Probiotics for Irritable Bowel Syndrome: A Comprehensive Guide

Probiotics for Irritable Bowel Syndrome: A Comprehensive Guide

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders in the United States, impacting between 25 and 45 million individuals. This staggering statistic has garnered the attention of scientists and medical providers alike in uncovering potential treatment options for patients that are effective and safe.

Probiotics, the beneficial microorganisms in the human digestive tract, have become a topic of research due to their potential role in managing IBS symptoms. They have proven effective at reducing common symptoms such as abdominal cramping, pain, bloating, diarrhea, and constipation, and therefore improved sufferers’ quality of life.

With so many probiotics on the market, it can be confusing to figure out what strain or brand is right for you if you are dealing with symptoms of IBS. 

This comprehensive guide will delve into the research surrounding probiotics and their role in managing IBS symptoms. We will uncover some of the most useful probiotic strains for IBS sufferers and give you the valuable knowledge and insight to consult your healthcare provider about treating your IBS with probiotics.

What Are Probiotics?

Probiotics are live microorganisms that when administered can result in numerous health benefits, particularly when it comes to gut health. These microorganisms are either bacteria or yeasts that work to restore the balance of beneficial bacteria and harmful bacteria in the digestive tract. They also can help support gastrointestinal health by strengthening the bowel wall, regulating the immune system, and reducing inflammation. 

Certain strains of probiotics are better suited for specific digestive ailments. For example, some strains, such as Bacillus coagulans, have been demonstrated to relieve IBS symptoms effectively. In contrast, others, such as Bifidobacterium spp., have been shown to induce remission in patients with crohn’s disease and ulcerative colitis. 

Research on Probiotics for IBS

Before choosing a probiotic for IBS support, it is essential to understand the research behind each strain of probiotics and how they can alleviate the symptoms of your specific digestive complaints. 

Numerous studies have investigated the efficacy of different probiotic strains in managing IBS symptoms, with mixed results. These studies provide valuable information in guiding individuals with IBS in selecting an appropriate probiotic for their condition. 

We will explore the research behind each specific strain and how they can help IBS sufferers regain control over their health. 

Lactobacillus plantarum 299V

Several studies have explored the use of Lactobacillus plantarum 299V in IBS patients. 

A 2012 clinical trial examining the efficacy of Lactobacillus plantarum 299V compared to placebo found that pain severity, daily frequency, and bloating were reduced after four weeks of treatment. These findings suggest that this strain of probiotics over four weeks can result in significant symptom relief for those suffering from predominantly abdominal pain and bloating. 

A 2021 study examining 12-week treatment with Lactobacillus plantarum 299V observed a significant and continuous reduction of IBS patients’ overall symptom scores. The patients in this study reported reduced severity and frequency of abdominal pain, gas, diarrhea, and constipation. They also reported a significantly increased quality of life. This study demonstrated that long-term use of Lactobacillus plantarum 299V may be warranted and well-tolerated.

This strain is a wonderful option if you suffer from many of the common symptoms of IBS, such as abdominal pain, bloating, gas, diarrhea, or constipation. It has the potential to improve your quality of life and alter your symptoms.

Lactobacillus acidophilus

Lactobacillus acidophilus is a popular probiotic with a significant body of research exploring the efficacy of varying strains of this microorganism in improving specific symptoms of IBS.

A 2008 study into the efficacy of Lactobacillus acidophilus SDC 2012 and 2013 comparing this probiotic to placebo found that patients reported a significantly reduced score for abdominal pain and discomfort after four weeks of treatment. Additionally, lending to this strain’s safety and tolerability, the trial had no dropouts or adverse events. This probiotic may be paramount in reducing abdominal pain in IBS patients. 

A 2003 randomized controlled study on Lactobacillus acidophilus LB compared to Lactobacilli in patients with chronic diarrhea found that at the fourth week of treatment, bowel movements were significantly lower, effectively reducing diarrhea. If you suffer from diarrhea-predominant IBS (IBS-D), Lactobacillus acidophilus LB may be an excellent choice. 

Multi-Strain Probiotics

As you can see, some strains are better at improving specific symptoms than others. This is why multi-strain probiotics can sometimes be an excellent tool to banish a wide array of symptoms for IBS patients. 

A 2021 study comparing a multi-strain probiotic to a placebo in IBS-D patients found that the supplementation of the mixture of Lactobacillus, Bifidobacterium, and Streptococcus thermophilus strains for eight weeks resulted in significantly improved IBS symptom severity. Study participants reported positive changes in stool consistency, normalization in the number of bowel movements per day, reductions in the severity of pain and gas, fecal urgency, and the feeling of incomplete evacuation after a bowel movement. 

A large 2018 study, including 400 adult participants, on a multi-strain probiotic containing 14 different bacterial strains resulted in a significant reduction in symptom severity, with a 100% reduction in patients rating their symptoms as moderate-to-severe. Additionally, this multi-strain probiotic improved all dimensions of quality of life for IBS sufferers. 

If you experience a wide array of symptoms, discussing a multi-strain probiotic with your physician may be an excellent choice for reducing symptoms and improving your quality of life. 

Bifidobacterium Strains

Bifidobacterium infantis 35624 has been studied extensively with mixed results in improving pain and overall IBS symptoms. A 2006 study on women with IBS demonstrated Bifidobacterium infantis 35624 improved abdominal pain, bloating, bowel dysfunction, incomplete evacuation, straining, and gas. 

On the other hand, a 2017 meta-analysis of numerous studies examining this strain’s efficacy found that alone, Bifidobacterium infantis 35624 did not demonstrate improvement in symptoms, but when administered in a composite probiotic it significantly alleviated IBS symptoms. 

These mixed results suggest that bifidobacterium strains may confer benefits for some patients, but may not be the best stand-alone strain to select.  

Final Thoughts

When selecting a probiotic strain for IBS treatment it is essential to understand the best strains for the unique symptoms of IBS patients. Certain strains like Lactobacillus plantarum 299V, Lactobacillus acidophilus SDC 2012 and 2013, and Lactobacillus acidophilus LB, may be great stand-alone options. Multi-strain probiotics may be a better choice for patients experiencing a long list of symptoms associated with IBS. Finding the best probiotic for you should include a conversation with your healthcare provider who can guide you towards the best strain for your unique needs to make substantial improvements in your quality of life.

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Dr. Kimberly Langdon

Kimberly Langdon

Dr. Kimberly Langdon has been an MD for 31 years, board-certified obstetrician/gynecologist with 19-years of clinical experience. She graduated from The Ohio State University College of Medicine, earning Honors in many rotations. She then completed her OB/GYN residency program at The Ohio State University Medical Center, earning first-place accolades for her Senior Research Project and Score of 98th percentile on a National Proficiency Test.

During her clinical career, she delivered over 2000 babies and specialized in minimally invasive procedures, menopause, endometriosis, menstrual disorders, and polycystic ovarian syndrome. After retiring from clinical practice, she founded a medical device company to commercialize her two patented and four patent-pending medical devices for both life-threatening and non-life-threatening infections.

Kimberly Langdon M.D.

Founder and Chief Scientific Officer, Coologics, 2010-present
The Ohio State University College of Medicine, Doctor of Medicine 1987-1991
The Ohio State University Hospital Department of Obstetrics and Gynecology Residency Program 1991-1995
Private practice 1995-2010

Po-Chang Hsu

Po-Chang Hsu

Po-Chang Hsu, M.D., received his medical doctorate from Tufts University School of Medicine in Boston. During his medical school training, Dr. Hsu worked with various patients, including adult and pediatric patients with acute and chronic conditions. Dr. Hsu’s interests include neurology, psychiatry, pediatrics, and sleep medicine.

Before medical school, Dr. Hsu finished a master’s degree at Harvard University and wrote a thesis on neuroimaging in schizophrenia patients at Brigham and Women’s Hospital, a Harvard Medical School-affiliated hospital. Dr. Hsu was also a part of the 2008 NASA Phoenix Lander Mission team, which sent a robotic spacecraft to the North polar region of Mars. Dr. Hsu also had research experience on neuroimaging in neonates at Boston Children’s Hospital, another Harvard Medical School-affiliated Hospital.

Since graduating from medical school, Dr. Hsu has worked as a full-time medical writer and consultant. In addition, he has experience writing and ghostwriting books and articles for physicians and health technology start-up companies. Dr. Hsu believes good communication between healthcare providers and patients creates the best results.


-Peer Reviewed Journal Article:
Kounaves, S.P., Hecht, M.H., West, S.J., Morookian, J.-M., Young, S.M.M., Quinn, R., Grunthaner, P., Wen, X., Weilert, M., Cable, C.A., Fisher, A., Gospodinova, K., Kapit, J., Stroble, S., Hsu, P.-C., Clark, B.C., Ming, D.W. and Smith, P.H. The MECA wet chemistry laboratory on the 2007 phoenix mars scout Lander. Journal of Geophysical Research. 2009, Mar; 114(E3): 10.1029/2008je003084.

-Poster Presentation:
2011 Harvard Psychiatry Mysell Poster Session; Boston, MA
Hsu, P.C., Rathi, Y., Eckbo, R., Nestor, P., Niznikiewicz, M., Thompson, E., Kubicki, M., Shenton, M.E. (March, 2011). Two-Tensor Diffusion Tensor Imaging of Acoustic Radiations in Schizophrenia

Dr. Nicolette Natale

Nicolette Natale

Dr. Nicolette Natale is a physician, with a background in Psychology, General Medicine, and English Literature, combining her expertise to provide readers with the most accurate, easy-to-understand, and comprehensive information regarding healthcare. She received her Doctorate in Osteopathic Medicine from Nova Southeastern University, and her bachelor’s in English Literature and Psychology from the University of Miami. Dr. Natale seeks to empower individuals with knowledge, fostering a greater understanding of holistic health and encouraging a proactive approach to well-being