Do Probiotics Help IBS?
Every IBS sufferer is looking for relief or even a way to eliminate the disorder, that's why millions are searching every month for help with their irritable bowel. One option is probiotics. Can probiotics Help IBS?
First, what are probiotics?
Probiotics are live microorganisms that may confer a health benefit on the host. In the past, there were other definitions of probiotics. The first use of the word “Probiotic” as microorganisms that have effects on other microorganism was accredited to Lilly and Stilwell (1965), expressed as follows: Substances secreted by one microorganism that stimulate another microorganism. Again, the term was used in 1971 by Sperti  to describe tissue extracts which stimulated microbial growth. The word was later described by Parker in 1974 who advanced the meaning of the term by adding the word organisms to the definition, thereby describing probiotics as “Organisms and substances that have a beneficial effect on the host animal by contributing to its intestinal microbial balance”. Later, the definition was greatly improved by Fuller in 1989, whose explanation was very close to the definition used today. Fuller in 1989 described probiotics as "live microbial feed supplement which beneficially affects the host animal by improving its intestinal microbial balance".
He stressed two important facts of probiotics: the viable nature of probiotics and the capacity to help with intestinal balance. Alternative expert review indicates there is insufficient scientific evidence for supplemental probiotics having a benefit. Lactic acid bacteria (LAB) andbifidobacteria are the most common types of microbes used as probiotics, but certain yeasts and bacilli may also be used. Probiotics are commonly consumed as part of fermented foods with specially added active live cultures, such as in yogurt, soy yogurt, or as dietary supplements. Probiotics are also delivered in fecal transplants, in which stool from a healthy donor is delivered like a suppository to an infected patient.
So probiotics are friendly bacteria that live in the gut and help us in some way. They can help reduce inflammation, create certain vitamins/minerals, kill bad bacteria, help digest food, help breakdown food, produce certain fluids and more.
But, can probiotics improve IBS? Can they help reduce or eliminate the symptoms? Here's some studies that may help us decide.
Probiotic Therapy for Irritable Bowel Syndrome
The etiology of irritable bowel syndrome (IBS) is thought to be multifactorial, with several factors (including alterations in gut motility, small-bowel bacterial overgrowth, microscopic inflammation, and visceral hypersensitivity) potentially playing a role. Recent studies have suggested that probiotics may be useful in the treatment of IBS. Although the exact mechanism for how probiotics may aid in the reduction of symptoms commonly found in IBS is unknown, the effects of probiotics on alterations in gut bacteria appear to play a part. This review focuses on recent studies examining the role of probiotics in the treatment of IBS.
Probiotics will likely have an emerging adjunctive therapeutic role in treating IBS. The studies to date simultaneously provide interesting observations and raise fundamental questions. Overall, many of the studies involved were small in size, of short duration, and had significant design flaws, but there is growing evidence that B. infantis is becoming the frontrunner for treatment of IBS. If larger, well-controlled studies involving other strains of probiotics are performed, we may begin to have other options regarding different probiotic species and for the treatment of more specific subsets of IBS symptoms.
Additional issues that still need to be determined include the most effective probiotic strain, dose, and duration of therapy; whether patients should be treated for specific IBS symptoms only; and whether there is a role for maintenance IBS therapy or only IBS therapy on an as-needed basis. In addition, cost-effectiveness analysis and safety profiles still need to be addressed in large, well-designed trials. As probiotics are not considered pharmaceutical drugs, they are not currently regulated by the US Food and Drug Administration, which would promote standardization for consistent clinical trials in the future.
Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care
Health-related quality of life (HRQoL) has been rarely evaluated as a primary endpoint in the assessment of the effect of probiotics on the irritable bowel syndrome (IBS).
To study the effects of fermented milk containing Bifidobacterium animalis DN-173 010 and yoghurt strains on the IBS in a multicentre, double-blind, controlled trial.
A total of 274 primary care adults with constipation-predominant IBS (Rome II) were randomized to consume for 6 weeks either the test fermented milk or a heat-treated yoghurt (control). HRQoL and digestive symptoms were assessed after 3 and 6 weeks on an intention-to-treat population of 267 subjects.
The HRQoL discomfort score, the primary endpoint, improved (P < 0.001) in both groups at weeks 3 and 6. The responder rate for the HRQoL discomfort score was higher (65.2 vs. 47.7%, P < 0.005), as was the decrease in bloating score [0.56 +/- (s.d.)1.01 vs. 0.31 +/- 0.87, P = 0.03], at week 3 in the test vs. the control group. In those subjects with <3 stools/week, stool frequency increased (P < 0.001) over 6 weeks in the test vs. control group.
This study suggests a beneficial effect of a probiotic food on discomfort HRQoL score and bloating in constipation-predominant IBS, and on stool frequency in subjects with <3 stools/week.
Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota.
Irritable bowel syndrome is the most common diagnosis in gastroenterology. Trials suggest certain probiotics to be beneficial.
To investigate the effects of multispecies probiotic supplementation (Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium animalis ssp. lactis Bb12) on abdominal symptoms, quality of life, intestinal microbiota and inflammatory markers in irritable bowel syndrome.
Eighty-six irritable bowel syndrome patients (Rome II criteria) participated in this randomized, placebo-controlled 5-month intervention. Patients were randomized to receive daily either multispecies probiotic supplementation or placebo. Irritable bowel syndrome symptoms, quality of life, microarray-based intestinal microbiota stability (n = 20), serum cytokines and sensitive C-reactive protein were monitored.
The composite irritable bowel syndrome score had at 5 months decreased 14 points (95% CI: -19 to -9) from baseline with the multispecies probiotic vs. three points (95% CI: -8 to 1) with placebo (P = 0.0083). Especially, distension and abdominal pain were affected. A stabilization of the microbiota was observed, as the microbiota similarity index increased with the probiotic supplementation (1.9 +/- 3.1), while it decreased with placebo (-2.9 +/- 1.7). No differences were seen in C-reactive protein.
This multispecies probiotic seems to be an effective and safe option to alleviate symptoms of irritable bowel syndrome, and to stabilize the intestinal microbiota.
The evidence is quite compelling, probiotics can help improve IBS (ir