Can Probiotics Help IBS Flare-Ups? Effective Strategies for Relief

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by changes in bowel habits, abdominal discomfort, and pain. Sometimes, symptoms worsen because of physiological and psychological changes. The effectiveness of many strategies, including probiotics, are researched to relieve IBS symptoms. Read more about how probiotics and other strategies help IBS flare-ups.

What is an IBS flare-up?

The term 'IBS flare-up' defines the times when IBS symptoms worsen. IBS flare-ups can be triggered by many factors, such as changes in diet and stress.

The exact cause of IBS is not known; however, genes, food intolerances, small bacterial overgrowth, infection, stress, and mental health disorders can contribute to the condition. The most common symptoms are abdominal bloating, pain, cramps, diarrhea, and constipation.

Do I need probiotics to manage IBS? What the research says

Probiotics are living microorganisms that can improve health when taken in adequate dosage. These beneficial microorganisms can improve gut microbiota balance. They’re naturally found in some fermented foods, such as yogurt, kefir, kimchi, and tempeh. Probiotic supplements containing different microorganism profiles and dosages are also available.

Probiotics can help manage IBS by improving gut microbiota balance. While research on how probiotics improve IBS is ongoing, it's believed that they may inhibit the growth and spread of pathogenic bacteria and enhance the function of the gut barrier. This barrier is vital for nutrient absorption and protection against foreign compounds.

A systematic review investigated the effects of probiotics on IBS symptoms. The review included eleven studies; seven reported significant improvement in IBS symptoms, while four did not find significant improvement upon probiotic use.

A meta-analysis of seventeen randomized controlled studies showed that probiotics significantly improved gut transit time (by around 12 hours), stool frequency (by 1.2/week), and stool consistency in patients with constipation-predominant irritable bowel syndrome (IBS-C).

Also, probiotics are shown to significantly improve global symptom score (GSS) in IBS twice more than placebo. GSS measures the overall severity of an improvement in IBS and can be used to measure changes before and after an intervention.

Another meta-analysis found that probiotics significantly improved quality of life but not depression or anxiety.

Unfortunately, the studies do not show consistent results, which may arise from the different interventions (such as different probiotic types, dosage, and duration), population, and size of participants. Therefore, it’s essential to consult your doctor to get a personalized approach to probiotic use. Your doctor can advise probiotics with specific strains, determine dosage and duration that may improve your IBS symptoms, and monitor changes.

How to choose the right probiotics for IBS?

Although most probiotics are sold without a prescription, when choosing probiotics, there are many factors to consider. For example, some probiotics may be effective in prevention but not treatment, and vice versa. It's important to detect why probiotics will be used, for what diseases, and the effective strains and combinations, dosage, and duration. Thus, consulting your doctor is best.

Let's say your doctor advised you to take probiotic supplements. How do you choose? Here are a few factors to consider:

Buy recommended CFU by your doctor. Probiotics generally contain 10⁶ to 10⁹ colony forming units (CFUs), representing the number of living cells. Look for probiotics containing the same CFUs as your doctor suggested.

Buy strains of your doctor's order. Probiotics contain a single or combination of strains. Different strains can be advised for different conditions. Therefore, look for probiotics containing the same strains or combination your doctor suggested.

Check the expiration or use-by date. Probiotics have expiration dates. When expiry or use-by-day passes, don't buy the supplement because the number of living microorganisms can decrease with time.

Search for quality. Note that probiotic supplements are not regulated by the FDA. These products don't need FDA approval before being displayed for sale. Thus, it's not always possible to know if the probiotic supplements you're buying contain precisely what they claim.

You can check for manufacturers that provide third-party laboratory testing certificates and are manufactured according to current good manufacturing practices (CGMP). CGMP certification may help ensure that the particular batch of the products contain exactly what the label claims and do not contain harmful substances.

Check other ingredients. Probiotic supplements can contain other ingredients, such as allergens or additives. If you're allergic or intolerant to any ingredients, choose a different product.

Store as recommended in the package. Different probiotic supplements require other storage conditions. Therefore, check the product's package and store it as instructed.

5 additional strategies for IBS flare-up relief

Many physiological and psychological factors can trigger IBS flare-ups. Food, anxiety, stress, hormonal changes, and infections can worsen the symptoms. Some interventions can soothe IBS flare-ups:

  • Stress relief and relaxation. Stress and anxiety can worsen IBS symptoms; therefore, psychological inerventions may help some patients. Relaxation techniques and treatments, such as cognitive behavioral therapy, could help improve symptoms.
  • Peppermint oil. It can temporarily help an IBS flare-up by relaxing intestinal muscles. Remember that peppermint oil can cause heartburn or acid reflux in some people.
  • Dietary changes. Foods are a common trigger for IBS symptoms. Patients may have various food intolerances (such as gluten intolerance), or some experience worsening symptoms if they consume dairy, sweeteners, caffeine, and carbonated drinks. Identifying trigger foods and adopting a healthy and balanced diet with the help of a dietitian and doctor can help relieve symptoms.
  • Exercise. Regular exercise can ease symptoms. You can start with 150 minutes of moderate-intensity aerobic activity, such as fast walking, hiking, cycling, dancing, and water aerobics.
  • Medication. Your doctor can prescribe medications to help with constipation or diarrhea. It’s best not to take over-the-counter constipation or diarrhea medication since constipation medication can cause diarrhea, and diarrhea medication can cause constipation, which worsens symptoms in some patients. Also, antibiotics and antidepressants can be prescribed to some patients as well.

More research is needed to determine effective interventions for IBS relief. Consult your doctor for advice on interventions that could help improve your symptoms.

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