From the Guidelines
Probiotics are a recommended treatment option for patients with Irritable Bowel Syndrome (IBS), as they have been shown to improve global symptoms and abdominal pain in clinical studies. The British Society of Gastroenterology guidelines on the management of IBS suggest that probiotics, particularly combinations of probiotics, Lactobacillus, Bifidobacterium, and Escherichia, can be effective in reducing symptoms 1.
Key Considerations
- The optimal duration of probiotic treatment is up to 12 weeks, and patients should discontinue treatment if there is no improvement in symptoms 1.
- The choice of probiotic strain and formulation can vary, but combinations of probiotics, Lactobacillus, and Bifidobacterium species have shown benefit in clinical studies.
- Probiotics are generally safe, but may cause temporary gas and bloating when first started.
- Patients should use quality products from reputable manufacturers that guarantee potency through the expiration date and store them according to package instructions.
Clinical Evidence
The AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders suggest that probiotics may be beneficial in treating IBS, but the evidence is limited by significant heterogeneity in study design, outcome, and probiotics used 1. However, the British Society of Gastroenterology guidelines provide more specific recommendations on the use of probiotics in IBS, based on a meta-analysis of 37 RCTs and 6352 patients 1.
Patient Guidance
Patients with IBS who wish to try probiotics should be advised to take them for up to 12 weeks and discontinue treatment if there is no improvement in symptoms. They should also be aware of the potential for temporary side effects, such as gas and bloating, and choose a high-quality product from a reputable manufacturer. Overall, the use of probiotics in IBS is supported by clinical evidence, and patients should be encouraged to try them as a treatment option.
From the Research
Probiotics for Irritable Bowel Syndrome (IBS)
- Probiotics have been studied as a potential treatment for IBS, with some studies suggesting they may be beneficial in improving global IBS symptoms 2, 3, 4, 5, 6.
- The evidence for the efficacy of probiotics in IBS is generally considered to be low to moderate, with some studies showing significant improvements in symptoms and others showing no benefit 5.
- Different probiotic strains and combinations may have different effects on IBS symptoms, with some strains (such as Escherichia and Lactobacillus) showing more promise than others 5.
- Multi-strain probiotics may be more effective than single-strain probiotics in improving IBS symptoms, particularly when supplemented over a period of 8 weeks or more 6.
Recommended Approach to Using Probiotics for IBS
- Probiotics may be considered as an adjunctive treatment to routine management of IBS, particularly in patients who have not responded to traditional symptom-based therapies 2, 3.
- A pretreatment gut microbiome analysis may help tailor a personalized probiotic regimen to optimize treatment effects 3.
- Patients with IBS should be advised to consult with their healthcare provider before starting probiotic supplements, as the evidence for their efficacy is still emerging and more research is needed to fully understand their effects 5.
Key Findings from Studies
- A 2021 study found that adjunctive treatment with probiotics partially alleviated symptoms and reduced inflammation in patients with IBS 3.
- A 2020 study found that Lactobacillus paracasei HA-196 and Bifidobacterium longum R0175 may reduce GI symptom severity and improve psychological well-being in individuals with certain IBS subtypes 4.
- A 2023 systematic review and meta-analysis found that some probiotics may be beneficial in IBS, but the certainty of the evidence was generally low to very low 5.
- A 2019 systematic review found that multi-strain probiotics supplemented over a period of 8 weeks or more may have the potential to improve IBS symptoms 6.