Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

Most treatments for IBS consist of medications that are often ineffective and can have numerous side effects.

According to a review published this month in Nutrients, researchers investigated the outcome-specific efficacy of different probiotics strains or combinations in adults with IBS.

The research team searched the literature up to June 2023 and included all randomized controlled trials (RCTs) that evaluated the efficacy of probiotics in IBS. This review consisted of 9,253 participants from 81 RCTs. As a result, four probiotic strains and five mixtures were significantly superior to placebo in improving IBS Symptom Severity Scale. The Lactobacillus acidophilus DDS-1 was ranked first. A mixture containing five probiotics ranked first in improving the IBS-Quality of life. Bacillus coagulans MTCC 5856 and Bacillus coagulans Unique IS2 were among the most effective probiotics for improving abdominal pain. Three probiotic strains and two mixtures were effective in alleviating abdominal bloating. Four probiotic strains and a mixture were significantly superior to placebo in reducing the bowel movement frequency in diarrhea-predominant IBS (IBS-D). Bacillus coagulans MTCC 5856 and Saccharomyces cerevisiae CNCM I-3856 were among the most effective probiotics for improving the Bristol stool form scale of IBS-D. Only some probiotics were effective for particular outcomes in IBS patients. This study provided the first ranking of outcome-specific efficacy of different probiotic strains and combinations in IBS.

Dietary fiber should also be considered an essential nutrient for the growth of beneficial bacteria as a prebiotic. The included studies support that increasing the intake of fiber, particularly, soluble fiber, shows beneficial results in patients with GI symptoms and modulation of the gut microbiome.

The gastrointestinal tract is the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammatory effects, which help normalize and promote health bowel function and provide relief from GI symptoms. Another consideration is a concentrated form of IgG as Immunolin as serum bovine immunoglobulin for IBS-D. Immunolin promotes a healthy inflammatory response in the cells of the gastrointestinal tract as well as supports the intestinal barrier.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Xie, P, Luo M, et al. Outcome-Specific Efficacy of Different Probiotic Strains and Mixtures in Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis. Nutrients. 2023 Sep 4;15(17):3856.

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