from multiple time series with or without the intervention.

Dramatic results in uncontrolled trials might also be regarded as this type of evidence Level III Opinions of respected authorities, based on clinical experience, descriptive studies or reports of expert committees. The National Institute for Health and Clinical Excellence in the United Kingdom recommends taking the probiotics at the dose recommended by the manufactures for at least 4 weeks to evaluate for effect In a meta-analysis conducted in summarizing 21 published studies indicated that probiotics use could improve overall IBS symptoms and quality of life for patients compared to placebo Studies examining probiotic dosage show that there is no difference in patient response to high dose more than 10 billion and lower dose billion treatments.

The studies which had a shorter treatment period of 8 weeks or less showed greater efficacy for symptom reduction, however this may be due to drop or non-compliance with treatment in longer therapy regimes.

IBS is a chronic condition and long-term treatment is likely necessary There has been a rise of multi-strain combination products in recent years. The theory is that multi-species probiotics may produce a more beneficial effects because each species has a distinct action on the gastrointestinal tract or have synergistic effects However, Zhang et al found that single strain probiotics appear to be more effective in overall symptom response but not quality of life improvement.

The advantages of multi or mono-species probiotics for IBS is still inconclusive. Current data suggest that probiotic supplementation is an effective and safe therapy for IBS in patients with an intact immune system.

Single species probiotics at a lower dose with a shorter duration of treatment less than 8 weeks appear to be more effective in improving overall symptom response and quality of life for the general study population There are no studies currently that compare the safety and efficacy of different probiotics to each other, so there is no evidence-based information as to which probiotic is superior in the treatment of IBS.

Probiotic choice within the IBS treatment indication may be based on the clinical expertise of individual health practitioners and patient preference. Irritable Bowel Syndrome IBS and Probiotics What is IBS?

There are several subtypes of IBS depending on the dominant symptoms. IBS — C: predominately constipation IBS — D: predominately diarrhea IBS — M: mixed stool pattern IBD — U: unclassified IBS is not associated with decreased lifespan but can cause significant burden for patients in terms of lost productivity, pain, reduced quality of life, medical cost and impact on caregivers.

What Causes IBS? Pathophysiology In a healthy intestinal tract, the cells in the intestinal cells are joined tightly together to form a barrier between the body and gut contents, while having functional channels for absorbing nutrients. Treatment for IBS 1,8,9 Treatment should be individualized according to the predominant symptom s.

For Low FODMAPs diet to reduce symptoms click here. Antibiotics Rifaximin Global symptoms and Anxiety Probiotics see below Psychological treatments Mindfulness-based stress reduction Hypnotherapy Acupuncture Yoga Probiotics in IBS Treatment Probiotics are live or attenuated microorganisms which when ingested in adequate amounts, may confer health benefit to the host.

The precise mechanism of action of probiotics is not known as of yet but may include 10 : lining the surface of the gastrointestinal tract and stopping harmful organisms from reaching it competitive exclusion , strengthening the tissue of the bowel wall, acting as antibiotics against other bacteria, and regulating the responses of the immune system, both at the level of the bowel wall and the body as a whole.

large multi-site RCT without randomization. Evidence from well-designed cohort or case-control analytic studies, preferably from more than one center or research group Evidence from multiple time series with or without the intervention. Probiotic choice within the IBS treatment indication may be based on the clinical expertise of individual health practitioners and patient preference References Ford A, Lacy B, Talley N.

Irritable Bowel Syndrome. New England Journal of Medicine [Internet]. The epidemiology of irritable bowel syndrome. Clinical Epidemiology [Internet].

Irritable bowel syndrome: A concise review of current treatment concepts. World J Gastroenterol [Internet]. htm Jones M, Tack J, Van Oudenhove L, Walker M, Holtmann G, Koloski N et al.

Mood and Anxiety Disorders Precede Development of Functional Gastrointestinal Disorders in Patients but Not in the Population. Clinical Gastroenterology and Hepatology [Internet].

Bowel Disorders. Gastroenterology [Internet]. html Begtrup L, Engsbro A, Kjeldsen J, Larsen P, Schaffalitzky de Muckadell O, Bytzer P et al. A Positive Diagnostic Strategy Is Noninferior to a Strategy of Exclusion for Patients With Irritable Bowel Syndrome. pdf Staying Healthy — Canadian Digestive Health Foundation [Internet].

Gastrointestinal Society. Microbiota restoration: natural and supplemented recovery of human microbial communities. Nature Reviews Microbiology [Internet].

Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. BMC Gastroenterology [Internet]. Double blind, placebo controlled trial of two probiotic strains in interleukin 10 knockout mice and mechanistic link with cytokine balance.

Gut [Internet]. long Skokovic-Sunjic D. Probiotic Chart [Internet]. html Irritable bowel syndrome in adults: diagnosis and management Guidance and guidelines NICE [Internet]. Effect of multispecies probiotics on irritable bowel syndrome: A randomized, double-blind, placebo-controlled trial. Journal of Gastroenterology and Hepatology [Internet].

Rome IV Criteria. Diagnostic time frame.

Ganjhu says. And due to the risk of sepsis , certain people should avoid probiotics, such as those with autoimmune or immunity disorders, she says.

Similarly, Dr. Michaels recommends regularly consuming fermented foods you can tolerate well. Yogurt or kefir are entry-level fermented foods to add to your repertoire.

They contain the same amounts of live bacteria as yogurt made from dairy. Give a probiotic about six weeks or so to see if it works. If probiotics or a probiotic food makes you feel worse, stop consuming them. Additional reporting by Sandra Gordon.

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Health Tools. Body Type Quiz Find a Doctor - EverydayHealth Care Hydration Calculator Menopause Age Calculator Symptom Checker Weight Loss Calculator. IBS can reduce quality of life, often results in missed school or work, and can have a substantial economic impact.

Physicians diagnose IBS by identifying symptoms laid out in the Rome Criteria, a set of diagnostic measures developed by a group of more than international experts. Limited diagnostic testing is also done, to help exclude other conditions that could present with similar symptoms.

Although the precise cause of IBS remains unknown, recent research suggests that an imbalance in intestinal microbiota the microorganisms living in your digestive tract and a dysfunctional intestinal barrier which, when working properly, helps keep potentially harmful contents in the intestine while allowing nutrients to be absorbed into the bloodstream may be involved in the development of IBS in some people.

Because of this, methods to restore the microbiota have been explored as treatment for this condition. Many digestive processes rely on a balance of various bacteria, which are found naturally in the gastrointestinal tract.

If these bacteria fall out of balance, gastrointestinal disorders may occur, possibly including IBS. Probiotics, which are bacteria or yeast that are associated with health benefits, may help restore this balance.

Most probiotics used in IBS treatment fall under two main groups: Lactobacillus and Bifidobacterium. These probiotics are thought to assist the digestive system. Among other functions, they may strengthen the intestinal barrier, assist the immune system in removing harmful bacteria, and break down nutrients.

The American College of Gastroenterology conducted a meta-analysis of more than 30 studies, which found that probiotics may improve overall symptoms, as well as bloating and flatulence, in people with IBS.

However, the overall quality of evidence of studies included in the meta-analysis was low, and specific recommendations regarding use of probiotics for IBS remained unclear. The probiotic strain Bifidobacterium bifidum MIMBb75 has been reported to adhere particularly well to intestinal cells, and therefore may have an advantage in altering the intestinal microbiota and increasing the intestinal barrier.

More recently, Bifidobacterium bifidum MIMBb75 has been shown to improve symptoms of IBS, even in its inactivated form. For the eight-week, double-blind, placebo-controlled clinical trial published in Lancet Gastroenterology , researchers studied whether the heat-inactivated form of Bifidobacterium bifidum MIMBb75 could alleviate IBS symptoms.

The heat-inactivated Bifidobacterium bifidum bacteria were nonviable, but retained their shape as well as their ability to adhere to intestinal cells. A total of patients probiotic and placebo completed the trial.

In addition, a significantly greater percentage of patients receiving the probiotic also reported adequate relief of symptoms compared to placebo. Finally, individual symptoms including bloating, bowel movement satisfaction, and quality of life were also significantly improved with Bifidobacterium bifidum MIMBb75 compared to placebo.

Previously, general consensus held that only active, living bacteria may have beneficial effects. But these results suggest that heat-inactivated Bifidobacterium can play a significant role in relieving symptoms of IBS, a syndrome with typically limited options for relief.

This is important because inactive probiotics have several potential advantages over active probiotics. For example, they are more likely to be stable, particularly if exposed to excessive heat.

Inactive probiotics are also easier to standardize than active probiotics. Additionally, common probiotic strains found in supplements include Lactobacillus and Bifidobacterium 8.

A significant amount of recent research has investigated how probiotics might be used to treat and manage IBS.

IBS symptoms have been linked to certain changes in the gut flora. For example, people with IBS have lower amounts of Lactobacillus and Bifidobacterium in their guts, and higher levels of harmful Streptococcus, E. coli and Clostridium 7 , 9. However, whether this change is a cause or result of IBS is uncertain.

Also, certain medications used to treat symptoms of IBS can damage the healthy bacteria living in the gut 7 , Changes in the gut flora may influence IBS symptoms by increasing inflammation, increasing sensitivity to gas in the intestine, reducing immune function and changing digestive motility 7 , Probiotics have been proposed to improve symptoms by 10 :.

However, not all probiotics are alike. Their health effects vary depending on the type. It cited small study sizes and lack of consistent data However, a number of studies have shown that specific probiotics may have the potential to target specific symptoms. Probiotics from the Bifidobacterium, Lactobacillus and Saccharomyces families have shown particular promise 10 , In a review by the British Dietetic Association BDA , 29 studies assessed overall symptom improvements, and 14 of these showed a positive result for 10 different probiotics For example, a study treated IBS patients with the probiotic L.

plantarum v. These findings were supported by another study in Poland. However, two other smaller studies on the same probiotic strain did not find a positive effect 13 , 14 , A German study of a two-strain probiotic liquid known as Pro-Symbioflor also had promising results.

Meanwhile, Symprove is a four-strain probiotic that was tested in patients in the UK. It was found to reduce overall symptom severity after 12 weeks of treatment Bifidobacterium infantis capsules have also been shown to marginally reduce pain, bloating and problems with bowel habits in all subtypes of IBS 3.

While some of these results are promising, there is some inconsistency between studies. In addition, most strains only have one study demonstrating their effectiveness. Therefore, more research is needed to confirm the results. Abdominal pain is one of the key symptoms of IBS.

It is often found in the lower or whole abdomen and subsides after a bowel movement Seven types of probiotics have been associated with improvements in abdominal pain symptoms The strain L.

plantarum was found to decrease both the frequency and severity of abdominal pain, compared to a placebo One study investigated the yeast S. cerevisiae , also known as Lesaffre. In another study, participants drank a probiotic solution consisting of B. bifidum, B. lactis, L. acidophilus and L.

casei for eight weeks. While this research is positive, the majority of studies on probiotics have not found a beneficial effect on pain.

More studies are needed to confirm the findings for these strains. It is also interesting to note how much impact the placebo effect seemed to have in these studies.

The placebo effect is when people experience a positive effect during a study even when they are just taking a placebo. This is commonly observed in IBS research Excess gas production and increased sensitivity can cause uncomfortable bloating and gas in IBS In the BDA review, only two studies found that probiotics specifically reduced bloating, and only one found they reduced gas plantarum was found to decrease the frequency and severity of bloating symptoms, compared to a placebo Another study treated patients with a rose-hip drink mixed with an oatmeal soup fermented with L.

The test group experienced significant reductions in gas, and both the test and placebo groups experienced reductions in abdominal pain An additional study found that participants with IBS experienced reduced abdominal bloating after four weeks of treatment with a four-strain supplement containing B.

acidophilus, L. bulgaricus and S. thermophilus If excess gas and bloating is your primary problem with IBS, then one of these probiotics may improve your symptoms. However, further studies are needed. While there has been a lot of research on probiotics for infection-related diarrhea, less is known about the effects of probiotics on non-infectious types, as in IBS.

One probiotic known as Bacillus coagulans has been found to improve multiple symptoms, including diarrhea and stool frequency. However, studies to date have only been small, so more research is needed 25 , The probiotic yeast Saccharomyces boulardii has also been investigated for the treatment of diarrhea-predominant IBS.