What are probiotics?

Although people tend to think that bacteria are harmful germs that can make you ill, there are many types that are good for our health. The gut contains trillions of bacteria that are important for helping us to stay healthy.

Probiotics are ‘good’ bacteria that can be found in food products or supplements. They can improve the balance and function of the gut bacteria, which help with food digestion and absorption. Probiotics are found in tablets, capsules, sachets and some yoghurts.

How do probiotics work?

Many probiotics have been shown to help restore the balance of gut bacteria, helping to evict potentially harmful bacteria. They also help stimulate our immune system so help us fight infections and also help us to digest fibre that is in our diet.

Probiotics and IBS

Certain probiotics may help reduce the symptoms of IBS, particularly bloating. Probiotics work by targeting specific strains of bacteria so what works for one person may not work for another. Dietitians recommend taking them for four weeks and if they don’t work for you, try another brand or stop taking them. They won’t work for everyone. Ask your GP or registered dietitian for the best type of probiotic to take for your symptoms.

Do probiotics work?

Not enough research has been conducted on any one product or any particular IBS symptom to come to any product specific recommendations for use in clinical practice. It’s a case of some of the products helping some people some of the time.

Not only is there variation among people, their symptoms and their colonic microflora, there is also enormous variability in the different products of probiotics. This is in terms of dose, strain, species and mixture of bacteria, the dosage form (capsule or liquid), the carrier (yoghurt, fruit juice, fermented barley), the shelf life of live products, and whether or not the bacteria survive passage through the acid in the stomach.

Should you believe the patient testimony?

Many products are supported by patient testimonies. The importance of the placebo effect cannot be underestimated in the treatment of IBS, especially for products that attract so much media interest. We all want to believe that something will relieve our symptoms, however, just because it has worked for one person, doesn’t mean it will work for you. So, persevere and if one brand doesn’t work, try another brand.

How long should I take a probiotic?

The National Institute of Clinical Excellence (NICE) advises that those with IBS who want to try a probiotic should do so for at least four weeks while monitoring the effect. Probiotics should be taken at the dose recommended by the manufacturer.

Are probiotics safe?

Probiotics are generally safe for healthy people, but those with a sensitive gut may find one brand of probiotic may not work or may upset them. Therefore, it is important to speak to a medical professional before taking a probiotic.

What products have evidence of efficacy?

The following products have some evidence of efficacy as a treatment for IBS (in alphabetical order).

  • Actimel           liquid
  • Alflorex          capsule
  • Biocare          capsule
  • Bioflora          capsule
  • Duolac           capsule
  • Lab 4              capsule
  • Multibionta    multivitamin tablet
  • Orchard Maid liquid
  • VSL~3            liquid
  • Yakult             liquid

It might be best to choose a multi-strain product that survives passage through the stomach, though single strain products that may not survive gastric passage can also work.

More information on probiotics is available here.