Probiotics & IBS

Probiotics are all the rage in our culture right now and have made their way to the top of the supplement industry. That’s no surprise, because as we gain knowledge about the connection of our gut microbiome to our overall health, probiotic use is becoming a common recommendation from medical professionals, as well as other health gurus. If you have IBS, you have probably heard that you should be taking a probiotic, but do you know why? And do you know what kind?

Probiotics are defined as “live microorganisms that confer positive effects on the host after oral administration.” More simply put, these are live bacteria that can improve our health when we eat them. Probiotics can be found in the diet, but I want to focus on supplements for today and we will talk food later on. While we do know probiotics are great, there are so many different types and each individual bacteria has a unique effect on the body, so different bacteria may be useful for different needs.

So, what DO we know? Currently, we know that probiotics may help protect the gut from pathogenic microbes via their antimicrobial properties; they may boost the intestinal tight junctions to stabilize permeability (ie more protection from the “bad guys” entering the body); and they may stimulate intestinal cells to produce mucus that improves intestinal barrier function (ie security guards), normalizes bowel movements, and reduces pain. It’s hard to extrapolate concrete evidence for each of these possible effects due to the diversity of bacteria available in probiotics and to the unique makeup of each individual’s microbiome. As we learn more, our recommendations can become more specific and targeted.

Although there’s a lot we don’t know yet, there’s also a lot we do know and have enough confidence in to apply! There are many strains of bacteria and specific probiotics that have at least one solid study to support a positive effect for those suffering with IBS. Note that the specific strain of bacteria, as well as dose matters when it comes to a probiotic. Also, note that there are some studies that show a decrease in effectiveness with long-term use. This means that, currently, probiotics are not a single solution to manage your IBS. They can be included, alongside individualized diet and lifestyle interventions given by a registered dietitian, to create a well-rounded plan. (I help my clients develop a plan like this in my signature IBS Management Program).

Here is a chart of specific brands and the strains they contain that have been shown (in at least one valid study) to have a positive effect on IBS, constipation, and/or diarrhea. Do not take this an individualized medical advice, but always consult with your doctor or dietitian to determine which may be best for you! Also, remember that the supplement industry is not regulated, so be intentional with choosing trusted brands like those below. Others may claim to contain the same strains of bacteria, but unless they conduct studies to prove their probiotic is what they say it is, it’s hard to know for sure what you’re getting.