New Insights into Probiotics for IBS
by Natasha Trenev
Irritable bowel syndrome (IBS) describes a group of symptoms that occur together including repeated pain in the abdomen, changes in bowel movements such as diarrhea, constipation or a mixture of both. Doctors try to rule out all other structural or GI abnormalities and, if nothing else ﬁts, they’ll often use IBS as the ﬁnal “catch-all” diagnosis. IBS affects females more than males, with about 70 percent of cases being in women. Unfortunately, since it’s often used as a last resort diagnosis, receiving this diagnosis will not necessarily lead to any clear treatment options.
Most doctors suggest a combination of diet and lifestyle changes to help relieve the symptoms of IBS, some of these include eating more ﬁber, avoiding gluten, or following a special diet called the low FODMAP diet. These changes often affect each individual differently since the root cause of each case is unknown and unique to each person. The downside to this is that it can take an individual years of experimenting with various changes in order to ﬁnally ﬁgure out what will really help them heal. Fortunately, more and more studies are now being completed to better understand the changes that occur in the gut of IBS sufferers. A better understanding of these gut level changes may result in more direct and natural approaches to healing.
The Gut Microbiota in IBS
When scientists compared the gut microbes of healthy individuals to the gut microbes found in the IBS sufferers, they noted that those with IBS-D, meaning they predominantly had diarrhea or alternated between diarrhea and constipation, are suffering from a loss of bacterial diversity in their guts.¹ This makes sense when you think about how the strong action of diarrhea can drain your body of nutrients — at the same time it can ﬂush out your gut microbes, both the good and the bad. It seems that a particular set of bacteria is missing or reduced in IBS sufferers. The species lacking are responsible for producing butyrate and methane. Butyrate is a type of fatty acid known to help the gut work and it contributes to the function of the internal gut barrier. When butyrate is lacking it becomes easier for all kinds of microbes and other digested particles to cross the intestinal barrier (often referred to as ‘leaky gut’), enter the bloodstream and potentially infect the body or otherwise interact with our immune system. This means bad bacteria, viruses, fungi, and more all have easier access to upset the overall workings of the rest of your body.
Probiotics and IBS
More doctors and patients are learning to appreciate the positive effects that probiotics have on restoring health to the GI tract and reducing the symptoms of IBS. In July of 2017, a research team from the University of Illinois compiled and published data from ﬁve human clinical trials on IBS that included the probiotic bacteria known as Biﬁdobacterium infantis.² After reviewing the data from these ﬁve trials and combining the overall results, they concluded that the probiotic, “B. infantis might be an effective therapeutic option for IBS patients, which could signiﬁcantly alleviate the symptoms of IBS without signiﬁcant adverse effects.”
The probiotics seem to go beyond alleviating the GI symptoms of IBS and have also been shown to positively inﬂuence some mood disorders associated with IBS. It should come as no surprise that people with IBS frequently suffer from depression and anxiety. Can you imagine trying to lead a normal life, but always needing to know where the closest bathroom is or having to take into account what color pants you wear each day because your bowels are unpredictable and painful.
A study conducted by researchers at McMaster University in Canada showed a link between a probiotic and mood improvement in people suffering from IBS.³ In this study, 44 IBS patients who also suffered from moderate depression and anxiety were divided into two groups. One group received daily doses of a probiotic that contained Biﬁdobacterium and the other group was given a placebo for six weeks. Individuals were asked to track their depression, anxiety and gastrointestinal symptoms throughout the study. At the end of six weeks, 64% of those who received the probiotic had improvements in depression scores, while only 32% of those in the placebo group reported these changes. Even four weeks after the end of the study, depression scores remained lower in the probiotic group.
The research went beyond just asking the participants about their feelings, they also used functional magnetic resonance imaging (fMRI) to measure brain patterns and noted improved depression in the probiotic group that was linked to changes in brain activity speciﬁcally in areas associated with mood regulation. This was a small study, and everyone involved agreed that larger human clinical trials will be needed to conﬁrm these ﬁndings, but the initial results are still exciting and promising for anyone suffering from IBS.
With multiple research teams, from multiple countries reporting these interesting and promising probiotic ﬁndings for IBS sufferers, the future sounds promising for a more natural approach to IBS symptoms through the balancing of the gut microbiota.
What to Look for in a Probiotic Product
Probiotics are live bacteria. So the most important consideration when selecting a useful probiotic is making sure that the beneﬁcial bacteria are actually alive and thriving when they reach you — anything else is just a waste of money. Check the label and look for a guarantee of potency through the expiration date. Products that only provide a guarantee at the time of manufacture may be substandard products.
Also, pay attention to the species of bacteria used in the supplement. The research presented here pointed predominantly to the use of Biﬁdobacteria for IBS and more speciﬁcally to Biﬁdobacterium infantis. Look for a probiotic that focuses solely on this strain so you can see if it will help you, without diluting it in a multi-strain supplement full of so many different bacteria that you’ll never know which one provided the ultimate results.
1. Reduction of butyrate- and methane-producing microorganisms in patients with Irritable Bowel Syndrome. Pozuelo,M., et al. 2015. Scientific Reports. 5, Article number:12693.
2. Efficacy of Bifidobacterium infantis 35624 in patients with irritable bowel syndrome: a meta-analysis. Yuan, F., et al. 2017. Current Medical Research and Opinion. Jul;33(7):1191-1197
3. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: a Pilot Study in Patients With Irritable Bowel Syndrome. Pinto-Sanchez, MI.,
et al. 2017. Gastroenterology.