Both of the review studies(1,2) that I mentioned yesterday discuss the growing evidence that probiotics, supplemental beneficial bacteria, seem helpful in managing IBS. Probiotics may help by reducing the level of inflammatory chemicals (cytokines), implicated in IBS. Imbalances in gut bacteria can lead to chronic low-level inflammation in the intestines and the measurable presence of inflammatory markers in the bloodstream. There are complications with the scientific studies that have taken place to date as it seems that the type of bacterial probiotic supplement used may be responsible for the degree of improvement noted in IBS sufferers. Supplements containing Bifidobacteria seem to be especially effective.
(For definitions of probiotic, prebiotic and symbiotic please read Part I)
The problem with probiotic only supplements is the survival of the bacteria through our digestive system before they arrive at the large intestine. It is often impossible to know how many, and which, live organisms are present in the supplements. It is important to look for brands that are enteric-coated, so that the bacteria are not destroyed/digested by the stomach. It is thought that probiotics work only as long as they are being taken, i.e. as the probiotic is no longer consumed, the added bacteria are rapidly washed out of the colon. Hence prebiotic or a symbiotic supplements are probably the most beneficial in the long-term. Another useful point to remember is that the bacteria are killed by heat so try not to take your probiotic supplement whilst drinking your morning cup of tea!
Recently there have been some trials using symbiotics(3,4,5), supplements containing both probiotics and prebiotics, in the treatment of IBS and they have shown encouragingly positive results. Two studies(3,4) found that the prebiotic-probiotic treatment significantly reduced feelings of general ill health, nausea, indigestion and flatulence. Another study (5) found that a prebiotic-probiotic preparation was particularly helpful for sufferers of constipation-type IBS. The supplement reduced general IBS symptoms, bloating and abdominal pain and increased stool frequency.
Larger trials are needed but a symbiotic supplement containing both probiotics and prebiotics may well be worth a try if you are suffering with the discomfort of IBS. Look for supplements containing bifidobacteria and lactobacilli as these seem to be most beneficial. After an initial period of a month or so you may wish to switch to a prebiotic (FOS) only supplement to maintain consistently high levels of gut friendly bacteria. As I mentioned in an earlier post, I take a daily FOS supplement out of habit now and feel good on it! Bacterial balance has been implicated in many conditions (not just those related to the digestive system) and may be important for keeping our immune system healthy.
Tomorrow I will be continuing the IBS theme so please check back for some more helpful ideas
(1)Wald A & Rakel D. 2008. Behavioural and complementary approaches for the treatment of irritable bowel syndrome. Nutrition in Clinical Practice. 23:284-292
(2)Heitkemper MM & Jarrett ME. 2008. Update on irritable bowel syndrome and gender differences. Nutrition in Clinical Practice. 23:275-283
(3)Bittner AC et al. 2005. Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome:a methodologically orientated, 2-week, randomized, placebo-controlled, double-blind clinical study. Clin Ther. 27:755-761
(4)Bittner AC et al. 2007. Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome:an open-label, partially controlled, 1 year extension of a previously published controlled clinical trial. Clin Ther. 29:1153-1160
(5)Colecchia A et al. 2006. Effect of a symbiotic preparation on the clinical manifestations of irritable bowel syndrome, constipation-variant. Results of an open, uncontrolled multicentre study. Minerva Gastroenterol Dietol. 52:349-358
Written by Ani Kowal