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Broad and learned
clinical background

Gut Reaction #33: Probiotics for irritable bowel syndrome (updated version)

Irritable Bowel Syndrome (IBS) affects up to 20% of the UK population with women at least twice as likely to be affected as men. Common symptoms include bloating, constipation, diarrhoea and abdominal discomfort.

While many help their symptoms by changing diet such as avoiding foods high in FODMAPS, this blog will examine the positive effects that probiotics may have on IBS by modifying the balance, or biodiversity, of the gut bacteria or microbiome. Probiotics are defined as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host.”

So, how may a probiotic help to reduce IBS symptoms?

  1. Probiotics may give a boost to the numbers of “friendly bacteria” in the gut. There is some evidence, albeit limited, that the bacterial biodiversity may be altered in individuals with IBS.
  2. An improvement in “friendly bacteria” may help to break down the FODMAPS foods that may exacerbate IBS.
  3. A change in the biodiversity of the gut microbiome may also play a role in modulating the gut’s nervous system, thus reducing the impact of stress on the gut.

Here, I mention 3 probiotics that, to the best of my knowledge, were shown in clinical trials to be significantly better than placebo at relieving symptoms in individuals with IBS.

Symprove is a water-based probiotic that contains four live strains of the ‘friendly bacteria’ lactobacillus available from the internet or directly from the manufacturer. About 70mls of Symprove is drunk at the start of the day, 10 minutes before eating or drinking anything, for 12 weeks. Once a bottle is opened it must be stored in a fridge.

It was shown in a large clinical trial to help IBS. Researchers at London’s King’s College Hospital found that more individuals with moderate-severe IBS achieved remission after a 12 weeks course of Symprove than those taking placebo (an identical looking and tasting supplement but one which didn’t contain any bacteria).

Bio-Kult contains a total of 14 different strains of 5 different bacteria and a minimum of 2 billion live bacteria per capsule. It is taken once or twice daily for at least 28 days and if of benefit, may be used long term. Bio-Kult does not need to be stored in a fridge, is stable at room temperature and has a long shelf-life. The capsules were shown in the laboratory to resist acid or up to 2 hours implying they should survive the acidic environment of the human stomach. A randomized, controlled trial in India found that Bio-Kult was significantly more effective than placebo in individuals with IBS with diarrhoea.

Alflorex, a single strain (Bifidobacterium infantis3564) probiotic is taken once daily in capsule form for a minimum of 28 days.  A single Alflorex capsule contains around 1 billion live bacteria. It was shown to be significantly better than placebo in a large study in women with IBS.

For more information about these treatment options, please do not hesitate to contact Dr. Adam Harris.