From the Guidelines
The most effective probiotics for treating Irritable Bowel Syndrome (IBS) and bloating are not well established, due to the significant heterogeneity between studies and variability in the probiotic strains studied 1, 2, 3, 4, 5.
Key Findings
- Lack of standardization: The majority of evidence for probiotics in IBS is derived from single trials with small sample sizes and variable quality, making it difficult to draw firm conclusions 3.
- Multistrain probiotics: Some studies suggest a potential benefit of multistrain probiotics, including the 8-strain combination of L paracasei subsp paracasei, L plantarum, L acidophilus, L delbrueckii subsp bulgaricus, B longum subsp longum, B breve, B longum subsp infantis, and S salivarius subsp thermophilus 2, 3.
- Specific strains: Certain strains, such as L plantarum 299v, L rhamnosus ATCC 53103, and B coagulans MTCC 5856, may improve abdominal pain scores or global IBS symptoms in some studies, but the evidence is limited and inconsistent 3.
Probiotic Formulations
- 8-strain combination: The 8-strain combination of L paracasei subsp paracasei, L plantarum, L acidophilus, L delbrueckii subsp bulgaricus, B longum subsp longum, B breve, B longum subsp infantis, and S salivarius subsp thermophilus may be beneficial for some patients with IBS, but the evidence is not strong enough to support a universal recommendation 2, 3.
- Other formulations: Other probiotic formulations, such as S boulardii, L plantarum 299v, and B coagulans Unique IS2, may also be beneficial, but the evidence is limited and more research is needed to confirm their effectiveness 3.
Clinical Practice
- Individualized approach: Given the limited and inconsistent evidence, an individualized approach to probiotic use in IBS may be the most appropriate, taking into account the specific symptoms, disease severity, and patient preferences 4.
- Further research: More high-quality studies are needed to establish the efficacy and safety of probiotics in IBS, and to identify the most effective strains and formulations 1, 2, 3, 4, 5.
From the Research
Effective Probiotics for IBS and Bloating
- The most effective probiotics for treating Irritable Bowel Syndrome (IBS) and bloating include: + B. coagulans, which exhibited the highest probability of being the optimal probiotic species in improving IBS symptom relief rate, as well as global symptom, abdominal pain, bloating, and straining scores 6 + Lactobacillus acidophilus DDS-1, which ranked first in improving IBS Symptom Severity Scale 7 + Bacillus coagulans MTCC 5856 and Bacillus coagulans Unique IS2, which were among the most effective probiotics for improving abdominal pain 7
- Probiotic combinations, such as a mixture containing five probiotics, can also be effective in improving IBS-Quality of life 7
- The efficacy of probiotics can be influenced by treatment length, with longer treatment durations potentially leading to better outcomes 6
Probiotic Strains and Mixtures
- Different probiotic strains and mixtures have been shown to be effective for specific outcomes in IBS patients, including: + Lactobacillus, Bifidobacterium, and Bacillus for individual symptoms 8 + A combination of 2 Lactobacillus strains, one Bifidobacterium, and one Streptococcus for overall symptom improvement 8
- The optimal dose and duration of probiotic treatment are still unclear, but studies suggest that higher doses and longer treatment durations may be more effective 6, 8