The Best Probiotic Strains for Irritable Bowel Syndrome – IBS

What is IBS?

Irritable bowel syndrome is a chronic (ongoing) disease distinguished by abdominal discomfort, together with bloating, gas and either constipation or diarrhoea.

Its causes are debated but overgrowth of harmful bacteria, infection and inflammation in the intestines are certainly involved.

IBS affects significantly more women than men and up to 20% of the overall population in the UK. It is diagnosed as a specific illness when you have at least one episode of abdominal pain per week.

There are actually four medically identified types of IBS:

IBS-D: Diarrhoea-predominant

Frequent loose bowel movements and cramping pain/sense of urgency.

IBS-C: Constipation-predominant

Infrequent bowel movements, usually accompanied by pain/sense of blockage.

IBS-M: Alternating between diarrhoea and constipation

Also called "Mixed". Commonly with more frequent pain.

IBS-U: Unspecified

For people who do not fit into one of the above categories, although this is often after an infection. Symptoms vary, but with gas, bloating and discomfort.

In almost all cases, bloating is a factor, and in most, excessive gas and abdominal pain, too.

And in addition to the often distressing physical symptoms, IBS can cause mood problems and even depression, via the well-identified gut-brain connection. Sleep disturbance is quoted by some 60% of sufferers, leading often to a general feeling of lethargy and tiredness.

So tackling the root cause of IBS is a priority.

What is the root cause of IBS?

Your gut is home to trillions of bacteria – many beneficial and indeed vital for overall health, for a strong immune system, for weight maintenance, and even for creating certain vitamins like vitamin K.

But some bacteria are harmful. It is when these harmful bacteria become too great a proportion of the overall gut flora – termed overgrowth – that trouble flares. Over 80% of IBS patients suffer from this overgrowth, which causes sensitivity and inflammation.

So overgrowth of harmful bacteria is at least one cause – and probably the key cause – of IBS.

How do probiotics help in IBS?

When you take probiotics (good bacteria), you begin to change the balance of ‘good’ to ‘bad’ bacteria in favour of the good – and IBS inflammation and symptoms start to reduce.

The total bacteria in your intestines is collectively called your Gut Microbiome. People with a higher diversity of bacterial species and strains of bacteria are generally more healthy.

The Canadian Society for Intestinal Research has usefully summarised the ways probiotics work as follows.

1. Lining the surface of the gastrointestinal tract and stopping harmful organisms from reaching it - competitive exclusion
2. Strengthening the tissue of the bowel wall
3. Acting as antibiotics against other bacteria, and
4. Regulating the responses of the immune system, both at the level of the bowel wall and the body as a whole.

The most effective strains of probiotic are vital to help IBS

Studies show that people with IBS have lower amounts of the good bacteria Lactobacillus and Bifidobacterium in their guts, and they have higher levels of harmful E. coli and Clostridium difficile.

By increasing the level of the beneficial Lactobacillus and Bifidobacterium probiotics, you crowd out and help neutralise the harmful or pathogenic bacteria.

The result is to inhibit the growth of disease-causing bacteria, to combat inflammation, to reduce gas and bloating pain and regularise bowel movements.

But all these benefits depend on consuming the most effective strains of probiotic.

By analysing the literature on probiotics and IBS it is possible to identify the most effective strains for Irritable Bowel Syndrome which are:

Lactobacillus plantarum / L. plantarum

78% of IBS sufferers in a well-designed study reported it as good or excellent in reducing IBS pain and bloating

Bacillus coagulans / B. coagulans

Shown to improve multiple symptoms including diarrhoea and stool frequency. Bacillus coagulans is an exceptionally hardy strain that colonises well in the gut - albeit it is expensive and therefore not found in many probiotic supplements.

Lactobacillus rhamnosus / L. rhamnosus

An important strain for IBS generally that also (coupled with L. plantarum and Bifidobacterium lactis) reduces constipation

Lactobacillus acidophilus / L. acidophilus

Shown to reduce pain and bloating in 64% of patients, when included with Bifidobacterium lactis.

Bifidobacterium lactis / B. lactis

Shown to reduce pain in 64% of patients when included with Lactobacillus acidophilus.

Lactobacillus casei / L. casei

Irritable bowel syndrome patients tend to have an overgrowth of the well-known harmful bacteria strain Escherichia coli (E. coli). A 2013 study showed that Lactobacillus casei was able to inhibit the impact of this common pathogenic bug.

Streptococcus thermophilus / S. thermophilus

Although Streptococcus thermophilus does not directly help address IBS, it should be included in any effective multi-strain probiotic. This is because it is very resistant to the harsh, hot, acidic conditions in the gut (‘thermophilus’ means heat-loving). It kickstarts the general fermenting process in the gut which then helps the other strains colonise.

Streptococcus thermophilus works synergistically with other strains and research shows improves gut health generally and robust immune system response in particular.

MicroBiotic Plus Probiotic supplement

You can find all these strains in the probiotic supplement Microbiotic Plus.

We created this supplement drawing on research referenced below and development work by the University of Nebraska, which has been a leading centre of probiotic research for over 40 years.

Bonus Benefits of Multi-Strain Probiotics

The good news is that the above combination of probiotic strains will also help strengthen your immune system, will help fight yeast infections, and will stimulate the production in the gut of a natural anti-viral called L-lysine. Recent studies in the American Journal of Clinical Nutrition also reported milder symptoms during the spring allergy season with a multi-strain probiotic.

✅ After Antibiotics

There is solid evidence for the use – possibly even need – for probiotic supplementation after a course of antibiotics.

This is because antibiotics kill good as well as bad bacteria. So re-colonising with good bacteria after a course of antibiotics is increasingly recommended by health professionals.

✅ Reduction in Cholesterol

A fact sheet from the US National Institutes for Health also suggests that a probiotic supplement could help reduce cholesterol levels:

“Overall, research suggests that the use of multiple probiotic strains in combination as well as of probiotics containing Lactobacillus acidophilus, a mixture of Lactobacillus acidophilus and Bifidobacterium lactis, or Lactobacillus plantarum might reduce total and LDL cholesterol levels. However, more research is needed to confirm these findings”.

✅ Improvement in mood and reduction in depression

New Scientist reported in 2018 on the development of what they called psychobiotics – probiotics that can reduce the symptoms of depression. This follows new and extensive research on the way the composition of the gut affects the brain via the gut-brain axis.

Facts about probiotic supplements that you should know

The number of CFUs and strains

Probiotics are measured in colony forming units (CFU), which indicate the number of viable cells. Amounts may be written on product labels as, for example, 1 x 10⁹ for 1 billion (1,000,000,000) CFU or 1 x 10¹⁰ (10,000,000,000) for 10 billion CFU.

Some probiotic brands appear to contain as many as 50 billion CFUs. However, the US National Institutes of Health (NIH) in a Fact Sheet for Health Professionals warns that:

“Higher CFU counts do not necessarily improve the product’s health effects.”

and

“Only trials of multi-strain products found a clinically meaningful improvement in quality of life.”

And use reliable brands

The NIH also cautions to use reliable brands:

“The quoted mass of a probiotic can consist of both live and dead microorganisms and, therefore, has no relationship with the number of viable microorganisms in the product.”

“Because probiotics must be consumed alive to have health benefits and they can die during their shelf life, users should look for products labelled with the number of CFU at the end of the product’s shelf life, not at the time of manufacture.”

In plain English, many of the ultra-high counts may be exaggerated. Some brands claim on the pack (in large letters) that they are using, for example, raw material that contains 20B (20 billion) CFU of probiotics per gram. But on closer inspection, the actual dose per capsule is 100 mg ie. one tenth of a gram or 2B (2 billion) per capsule.)