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Kirsten Jackson Consultant BSc Hons PG Cert RD

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Probiotics for IBS

by Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert 4 Comments

Table of Contents

  • Introduction 
  • What is a probiotic?
  • Benefits of probiotics for IBS
  • How do probiotics benefit IBS?
  • How do probiotics help with bloating?
  • Which probiotics help with bloating?
  • Here is a list of specific probiotics shown to help IBS;
    • VSL#3: 
    • PrecisonBiotics Alflorex:
    • Optibac Probiotics Every Day EXTRA (Named Daily Wellbeing EXTRA Strength outside of the EU):
    • Bio-Kult: 
  • Can probiotics cause bloating?
  • Are probiotics good for gas?
  • Are fermented foods probiotics?
  • How long should you take a probiotic for?
  • Summary

Introduction 

Probiotics are a hot topic when it comes to gut health, so you’ve probably already heard of probiotics for IBS.

But what is a probiotic and should you take probiotics for IBS? AND which one should you take when there are so many to choose from? 

This post will explain some of those questions you may be asking yourself when thinking about probiotics for IBS.

probiotics for IBS

What is a probiotic?

When you think of consuming bacteria, you may instantly think of having a tummy bug. However, our gut is full of microbes which have a range of benefits for gut health and overall health. 

The term probiotic refers to live microorganisms (bacteria, yeasts, etc) that have a positive effect on your health or on a symptom you may have. Probiotics are not the same as prebiotics.

You can find probiotics in lots of different forms and brands. They can come in powders, capsules, sachets, fermented food products and more.

Different probiotics will contain different species and strains of bacteria that will increase the levels in your gut microbiome. 

It is the specific strains that can help you choose what probiotic is right for you. 

There are also other factors to consider when looking into taking a probiotic:

  • Count of live bacteria (colony-forming units aka CFU)
  • Ensuring you store them as instructed
  • Not taking them past the expiry date, as the count of live bacteria decreases 

Benefits of probiotics for IBS

There are currently no officially approved health claims for probiotics to date. This means that official guidelines for IBS management are currently unable to make recommendations on specific probiotics.

This does not mean that you definitely won’t benefit from one – the research is there. It just isn’t considered strong enough by some organisations to make sweeping recommendations . 

The current British Society of Gastroenterology guidelines 2021 recommend that probiotics can be trialled as a first line management for IBS [1]. 

But you need to be cautious when choosing a probiotic as not every probiotic will be specific to what you need for your symptoms. 

Probiotics have been shown to reduce the following symptoms of IBS: 

  • Constipation 
  • Diarrhoea 
  • Bloating
  • Flatulence
  • Pain and discomfort  

Another interesting use of probiotics for IBS is on the low FODMAP diet. This diet has been shown to  reduce levels of bifidobacteria but the use of probiotics prevents this [2]. 

Probiotics can also be used when taking a course of antibiotics to prevent antibiotic-related diarrhoea [3]. This decreases the risk of post-infectious IBS.

How do probiotics benefit IBS?

It makes sense that probiotics may help relieve your symptoms. This is likely due to IBS sufferers having an altered balance of gut microbiota) [4]. 

Probiotics may reduce your symptoms by [5, 6]:

  • Providing your gut with the beneficial bacteria it is lacking 
  • Altering your gut motility 
  • Improving gut barrier function
  • Increase your production or secretion of substances such as short chain fatty acids
  • Altering your gut-brain axis

How do probiotics help with bloating?

Gut bacteria play a key role in the digestion (fermentation) of fibre, releasing gases as they do so. This can leave you feeling bloated and in pain and discomfort. 

Probiotics therefore may help relieve your bloating due to restoring the good bacteria in your gut microbiome. This can result in changes such as changes in the fermentation and those listed above (6).

Which probiotics help with bloating?

Studies have shown mixed results, depending on the microorganisms used in the probiotic product. The microorganisms are classified using the following:

  • Genus e.g. Lactobacillus 
  • Species e.g. acidophilus
  • Strain e.g. NCFM

Well researched bacteria genera into the reduction of bloating include (7, 8): 

  • Lactobacillus 
  • Bacillus
  • Bifidobacterium 

However, it is important that the specific species and strains within the genera are also considered when looking into the research. This is because different species and strains have been shown to only have an effect on specific symptoms. 

This will help in choosing a probiotic that is right for you and your specific IBS symptoms. This will also prevent you from wasting your money – probiotics are not cheap!

Here is a list of specific probiotics shown to help IBS;

VSL#3: 

This is a multi-strain probiotic beneficial for bloating in IBS. One research trial showed promising results in those with IBS-D (8).

This probiotic has also shown to be beneficial in maintaining Bifidobacterium levels during the low FODMAP diet (9).

It has 112.5 billion CFU and must be kept refrigerated. 

PrecisonBiotics Alflorex:

This probiotic contains Bifidobacterium longum (or infantis) 35624® culture (10). This culture is not available in any other probiotic products in the United Kingdom. One large clinical trial showed a significant reduction in bloating in women with IBS and contributed to a 20% reduction in general IBS symptoms (11).

It is suitable for those on the low FODMAP diet. It is also free from milk, lactose, gluten and soya and bonus points that it does not need to be refrigerated.

Optibac Probiotics Every Day EXTRA (Named Daily Wellbeing EXTRA Strength outside of the EU):

This product contains four strains including Lactobacillus acidophilus NCFM and bifidobacterium lactis Bi-07. One trial showed a significant reduction in bloating after just four weeks (12). 

This Every Day EXTRA version is free from fructo-oligosaccharides (FOS) making it suitable for the low FODMAP diet. It is also suitable for vegans, vegetarians, and gluten-free, dairy-free or soy-free diets.

This probiotic contains 20 billion CFU. Refrigeration is not required.

Bio-Kult: 

This is a multi-strain probiotic containing 14 strains of live bacteria. 

One study showed that symptoms (including bloating) were significantly reduced in those with IBS-D taking this probiotic (but not those with IBS-C). It also showed that quality of life significantly improved, where the gut-brain axis plays a key role (13).

This product contains soya and milk.

It contains 2 billion CFU and does not need to be stored in the refrigerator.

Can probiotics cause bloating?

Side effects of probiotics are not common or expected. However, probiotics may cause you to have initial side effects, such as bloating. This will be short lived as your digestion system adjusts.

Symptoms such as bloating will be individual to you. This may depend on your original gut bacteria and if the strain selected is right for you or not. Symptoms such as bloating are more likely to occur if the probiotic contains a prebiotic, such as fructo-oligosaccharides (FOS). 

Prebiotics are beneficial as they feed good bacteria, enhancing their growth. FOS is classified as a fructan (a type of FODMAP) and may be poorly tolerated in those with IBS. They may result in bloating, flatulence and diarrhoea. If you are on the low FODMAP diet, you should look to take a probiotic that is free from FOS.

Are probiotics good for gas?

Excess gas production can result in bloating, discomfort and flatulence. It can be a result of the fermentation process by bacteria in your gut whereby gases are released. 

Probiotics may therefore help to reduce gas and flatulence in the same way that they reduce bloating. 

Gas may also be an initial side effect of taking a probiotic, but this should settle.

Are fermented foods probiotics?

Fermented foods are those that have been ‘pre-digested’ by microbes – known as fermentation. This results in the conversion of carbohydrates to organic acids (14). 

Examples include:

  • Kimchi
  • Kombucha
  • Miso
  • Tempeh
  • Fermented dairy products

Fermented foods can be a probiotic product if the microbes are still alive in the product. They must survive the digestion process and make their way to your large intestine. They must also be present in sufficient numbers to have a positive impact on you.

Unlike probiotic supplements, it can be difficult to label the exact strains and amount of cultures in the food product. This can also make the research into the positive health benefits of fermented foods difficult. 

Fermented dairy has the strongest clinical evidence behind it in terms of health benefits. 

These include fermented yoghurts, milk and cheeses, where Lactobacilli are used in the fermentation process. Benefits include improvements in heart health, weight management and digestion (15).

How long should you take a probiotic for?

The British Society of Gastroenterology guideline on IBS management states that probiotics can be taken for up to 12 weeks. If there is no improvement after this point, they should be discontinued (16).

Summary

Taking a probiotic for IBS may help your symptoms but you need to ensure that it has been scientifically proven to work. Taking probiotics is not a one size fits all approach.

Article written by Beth Wilson (Registered Dietitian with specialist interest in gastroenterology) and reviewed by Kirsten Jackson Consultant IBS Dietitian

Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

Filed Under: Supplements Tagged With: probiotics, Probiotics for IBS

About Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

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Reader Interactions

Comments

  1. Sarah Moshe says

    at

    Very informative.
    I have a long history of IBS – D. The worst of my symptoms is the debilitating weakness after bowel movements with feeling of gut emptiness (after having eaten, especially in the morning), forcing me to lie down in fetal position for hours. I need to drink warm herbal tea, sometimes even a sip of pure prune brandy to warm up my stomach.
    What causes this symptom?
    I follow the FODMAP diet, not strictly. I take probiotics.
    I would like to take your free course on IBS.

    Reply
    • Kirsten Jackson Specialist Dietitian says

      at

      Hi Sarah, sadly we can not give personalised dietary advice out without further assessment.

      Reply
  2. Faith says

    at

    Very useful inormation on probiotics..I have been using one ,thatcontains 15 strains and 90 billionCFU.
    I have always taken probiotics as part of my ongoing regime for IBS and overall gut health.What do they mean by indicating that it can be taken for up to 12 weeks?

    Reply
    • Serena Bansal Registered Dietitian BSc Hons says

      at

      Hi Faith. It means that if you do not see an improvement in your symptoms within 12 weeks of starting the probiotic, then that probably means it is not helping you in any way, so it is advised to stop using it. Probiotics are strain specific so sometimes it can be trial and error to find which one works for you. Hope that makes sense 🙂

      Reply

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🙋🏼‍♀️ I am a huge advocate of the Mediterranean diet because it is repeatedly shown to be the best option for our health regardless of what is studied. AND especially in gut health.

💩 Including wholegrain, oily fish, plenty of veggies, fruits, nuts and olive oil is easy with a few tweaks to any diet!

✅ Swap your white carbs to brown
✅ Add 2 portions of fish per week - one should be oily like mackerel or salmon
✅ Eat the rainbow with fruit and veg
✅ Snack on nuts
✅ Switch your oil to olive oil

💩💩 What could you do this week to make your diet more in line with the Mediterranean diet? comment below 👇
DO YOU MOVE FOR YOUR GUT HEALTH? Comment below 👇​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​
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🥵 We get told that the more intense we exercise, the better. But exercising intensely can trigger our IBS, making us feel confused about the best way to stay healthy and control our symptoms. ​​​​​​​​
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🤔 In reality, people like to over complicate exercise. This is why we use the term 'movement' in the Take Control method. Avoid the confusion and keep it simple by going for a daily 30 min gentle walk and you will see the benefits!​​​​​​​​
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🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning guide! Link in bio.​​​​​​​​​​​​​​​​​​​​​​​​
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#ibs #walking #movement #irritablebowelsyndrome #ibsexpert #ibs diet #ibs #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealthiskey #healthylife #bloating #irritablebowelsyndrome #fodmapfree  #healthygut #goodguthealth #gutfood #fermentedfoods #trustyourgut #chronichealth
🤔 Can you relate to any of these comments? Let 🤔 Can you relate to any of these comments? Let me know below 👇 ​​​​​​​​
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😔 When you have IBS, you may feel that how you come across appears rude at times. IBS impacts every area of your life and you can feel you are constantly having to cover it up. Over time, this style of 'coping' can leave you feeling pretty isolated.​​​​​​​​
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🙏 Instead of treading water with your symptoms, use research proven methods such as the low FODMAP diet process and mindfulness (part of the Take Control approach) to move forward with your symptoms and regain confidence in yourself and your social life!​​​​​​​​
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🎉 🎉 I am giving away a FREE IBS morning routine guide which you can download via the link in my bio.​​​​​​​​
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#ibs #ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #ibsd #ibd #chronichealth
⏩ Do you suffer from bloating? Comment below 👇​​​​​​​​
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🤰 Bloating is a common symptom for those suffering with uncontrolled IBS. Having bloating which is unpredictable and there everyday will make you feel tired, impact your relationship with your body and give you real anxiety about eating food.​​​​​​​​
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⏩ Instead of suffering with unpredictable bloating try the Take Control 2.0 approach of using the low FODMAP diet to identify your dietary triggers. By doing this, you can avoid foods which cause you bloating and start to feel more confident in your body.​​​​​​​​
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🎉 Would you like to start the day in a way which would benefit your gut? Download my FREE IBS morning guide! Link in bio.​​​​​​​​​​​​​​​​
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#ibsbloattips #ibsbloat #ibs #ibsdiet #ibsmanagement #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree #gutinstinct #healthygut #ibsd #ibsmanagement #ibssymptomrelief #ibshelp
WHAT WOULD YOU ADD? Comment below 👇 ​​​​​​​​​​​​​​​​
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😣 IBS is a condition that others cannot see. As humans, we struggle to understand or truly believe in things that we can't touch, hold or see. As a result, IBS sufferers often feel quite alone.⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​​​​​​​​​
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😇 IBS is estimated to affect 5-10% of the worldwide population - so you really aren’t alone! Follow the Take Control process of finding a community to support you - there are lots of online forums where you can chat and share your worries with other people who completely understand. ​​​​​​​​
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🎉 🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning routine guide! Link in bio.⠀⠀⠀⠀⠀⠀​​​​​​​​​​​​​​​​
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#ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #mumlife #dubaimom #constipation #chronicpain #chronicallyunwell #women'shealth #ibswishes
⁉️ Have you heard of these symptoms before?

😳 Both of these symptoms can be caused by a few things and one of them is bowel cancer. But we don't know based on symptoms alone so please go and get checked.

🩸Blood can appear on a toilet tissue, in the toilet bowl or it can look like part or all of your stool is black.

⚖️ Unexplained weight loss means that you have lost weight despite eating adequate calories and not really changing your exercise routine. It can be common in IBS to lose weight but this is due to eating less food and so it is explainable.

🙏🙏 If you have either of these symptoms please see your doctor to get checked, don't take the chance.

#bowelcancer #cancer #theibsdietitian
😭 Can you relate? Comment below👇👇​​​​​​​​​​​​​​​​​​
😫 Suffering from IBS can be difficult and burdensome especially when trying to go about your daily life. IBS is a condition that cannot be seen which makes it even more difficult for others to understand and can often feel very isolating😢. 

👉 Instead of keeping this condition to yourself, adopt the Take Control principle of community and get support from people who also have this condition. You can do this by opening up to friends (1 in 10 people have this!) or joining  online FB groups - this way you won't feel so alone in your fight! 
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🎉 🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning guide - link in bio.​​​​​​​​

#ibs diet #ibsbehindthescene ibs #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #bloating #irritablebowelsyndrome #fodmapfree  #healthygut #goodguthealth #gutfood #fermentedfoods #trustyourgut #chronichealth #microbiome #dubaidietitian #londondietitian #dubailife #dairyfree #prebiotics
🤔 WHICH ONES DID YOU KNOW? Comment below 👇 ​​​​​​​​​​​​​​​​
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😞 IBS is a very complex disorder to navigate by yourself. It’s more than just altering your diet, a lot of factors are at play with your IBS. Trying to work out what triggers your IBS is an absolute mind field.​​​​​​​​​​​​​​​​
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Adopting the Take Control Method, where the 4 pillars of IBS relief are all addressed (diet, movement, mental health and sleep), has helped so many of my clients to achieve that ultimate symptom relief because it considers EVERYTHING, not just what you out in your mouth.​​​​​​​​​​​​​​​​
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🎉 🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning guide - link in bio.​​​​​​​​​​​​​​​​
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#ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #ibsd #ibd #tea #5steps #chronichealth #multifactorial. #chronicallyunwell #endo #ibstype #ibstyping #ibsc
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