Do Probiotics Help IBS Sufferers?

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.

Probiotics supplements are often recommended after a course of antibiotics.

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.

Probiotics Capsules

Probiotic Capsules

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:

Lactobacillus, Bifidobacterium, Bacillus, Saccharomyces and Streptococcus.

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)

References:

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.

References:

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

References:

  • PubMed.org -Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.
  • Medscape.com

LAB4

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.

References:

PubMed.org – Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study

VSL#3

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).

References:

Conclusion

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.

xo Larah

About Larah Brook

I have been suffering from Irritable Bowel Syndrome for many years, but it took a longtime to get a diagnosis, since then I have been following a low FODMAP diet, which has changed my life for the better. This is my story and experience with IBS and the low FODMAP diet.

12 comments on “Do Probiotics Help IBS Sufferers?

  1. I have had Crohn’s for 20 years. After having 2 feet of intestine removed, a friend recommended the Paleo diet. It has made a dramatic difference. First time I haven’t been bloated in 20 years and I lost significant weight without even trying. I have also added probiotics which has made me more regular. To prevent mono cropping, I alternate between VSL#3, Pro15, 299V, and fermented foods like raw sour kraut. I haven’t tried low FODMAP, but I feel the missing piece is probiotics. An excellent book on probiotics and the gut brain connection is Brain Maker by Dr. Perlmutter.

    • Hello DJB, thank you for your comment. I am glad that you have found what works for you. I follow a healthy low FODMAP diet (not as extreme as the Paleo diet, nevertheless healthy) and I also use probiotics to manage my IBS symptoms. I am also fascinated by the brain-gut connection and in my latest podcast episode, I am talking about that with a gastroenterologist doctor. I’ll invite you to check it out, if you can, http://www.lowfodmapdiets.com/23 (it will be published in less than 2 days). All the best to you. x Larah

  2. One Yakult after every meal is now a habit.
    It is a probiotic drink readily available in my place.
    Doctor said that a medical substitute would be better and less costly. But never been able to find that brand in my country.

  3. Hi Dana. I have always known about taking probiotic and vitamins while taking a course of antibiotic. The IBS support probiotic, which I am taking at the moment seem working well. I let you know how it goes with the 299v.

  4. Is there an update on the L. plantarum? I have never taken a probiotic and to be truthful I only really started thinking about them when I came on this site and read the post Can Antibiotics Help or Cause IBS? https://www.lowfodmapdiets.com/antibiotics-and-ibs/ Was this was prompted to write that post?

    I need to research Probiotics more because I do find them interesting and I am wondering how they would play a part in my health.

  5. Is there any updates on the L. plantarum 299v at this point? Has anybody found it helps with symptoms? I am very interested to hear people’s experiences with the pro biotics.

    • Hello Jacinta, I haven’t received my L. plantarum 299v yet, but I am looking forward to see how much difference it will make my life, after all is the most efficient probiotic strains on the market for IBS. If anyone has tried it, it would be great to hear from you.

  6. I’ve just done a bit of research on L. plantarum 299v, which I’d never heard of. The reports across the internet seem incredibly positive. Thankfully it’s also available in my country, I’m going to give it a try. Thank you so much for this post!

  7. Larah, Very brave on sharing your story which I doubt many of us would hide. Do you/Have you had any success with Lactobacillus plantarum 299v as mentioned above??

    • Hello Tania S.
      Yes probiotics have helped me a lot, I have just ordered from Amazon this specific brand
      ‘Jarrow Formulas Ideal Bowel Support 299v’ and I am waiting for it to arrive. I’ll keep you posted.

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