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.
When it comes to managing IBS, foods with Lactobacillus or Bifidobacterium bacteria show promise.
But there’s still not enough evidence that they definitely work.
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.
People with IBS-D who took a supplement containing L. plantarum for 8 weeks reported that they were less bloated — and that IBS symptoms were interfering less with their lives.
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.
The team found that probiotics could reduce constipation, but they called for more high-quality research.
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.
You can find B. bifidum in some fermented foods, like yogurt, kefir, and sauerkraut.
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.
Some research suggests that certain strains of Lactobacillus and Bifidobacteria bacteria could help with IBS. But we need more research to back it up.
You can find probiotic strains of bacteria in many fermented foods, such as yogurt and kefir.
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.
You may be better off with fermented foods that are low in FODMAPs, like miso paste and kimchi.
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.
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:
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.
Research shows that foods as well as supplements can deliver probiotics to your gut.
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.
It’s also important to be aware of the disadvantages of getting your probiotics from supplements instead of whole foods.
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:
Peppermint oil: There’s some evidence that it can help with IBS symptoms. But some participants reported acid reflux as a side effect.
Reducing caffeine intake: In one study, participants with higher caffeine intakes were more likely to have IBS.
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.
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.
Exercise: Studies show that exercise can help with IBS symptoms, particularly bloating and abdominal pain.
Acupuncture: One trial with over 500 people found that acupuncture significantly reduced IBS symptoms, compared with medication.
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.
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.
If you’re looking for ways to manage your IBS, it’s best to look at your diet as a whole, as well as your gut health.
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.
Association of coffee and caffeine intake with irritable bowel syndrome in adults. Frontiers in Nutrition. (2021). https://pubmed.ncbi.nlm.nih.gov/34211993/
Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients! World Journal of Gastroenterology. (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467063/
Effect of acupuncture in patients with irritable bowel syndrome: A randomized controlled trial. Mayo Clinic Proceedings. (2020). https://pubmed.ncbi.nlm.nih.gov/32499125/
Effectiveness and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: A systematic review and meta-analysis of 10 randomized controlled trials. Nutrients. (2022). https://www.mdpi.com/2072-6643/14/12/2482
Efficacy of the low-FODMAP diet for treating irritable bowel syndrome: The evidence to date. Clinical and Experimental Gastroenterology. (2016). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918736/
Heat-inactivated Bifidobacterium bifidum MIMBb75 (SYN-HI-001) in the treatment of irritable bowel syndrome: A multicentre, randomised, double-blind, placebo-controlled clinical trial. The Lancet Gastroenterology & Hepatology. (2020). https://pubmed.ncbi.nlm.nih.gov/32277872/
Lactobacillus plantarum CCFM8610 alleviates irritable bowel syndrome and prevents gut microbiota dysbiosis: A randomized, double-blind, placebo-controlled, pilot clinical trial. Engineering. (2021). https://www.sciencedirect.com/science/article/pii/S2095809920303714
Mindfulness‐based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness. Neurogastroenterology & Motility. (2020). https://pubmed.ncbi.nlm.nih.gov/32266762/
Prebiotics in irritable bowel syndrome and other functional bowel disorders in adults: A systematic review and meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition. (2019). https://pubmed.ncbi.nlm.nih.gov/30949662/
Systematic review and meta‐analysis: Efficacy of peppermint oil in irritable bowel syndrome. Alimentary Pharmacology & Therapeutics. (2022). https://eprints.whiterose.ac.uk/190294/3/APT-1040-2022R1%20CLEAN.pdf
The comparison of food and supplement as probiotic delivery vehicles. Critical Reviews in Food Science and Nutrition. (2016). https://pubmed.ncbi.nlm.nih.gov/25117939/
The efficacy and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: A systematic review and meta-analysis based on seventeen randomized controlled trials. International Journal of Surgery. (2020). https://www.sciencedirect.com/science/article/pii/S1743919120303630
The impact of a twelve-week moderate aerobic exercise program on gastrointestinal symptom profile and psychological well-being of irritable bowel syndrome patients: Preliminary data from a southern Italy cohort. Journal of Clinical Medicine. (2023). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455088/
The unregulated probiotic market. Clinical Gastroenterology and Hepatology. (2019). https://pubmed.ncbi.nlm.nih.gov/29378309/
Yogurt, cultured fermented milk, and health: A systematic review. Nutrition Reviews. (2021). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579104/