Probiotics for Irritable Bowel Syndrome
We constantly hear about curing ourselves or boosting our immune system with vitamins, healthy supplements and integrators.
Probiotics are, for Irritable Bowel Syndrome sufferers, on the top list of supplements to be taken; lately I have also started to take some, which are specific for IBS.
It is important to understand that not all probiotics are the same and especially for IBS sufferers, there may be probiotics brands that are high in FODMAPs, so we need to be careful.
On this note, I need to share with you a story. A while ago, before I learnt properly about FODMAPs, I bought some probiotic, who were sold in little individual bottles; in the cap there was a powder containing the probiotics, which had to be pushed down into a liquid, to be dissolved. I did not realise that those specific probiotics contained fructo-oligosaccharides (FOS), simple carbohydrates which are added to the probiotic to stimulate their growth and help replenish the gut flora. Prebiotics have an important function, but unfortunately those with high FODMAPs are a ‘killer’ for IBS sufferers.
I took one flacon of probiotics in the middle of the afternoon and then started to prepare food for some friends, who I had invited for dinner. Well, I can tell you that evening I did not spend much time with my guests, unfortunately most of my time was spent in the bathroom, as I had many episodes of cramps and diarrhoea, it was very embarrassing 😡
So to understand more about probiotics and their effects, I have asked a doctor, to explain what they are and their effectiveness in helping individuals with irritable bowel syndrome.
This is what he said:
Around 15% of the population (more in some countries) suffer from IBS (Irritable Bowel Syndrome). The main characteristic of IBS is irregular bowel habits, (diarrhoea, constipation or alternate diarrhoea and constipation). Another characteristic of IBS is the constant bloating and abdominal pain.
A lot of research points to an imbalance in the intestinal flora, as a cause and this is why there are a lot of probiotics products claiming to be able to help IBS symptoms.
Probiotics are live microorganisms which, when administered in adequate amounts, confer a health beneﬁt on the host.
They are often advertised as ‘friendly bacteria’, especially by manufacturers of fermented dairy products (like yoghurts) and probiotic fortified foods.
A lot of probiotics are taken orally and they can get destroyed by the acids, once they reach the stomach.
There are some probiotics which successful survives the passage through the stomach’s acid secretion and reach the intestines. These types of probiotics may assist regulating the motility of the digestive tract by converting undigested carbohydrates into short chain fatty acids, which act as nutrients for colonocytes.
What types of probiotics exist?
There are several strains of probiotics and they are classified according to the following species:
What is the difference between probiotics and prebiotics?
We have already mentioned that probiotics are live microorganism (good bacteria) that help to keep the intestines healthy, digest food and give protection from harmful bacteria. Probiotics can be found in food or be taken as a supplement.
Prebiotics are non digestible carbohydrates, but they can be digested by our gut flora. Prebiotics help the probiotics to grow and multiply by nourishing them.
Common prebiotics include: inulin, fructooligosaccharides (FOS), galactooligosaccharides (GOS) which are rapidly fermented and high FODMAPs, hence causing IBS symptoms like bloating, flatulence, abdominal cramp and diarrhea.
There are some prebiotics, which are not low FODMAPs and therefore better tolerate by individual with IBS, Acacia Senegal is one of those, it is a soluble fiber supplements (help to regulate water content in the bowel preventing both diarrhea and constipation) and also a prebiotic.
In this article we will go through the probiotics that claim can help IBS symptoms, but pay attention because they could still contain ingredients which you may be intolerant to (e.g. milk).
The Research Behind Probiotics
Lactobacillus plantarum 299v
Lactobaccilus plantarum 299v (Lp 299v) is considered a superior probiotic strain, which was initially isolated from human intestine.
It has been found that when a healthy colony of Lactobacillus plantarum lives in the intestines, it prevents harmful bacteria from attaching to the mucosal lining and competes for the nutrients the bad bacteria need to survive. With no food and no room to live, the harmful bacteria pass harmlessly through the body.The LP299V probiotic has gone through four trials, so far, three of which have demonstrated positive effect on the intestinal health of people with irritable bowel syndrome (IBS) and one smaller single study showed little effect.
A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome was performed in 2001 in Sweden and the result demonstrated that the LP299V reduced abdominal bloating in individuals with IBS.
A different study by Polish researchers in that same year showed normalization in stool frequency in the majority of the patients.
Another study published in 2002 reveals that a double-blind, placebo-controlled, cross-over, four-week trial of Lactobacillus plantarum 299V in 12 previously untreated patients with IBS did not appear to alter colonic fermentation or improve symptoms in patients with the irritable bowel syndrome.
A more recent study published in 2012 concluded that a 4 weeks treatment with Lactobacillus plantarum 299v (DSM 9843) provided effective symptom relief, particularly of abdominal pain and bloating, in IBS patients fulfilling the Rome III criteria.
LP299V probiotic can be hard to find outside of Scandinavia, although it is available in a supplement by Jarrow Formulas, which can be bought on Amazon.
Jarrow Formulas Ideal Bowel Support 299v, 30 VCaps (Pack of 2)
- Jarrow Formulas
Bifidobacterium bifidum MIMBb75
The bifidobacteria group (often simply called B.Bifidus) is a probiotic which helps to maintain intestinal health and serve as a natural antibiotic against potentially harmful organisms.
Yoghurt is considered a great source of Bifidus as long as there is the right quantity and quality. Some brands claim that their product contains the ‘live’ cultures of these healthy bacteria, which means they have been added after pasteurisation (otherwise they would have been destroyed during pasteurisation)
Bifidobacteria supplements are sold in health-food stores, often in combination with Lactobacillus acidophilus, another group of organisms that function as probiotics.
It is helpful to take probiotic like Bifidus, while on a course of antibiotics, as they can eliminate the good bacterias and trigger the growth of yeast infections, while the probiotic will act as safeguard.
Bifidobacterium infantis 35624
The B. infantis 35624 strain was isolated from pieces of healthy human intestines in Ireland.
A study was performed in 2006 with 362 women suffering from IBS symptoms. The study looked at the effect of different doses of B. infantis 35624 and it was concluded that with the right dose, the women tested had a significant reductions in IBS symptoms such as bloating, abdominal cramps and pain, flatulence and it was more responsive with subjects suffering from IBS – D.
The B. infantis 35624 probiotic is sold as Align Probiotic and can be purchased from Amazon.
Align Digestive Care Probiotic Supplement
PubMed.org -Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.
Lab4 is a probiotic multi strain, developed by Cultech Ltd and produced by Pharmex.
Clinical results were seen in a study performed in 2009 showing great improvement during an eight-week treatment period, patients had an improved global IBS score as compared to placebo. Specific significant improvements in pain and bowel movement satisfaction were also found. Moreover, there was a significant improvement in quality of life at eight weeks.
Unfortunately that was the only study I was able to find.
PubMed.org – Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study
VSL#3 contains eight strains and has had 3 study done with good results in the reduction of bloating and gas.
VSL#3 is considered medical food and therefore must be administered and used under medical supervision after medical evaluation.
VSL#3 products may contain trace amounts of lactose [0.1g per 100g] and dehydrated skim milk or milk protein (casein and beta-lacto globulin of less than 2mg/Kg).
There has been several positive controlled studies looking at the benefits of using probiotic supplementation as therapy in IBS. All in all there is reasonable evidence that although not a cure for IBS, certain probiotics can help to reduce IBS symptoms.
Recently (April 2017) the website Review.com has researched the best probiotic strains, by consulting doctors and an internationally recognised probiotic microbiologist. They started with 221 probiotics and came down to the best eight. You can read their Best Probiotic Supplement article here.
Until next time, take care.