Can probiotics help with irritable bowel syndrome symptoms?

Some people with irritable bowel syndrome (IBS) might find that probiotics help manage their symptoms.

Probiotics are foods or supplements that contain beneficial live yeast or bacteria. These are similar to the microbes that live in your gut. 

Some people see probiotics as a possible treatment because the gut microbiome may play an important role in IBS symptoms.  

The gut microbiome is the name for the trillions of microbes that live in your gut. It has a big impact on your health. 

Since everyone’s gut is different, and because there are different types of IBS, the best ways to manage this condition vary from person to person. 

Which probiotics might help?

Let’s look at how different probiotics might help with different types of IBS. 

Which probiotics could help IBS with diarrhea?

When this condition causes diarrhea, it's sometimes called IBS-D. Compared with healthy people, people with IBS-D tend to have a less diverse range of gut bacteria.

Diversity, including many beneficial bacteria, is key to a healthy gut microbiome.

A trial that included IBS-D patients found that a strain of bacteria called Lactobacillus plantarum may help.

The scientists also looked at the participants' poop samples before and after they took the supplement. The participants had more “good” bacteria and a more diverse range of gut bacteria overall at the end of the trial. 

This suggests that L. plantarum could help with gut health and IBS-D symptoms.

Many fermented food products, including some yogurt and sauerkraut, contain this probiotic bacteria.

Which probiotics could help IBS with constipation?

If you have IBS with constipation (IBS-C), there’s less clear evidence that specific probiotics can help. 

One meta-analysis looked at 10 studies that had included people with IBS-C.

Also, there was no evidence that probiotics helped with abdominal pain, bloating, or the overall quality of life. 

Another review was more optimistic. 

Still, there’s not enough research to suggest that specific probiotic bacteria can relieve IBS-C symptoms.

Which probiotics could help with IBS in general?

Some studies have looked at all types of IBS. In one trial, a Bifidobacterium bifidum supplement helped relieve symptoms.

This study was particularly exciting because the scientists used inactive bacteria, which might be safer for people who are very ill or have weakened immune systems.

Things to bear in mind

While some research has been promising, there’s been a lot of variation in the results. Right now, we can’t say for sure whether a particular probiotic will help with IBS.

If you’re living with IBS symptoms, you could try adding different probiotic foods to your diet to see if it helps. 

To keep track, it’s a good idea to note down your meals and your symptoms in a food journal. 

Can probiotics make IBS worse?

Probiotics themselves are unlikely to make IBS worse.

However, some probiotic-rich foods contain other substances that could worsen your symptoms.

Fermented foods are an excellent source of probiotics. But some people with IBS may not be able to tolerate large amounts.

Some common fermented foods — like yogurt, kombucha, and sauerkraut — have high levels of sugars called FODMAPs, which can make IBS symptoms worse. 

When you have IBS, it’s important to make any dietary changes gradually. This gives your gut time to adjust. It also gives you time to notice any changes to your IBS symptoms.

In general, introducing small amounts of fermented foods into a varied, balanced diet can be beneficial for your health.

However, fermented foods aren’t a cure for IBS, and they won’t necessarily help with your symptoms.

To learn more about the science behind diet and nutrition, check out ZOE’s newsletter. You can subscribe using the banner below.

Join the community

Be the first to know about ZOE’s breakthrough research, content from the world’s leading scientists, and more.

How might prebiotics affect IBS?

Prebiotics are different from probiotics. 

As we’ve covered above, probiotics are foods that contain helpful live bacteria or yeast.

Prebiotics, on the other hand, contain “food” for your beneficial gut bacteria. These foods are usually types of fiber. 

Good sources of prebiotics include:

• mushrooms

• onions

• artichokes

• asparagus

• oats

• almonds

• apples 

These plant foods may provide other health benefits, but scientists don’t think prebiotics are useful for managing IBS. 

A review of 11 studies found no evidence that prebiotics can improve IBS symptoms. 

Also, overly large doses of prebiotics can cause side effects, like gas, bloating, and diarrhea, in people with IBS.

And like some fermented foods, many sources of prebiotics are high in FODMAPs, which can make IBS symptoms worse for some people.

Do supplements work?

The market for products with probiotics is huge. And you can get the benefits of probiotics without paying for expensive supplements. 

And food sources contain other nutrients that help the probiotic bacteria work. 

Plus, most probiotic foods also have other health benefits. For example, yogurt can improve your gut, bone, and heart health. And it can lower the risk of type 2 diabetes. 

To learn more about which foods contain probiotics and how to add them to your diet, check out this article.

Probiotic supplements aren’t regulated in the same way as medicines — unless the supplement claims it can help with a specific disease. 

Regulatory agencies focus on whether manufacturers’ claims are true, not whether a supplement is safe, effective, or high-quality. 

It’s difficult to know if you can trust the claims that manufacturers make. And even if their promises are made in good faith, everyone responds to probiotics differently. Our digestive systems are all slightly distinct.

Other ways to manage IBS

Everyone with IBS has a different experience. Trying different approaches and changing your routine will help you find out what works best for your body. 

Below are strategies that have some scientific backing:

1. The low-FODMAP diet: Experts designed this diet for people with IBS. While it might feel restrictive at first, scientific evidence suggests that it’s effective. 

2. Peppermint oil: There’s some evidence that it can help with IBS symptoms. But some participants reported acid reflux as a side effect. 

3. Reducing caffeine intake: In one study, participants with higher caffeine intakes were more likely to have IBS. 

4. Drinking less alcohol: Alcohol use and IBS aren't strongly linked in the general population. But there’s evidence that IBS symptoms may be worse if you have more than 4 drinks in a day. 

5. Avoiding spicy foods: Many people with IBS say that spicy food can trigger symptoms. Spicy meals also often contain FODMAPs, like onion and garlic, which may be behind IBS symptoms.

6. Exercise: Studies show that exercise can help with IBS symptoms, particularly bloating and abdominal pain.  

7. Acupuncture: One trial with over 500 people found that acupuncture significantly reduced IBS symptoms, compared with medication. 

8. Mindfulness: One study showed that mindfulness-based stress reduction training helped with IBS symptoms. 

Different techniques will help different people. The best way to find out what works for you is through trial and error. Commit to one intervention at a time, and see how you feel. 

For more tips on managing your IBS symptoms, check out the ZOE Science & Nutrition podcast on IBS.

Summary

Overall, there’s some evidence that probiotics can help relieve IBS symptoms, particularly if you have IBS-D. 

The strategies in the list just above might also help. But none is a magic cure. 

ZOE runs the largest study on gut health in the world. Our research has identified certain “good” gut bacteria linked with better health and certain “bad” gut bacteria associated with worse long-term health. 

The ZOE at-home test will tell you everything you need to know about what’s going on in your gut — along with how your blood sugar and fat levels respond to different foods.

With this information, we can provide nutrition advice that’s tailored to your unique gut microbiome.

To find out how it works, take our free quiz.