Can probiotics fix my IBS?

This is probably the most common question I get asked by clients in relation to their irritable bowel syndrome symptoms. It’s an important and relevant question and one I am hoping to answer in this blog post. Probiotics have been getting a lot of attention in the past few years particularly in relation to gut issues but what exactly are they? Probiotics are live microorganisms (generally bacteria and/or yeast) that when taken in adequate amounts are said to “confer a health benefit on the host”. They are thought to mimic the effects of our intact gut microbiota.

Just a reminder, the gut microbiota is all the microorganisms (bacteria, yeast, parasites, viruses and archaea) that live in the gut, of which there are an estimated 39 trillion. Diversity is key and just as you and I prefer variety in our diets these microorganisms don’t all like to eat the same food. They are involved in everything from helping to digest food for absorption and provide fuel for the cells lining the gut, producing neurotransmitters central to mood regulation, immunity, hormonal balance and gene expression. To say that they are crucial not just to gut health but to overall health is an understatement.

Where can you find probiotics? Probiotics are available in both supplement form but also in fermented foods, more on those later. For the purposes of this blog post I am mostly talking about probiotic supplements. So to answer the question can probiotics fix IBS, firstly no.

No probiotic, no matter how potent or high quality can fix or reverse the effects of a bad diet. Food and lifestyle should always be the first port of call with any digestive complaint.

Secondly, probiotics don’t stay in the gut permanently when taken, nor are you adding back in new strains of bacteria or ones you’ve lost. If you stop taking a probiotic, with 2-5 days it’ll be like you never took it in the first place.

But before you think I’ve written them off completely, there is some evidence to suggest that probiotics may play a role in managing IBS symptoms.

Studies have shown they improve abdominal pain, bloating, constipation and diarrhoea as well as other symptoms of IBS. Through my work I have also had many clients report feeling better after taking a probiotic supplement. Probiotics appear to exert their beneficial effects as they transiently pass through the gut. Essentially, they offer a helping hand to the microbes already present in the gut but they don’t stick around.

Dairy, and more specifically, lactose can prove problematic for some people with IBS and result in symptoms including bloating, gas and diarrhoea. Some studies have shown that probiotics can improve our ability to handle lactose. It is thought that the digestive enzymes in probiotics may help us to break down the carbohydrate sugars. Probiotic strains such Lactobacillus acidophilus, Bifidobacterium lactis and infantis have also shown positive results for reducing intestinal bloating in numerous studies. Often a probiotic is recommended after an antibiotic course but there is some evidence to suggest that probiotics actually prolong the time it takes for the microbiota to stabilise and return to normal when taken after an antibiotic.

Earlier I mentioned fermented food being a source of probiotics but it is important to note that they are not the same as probiotic supplements. Although they both contain live bacteria, fermented foods contain a more diverse array of microorganisms but in lower numbers in contrast to probiotic supplements which are highly concentrated versions of a limited number of bacterial strains. Fermented foods include sauerkraut, kimchi, miso, live yoghurt and kefir. As well as being rich in probiotics they also contain vitamins, prebiotics and polyphenols.

So as probiotics go, fermented foods are by far superior to any supplement on the market.

Probiotics alone will not fix IBS, or any other gut issue for that matter. Their true power is unleashed when together with prebiotics they produce short chain fatty acids (SCFAs) that help to repair the gut and dampen inflammation. If you want to read more about prebiotics then refer to my previous blog post on the gut microbiome. In Dr Will Bulsiewicz’s book, Fiber Fueled he argues that “until we can test an person’s unique microbiome and identify it’s strengths and weaknesses and then give them the exact strains in the exact proportions they need to fix a problem we are just shooting in the dark”. Microbes don’t work in isolation but instead in ‘teams’. Sometimes your gut needs a high concentration of a specific bacterial strain to give it a boost and this is when a probiotic is useful.

But before running off to buy a probiotic you may want to first ask yourself a few questions:

  1. What am I trying to acheive?
  2. Is there a specific symptom I want to improve?
  3. How is my current diet?
  4. Am I getting enough sleep?
  5. Am I fitting in regular movement or exercise?

My advice based on the evidence? Probiotics are no ‘silver bullet’ when it comes to IBS. Diet and lifestyle should form the cornerstone of any treatment plan. Food first, then lifestyle. Then, and only then consider a supplement. Often it is a case of trial and error. If you’ve taken one and found it beneficial then stick with it but if not, move onto another. Try one product at a time for a minimum of 4 weeks and monitor your symptoms. Remember to always consult your doctor before commencing any supplements if taking any other medication.

If you would like to find out more about working with me then drop me a message using the form on my contact page or book in for a free 15 minute clarity call here.