Probiotics for IBS: To Use or Not to Use? That is The Question

Published on: 07/24/2018

Probiotics are a hot topic these days. Articles in magazines highlight them, supplements are growing in greater numbers, and they are also added to certain foods. Why do probiotics get so much attention? And should you take them if you have IBS? Let’s find out.

What Are Probiotics?

Probiotics are microorganisms that can live in our gut and might improve gut health. The scientific definition is: “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”.

Some of these potential gut benefits include fighting off bad bacteria, protecting the lining of our intestinal tract, and minimizing intestinal permeability (also known as “leaky gut”). Studies on people with IBS are suggesting that they may also improve some symptoms.

Should You Take a Probiotic Supplement for IBS?

It would seem natural for someone with IBS to think about trying one, but should you? It’s a big question without an easy or straightforward answer. Here are a few key points from the emerging literature:

  • After only 3-4 weeks of a low FODMAP elimination diet, gut bacteria decrease in numbers and variety and probiotics may be useful in restoring them. However, this is not necessary as, when you reintroduce FODMAPs back into your diet, gut bacteria bounce back.
  • A lot of research has been done to study the effects of probiotic supplementation in people with IBS but we don’t yet have all the answers and there isn’t enough consensus to give firm recommendations.
  • Nonetheless, probiotics seem generally safe to use, and if you’d like to try one there doesn’t seem to be any harm in doing so.

Recommendations When Trying a Probiotic

If you decide to give probiotic supplements a try, researchers at Monash University recommend that you:

  • Don’t expect miracles, the improvement in symptoms may be mild at best.
  • Take them consistently for 4 weeks as it may take that long to see any benefits.
  • Make sure there aren’t any prebiotic fibers mixed with the probiotic supplement (such as inulin or fructooligosaccharides), as they may trigger IBS symptoms.
  • Those who are most likely to benefit are IBS patients with mild symptoms and those with a compromised microbiome, such as in post-infectious IBS.
  • Test only one management strategy at a time: try the low FODMAP diet first, then consider probiotics.
  • Ask your doctor or gastroenterologist to recommend a product that has been researched for IBS and is most suitable for your symptom profile.

What About Probiotics in Food?

Last but not least, probiotics may be naturally present in some fermented foods, which still contain live bacteria. You may want to consider including some low-FODMAP probiotic foods in your diet:

  • Lactose-free yogurt and kefir (look for “Contains live and active cultures” on the nutrition label)
  • Very small amounts of sauerkraut, kimchi, or kombucha

After you have completed the reintroduction phase of the low FODMAP diet, you may expand the range of probiotic-rich foods. If you tolerate lactose, you can use regular yogurt and kefir. In addition, if you find that mannitol and oligosaccharides are not a trigger, you may be able to eat bigger portions of sauerkraut or kimchi (beware that some may also contain garlic), and drink higher amounts of kombucha.

Final thought

In summary, although we still don’t know the exact probiotic strains and amounts that can help with IBS symptoms, some people may benefit from taking a probiotic supplement. As there are so many supplements in the market, it’s ideal to consult with your doctor or a dietitian specializing in IBS to find out which one(s) may be worth a try. You could also start by adding some fermented foods to your diet. Unlike pills, they come packaged with nutrients and confer more benefits.

Want to learn more?

Check out more IBS Diet Basics

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I’m a registered dietitian with a passion for helping women with IBS find their way back to eating without fear of painful gut symptoms and without unnecessary diet restrictions.

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