Probiotics for irritable bowel syndrome

Posted on Mon, 30 May 11

Probiotics are widely claimed to help relieve irritable bowel syndrome (IBS) and while some do, others may not work at all and some may even make things worse. Not all probiotics are the same and it pays to know the difference.

In general most probiotic supplements have shown some promise for IBS relief however not all probiotics are created equal, different probiotic strains may have very different clinical effects. Not surprisingly studies in IBS have been mixed.

What actually works?

For example a recent study found that a probiotic supplement actually made symptoms worse (1) while previous studies have shown some probiotics have no effect (2) and others provide relief from only certain symptoms such as bloating (3). However several probiotics may provide substantial overall relief (4).

So, if you are considering using a probiotic for IBS it pays to use one that has been shown to improve the condition in a clinical study. Here are a few that have (from Haller et al 2010).

Probiotic strains shown to benefit IBS

• L. plantarum strain 299V: Significantly reduced pain and tendency to improvement in constipation and bloating.

• Mixture of L. plantarum strain LP01 and B. breve strain BR03: Significantly reduced pain and overall symptom severity.

• L. acidophilus strain LA02: Significantly reduced pain and overall symptom severity.

• Mixture of: L. rhamnosus strain GG, L. Rhamnosus strain LC 705, P. freudenreichii shermanii strain JS, B. breve strain Bb99: Significantly reduced overall symptoms and bloating.

• L. salivarus strain UCC4331:  Reduced abdominal pain/discomfort, bloating, and straining

• B. infantis strain 35624:  Reduced overall symptoms.

• B. longum strain W11: Significantly increased stool frequency in IBS-constipation and reduced pain and bloating.

• E. coli strain DSM 17252: Significant improvement in overall symptoms and pain.

• LAB4 (mix): L. acidophilus strain CUL60 CUL21, B. lactis strain CUL34, B. bifidus strain CUL20;  Significantly improved overall symptoms, quality of life, days with pain, and satisfaction with bowel habit.

•  Mixture of L. rhamnosus strain GG (ATCC 53103), L. rhamnosus strain Lc705 (DSM 7061), P. freudenreichii shermanii strain JS (DSM 7067), B animalis strain Bb 12 (DSM 15954): Significantly decreased overall bowel symptoms, as well as in abdominal pain and bloating.

You may need to do a bit of research to look beyond potentially misleading marketing claims and find a probiotic supplement that has been shown to actually work, but it could be worth the extra effort.  

Note: What strain is that?

How probiotics are named: Lactobacilus (genus), plantarum (species), 299v (strain).

Sources:

1. Ligaarden SC, Axelsson L, Naterstad K, Lydersen S, Farup PG. A candidate probiotic with unfavourable effects in subjects with irritable bowel syndrome: a  randomised controlled trial. BMC Gastroenterol. 2010 Feb 10;10:16.

2. Niv E, Naftali T, Hallak R, Vaisman N. The efficacy of Lactobacillus reuteri ATCC 55730 in the treatment of patients with irritable bowel syndrome--a double blind, placebo-controlled, randomized study. Clin Nutr. 2005 Dec;24(6):925-31.

3. Bausserman M, Michail S. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr. 2005 Aug;147(2):197-201.

4. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008 May 7;14(17):2650-61.

5. Haller D, et al Guidance for substantiating the evidence for beneficial effects of probiotics: probiotics in chronic inflammatory bowel disease and the functional disorder irritable bowel syndrome. J Nutr. 2010 Mar;140(3):690S-7S.