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August 21, 2023

Which is the Best Probiotic for IBS? 13 Science-backed

Discover the best probiotic for IBS supplements to relieve IBS symptoms and improve gut health. Start your journey towards digestive relief today.

Xam Richie

Probiotics for IBS recommendations — Best Probiotics for Irritable Bowel Syndrome

Looking for relief from IBS symptoms? Discover the best probiotic for IBS and improve your gut health today! Our science-backed recommendations and reviews will help you choose the right probiotic supplement for your needs. Say goodbye to bloating, gas, and other uncomfortable symptoms with the help of the best probiotic for IBS.

In This Article

The diagnosis of Irritable Bowel Syndrome (IBS) is based on symptoms taken as criteria for determining the condition.

There is no specific test to diagnose IBS, and the diagnosis is usually made by a healthcare provider based on the patient’s symptoms and medical history.

According to the Rome IV criteria, IBS is diagnosed when a patient has recurrent abdominal pain, on average, at least one day per week in the last three months, associated with two or more of the following criteria: related to defecation, associated with a change in frequency of stool, or associated with a change in form (appearance) of stool. The symptoms should have started at least six months before diagnosis✅.

Diagnostic Criteria	Description
Recurrent abdominal pain	On average, at least one day per week in the last three months
Associated with two or more of the following criteria	Related to defecation, associated with a change in frequency of stool, or associated with a change in form (appearance) of stool
Duration of symptoms	Symptoms should have started at least six months before diagnosis

Summary of diagnostic criteria used to define irritable bowel syndrome

Small Bowel Bacterial Overgrowth

Small bowel bacterial overgrowth (SBBO) is a condition characterized by an abnormally high population of bacteria in the small intestine.

It is associated with symptoms such as pain, bloating, diarrhea, and signs of malabsorption, similar to those observed in people with IBS.

Generally, IBS patients experience changes in Lactobacillus and Bifidobacterium composition and activity, impacting their digestive health and overall well-being.

Studies show that those with IBS have lower levels of microbial diversity and are more likely to have a reduced presence of Methanobacteriales and a higher prevalence of Bacteroides enterotypes^✅.

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Lower counts of methanogens may explain the symptoms of flatulence or excess gas in the abdomen.

In patients with IBS, there is an overgrowth of certain types of bacteria, specifically Proteobacteria (Veillonella) and Firmicutes (Lactobacillus and Ruminococcus), while other beneficial bacteria like Bifidobacterium, Faecalibacterium, Erysipelotrichaceae, and methanogens are decreased^✅.

This imbalance (Dysbiosis) in gut bacteria may contribute to the symptoms experienced by those with IBS.

How Probiotics Help IBS

First of all, we need to understand the pathophysiology of IBS involves various central and peripheral mechanisms, and the management of gut microbiota can significantly affect the improvement of subjective disorders in patients with IBS.

Although the pathophysiology of IBS has not been fully elucidated, nowadays, we
can claim with certainty that IBS is an unexplained brain-gut disorder^✅.

Gut microbiota plays a role in brain-gut dysregulation in patients with IBS through the microbiota-brain axis.

The most important communication pathway in this relationship is the vagus nerve, which connects the gut and the brain.

The gut microbiota can produce neurotransmitters and metabolites that can affect mood and behavior in humans.

Some studies have shown that ingestion of fermented milk products with probiotics can modulate brain activity and regulate emotional behavior and central GABA receptor expression in mice via the vagus nerve^✅.

In visceral sensitivity, gut microbiota can produce gases such as hydrogen sulfide (H₂S), which can influence intestinal inflammation and sensitivity and play an important role in modulating visceral pain.

Additionally, studies have shown that probiotics such as Lactobacillus reuteri can directly alter the visceral perception of nociceptive stimulants and inhibit the autonomic nervous system response to colorectal distension in mice^✅.

Bacteria can produce short-chain fatty acids (SCFAs) that stimulate the secretion of gastrointestinal hormones that regulate gut motility.

Moreover, some studies have shown that gut microbiota can affect the enteric nervous system and the interstitial cells of Cajal, which are involved in regulating intestinal motility^✅.

Some specific strains of bacteria such as Bacteroides thetaiotaomicron, Escherichia coli Nissle 1917, and Lactobacillus rhamnosus have been shown to alter gene expression and improve contractility of the colon^✅.

The gut microbiota is a fascinating world within us that interacts with our intestinal epithelium and helps regulate the expression of tight junction proteins^✅.

These proteins are crucial for maintaining the integrity of our intestinal barrier function.

Unfortunately, when this barrier is disrupted, it can lead to increased intestinal permeability and inflammation.

But did you know that the metabolites produced by the gut microbiota can also influence the activation of our immune system and inflammation in the gut?

Some bacteria produce lipopolysaccharides (LPS), which can activate the immune system and promote inflammation.

List of Best Probiotics for IBS

Here is the list of the 6 best probiotics for IBS patients. These recommended probiotics products are ones with trusted sustainability certification(s) and USDA Organic:

Physician’s CHOICE Probiotics 60 Billion CFU ^{Best Price}

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Garden of Life Raw Probiotics Ultimate Care ^{Best Formula}

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Garden of Life Once Daily Dr. Formulated Probiotics ^{Best for Women}

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Garden of Life Probiotics for Men Dr. Formulated ^{Best for Men}

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MaryRuth’s USDA Organic Liquid Probiotics ^{Best for Child/Pregnant}

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Garden of Life Whole Food Probiotic Supplement ^{Best Overall}

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Best Probiotics For IBS

Probiotics have been suggested as a possible therapeutic option for the treatment of IBS.

Probiotics are live microorganisms that can confer health benefits to the host when administered in adequate amounts.

Probiotics can modulate the gut microbiota and improve gut barrier function, reduce inflammation, and regulate intestinal motility in patients with IBS.

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Some specific strains of probiotics, such as Bifidobacterium infantis, Lactobacillus plantarum, and Streptococcus thermophilus, have been shown to improve IBS symptoms in clinical trials.

However, more research is needed to determine the optimal dose, duration, and strain of probiotics for the treatment of IBS.

Additionally, other therapeutic options such as prebiotics, synbiotics, and fecal microbiota transplantation (FMT) have also shown promising results in improving IBS symptoms.

Some studies have shown that certain probiotics can alleviate symptoms in specific IBS subtypes.

For example, Bacillus coagulans MTCC 5856 was successful in alleviating symptoms in patients with a predominantly diarrheal form of the disease.

Another study found that a combination of probiotic strains improved symptoms in patients with a predominantly abdominal pain form of the disease.

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Best Probiotic For IBS Symptoms

List of Probiotics for IBS Symptoms:

Here is the list of the 7 best probiotics for IBS symptoms. These recommended probiotics products are ones with trusted sustainability certification(s) and USDA Organic:

Gas & Bloating

All IBS Symptoms

IBS-D

Constipation & Diarrhea

Gastric Acid Reflux

IBS-M

Abdominal Pain & Bloating

Probiotics can improve global IBS symptoms, while others only improve individual IBS symptoms, such as bloating scores and abdominal pain scores.

Only a few clinical trials have found no apparent effect of probiotics on IBS symptoms.

Generally, probiotics appear to be safe for patients with IBS.

A meta-analysis of randomized controlled trials showed that probiotics were more effective than placebo in improving overall IBS symptoms, abdominal pain, bloating, and flatulence.

Ref.	Sample size	Probiotic	Common Outcome (probiotic group)
Sinn et al ^✅, 2008	40	L.acidophillus	A decrease in visceral hypersensitivity in both groups decreased pain in both groups, and no significant difference in overall symptom improvement
Hong et al ^✅, 2009	70	Bifidobacterium bifidum BGN4, B. lactis AD011, Lactobacillus acidophilus AD031, L. casei IBS041	Improvement in the frequency of abdominal pain (23% vs 6%), abdominal distension (27% vs 7%), bowel habits (26% vs 8%), and dissatisfaction with defecation (20% vs 10%).
Guglielmetti et al ^✅, 2011	122	Bifidobacterium bifidum MIMBb75	Improved global IBS symptoms by -0.88 points, reduction in pain/discomfort by -0.82 points, distention/bloating by -0.92 points, urgency by -0.76 points (Likert scale)
Cui and Hu^✅, 2012	60	Bifidobacterium longum and Lactobacillus acidophilus	Reduction of pain score (-31.9), defecation and discomfort (-29.2), no significant change in QOL and bowel habits (defecation frequency and stool consistency)
Dapoigny et al ^✅, 2012	50	Lactobacillus casei rhamnosus LCR35	D: significant reduction in abdominal pain; M: no relevant difference between groups
Ducrotté et al^✅, 2012	214	Lactobacillus plantarum 299v	The mean frequency of abdominal pain was reduced significantly by 51.9%, with reductions in stool frequency, bloating and feeling of incomplete emptying, significant reduction of the daily number of stools
Amirimani et al^✅, 2013	102	Lactobacillus reuteri	Adequate relief of symptoms at least 50% of the time (52% vs 41%), no difference in diarrhea, bloating, and satiety
Begtrup et al^✅, 2013	131	L. paracasei ssp paracasei F19, L. Acidophilus; La5 and Bifidobacterium Bb12	Improvements in symptoms scores, bloating, flatulence, ease of bowel movement, and quality of life (48% vs 33%)
Roberts et al ^✅, 2013	179	Bifidobacterium lactis CNCM I-2494, S.thermophilus, L.bulgaris	Increased frequency of defecation, no significant difference in bloating, urgency, abdominal pain, or stool shape. The study did not classify between D and C subtype
Jafari et al ^✅, 2014	108	Probio-Tec® Quatro-cap-4	Decrease in VAS score for abdominal pain and bloating, decrease in feeling incomplete defecation
Ludidi et al ^✅, 2014	40	Bifidobacterium lactis W52, Lactobacillus casei W56, L. salivarius W57, Lactococcus lactis W58, L. acidophilus NCFM, and L. rhamnosus W71	A decrease in visceral hypersensitivity in both groups decreased pain in both groups and no significant difference in overall symptom improvement
Pedersen et al ^✅, 2014	81	Lactobacillus rhamnosus GG	Improvement in IBS-SSS score and QOL score. Low FODMAP diet showed efficiency in IBS-C, and probiotics in IBC-D.
Improvement in IBS-SSS score and QOL score. Low FODMAP diet showed efficiency in IBS-C and probiotics in IBC-D.	186	Lactobacillus rhamnosus NCIMB 30174, L.plantarum NCIMB 30173, L.Acidophilus NCIMB 30175, Enterococcus faecium NCIMB 30176	Reduction in IBS-SSS score (abdominal pain, bloating, bowel habit satisfaction)-63.3 vs -28.3. No difference in QOL score.

Probiotics versus placebo in different types of irritable bowel syndrome

The probiotic bacteria that are most frequently used in studies include Lactobacillus, Bifidobacterium, Enterococcus, and Streptococcus.

In the majority of studies that have examined the effects of these probiotics, there has been a significant reduction in abdominal pain and discomfort.

However, the effect size of probiotics was small, and the quality of evidence was low to moderate

The symptoms of IBS include:

Abdominal distension
Bloating
Flatulence
Diarrhea
Constipation
A combination of two or more of these symptoms

IBS can be classified into different subtypes based on bowel habit patterns. The following are the three main IBS subtypes:

IBS with constipation (IBS-C): This subtype is characterized by infrequent bowel movements and hard, lumpy stools.
IBS with diarrhea (IBS-D): This subtype is characterized by frequent bowel movements and loose, watery stools.
IBS with mixed bowel habits (IBS-M): This subtype is characterized by a combination of both constipation and diarrhea.

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Frequently Asked Questions

Should IBS sufferers take probiotics?

Yes, probiotics can be beneficial for individuals with Irritable Bowel Syndrome (IBS). Studies have shown that probiotics can help alleviate symptoms such as bloating, gas, and abdominal pain. See more information: Which is the Best Probiotic for IBS? | Yourfitnature

What is the best probiotic to take for irritable bowel syndrome?

The best probiotics for IBS contain some strains of probiotics that have been found to be helpful for IBS including Bifidobacterium infantis, Lactobacillus plantarum, and Streptococcus thermophilus: Physician’s CHOICE Probiotics 60 Billion CFU, Garden of Life Raw Probiotics for Women and Men Ultimate Care 100 Billion CFU, MaryRuth’s USDA Organic Liquid Probiotics

Which probiotic is best for bloating and gas?

Some of the best probiotics for IBS’s bloating and gas include Lactobacillus acidophilus, Bifidobacterium lactis, Lactobacillus plantarum, Streptococcus thermophilus. Some of the best probiotics supplements for bloating : Klaire Labs Saccharomyces Boulardii Probiotic, Hyperbiotics Pro 15 Probiotic Time Release Pearls and Endomune Advanced Adult Multi-Strain Probiotic

What are the coping strategies for IBS?

Coping strategies for IBS should involve a multidimensional approach that addresses psychological distress, pain-coping strategies, and individual characteristics. Psychological treatments like CBT (Cognitive Behavioral Therapy), self-management interventions, and addressing comorbid psychopathologies can all play a role in managing IBS symptoms and improving quality of life.

21 References

Amirimani, Behnaz, et al. “Probiotic vs. Placebo in Irritable Bowel Syndrome:A Randomized Controlled Trial.” Middle East Journal of Digestive Diseases, vol. 5, no. 2, Apr. 2013, pp. 98–102.
Bär, F., et al. “Cell‐free Supernatants of Escherichia Coli Nissle 1917 Modulate Human Colonic Motility: Evidence from an in Vitro Organ Bath Study.” Neurogastroenterology & Motility, vol. 21, no. 5, pp. 559-e17, https://doi.org/10.1111/j.1365-2982.2008.01258.x. Accessed 21 Aug. 2023.
Begtrup, Luise Mølenberg, et al. “Long-Term Treatment with Probiotics in Primary Care Patients with Irritable Bowel Syndrome – a Randomised, Double-Blind, Placebo Controlled Trial.” Scandinavian Journal of Gastroenterology, vol. 48, no. 10, Aug. 2013, pp. 1127–35, https://doi.org/10.3109/00365521.2013.825314.
Bischoff, Stephan C., et al. “Intestinal Permeability – a New Target for Disease Prevention and Therapy.” BMC Gastroenterology, vol. 14, no. 1, Nov. 2014, pp. 1–25, https://doi.org/10.1186/s12876-014-0189-7.
Cui, Shusheng, and Ying Hu. “Multistrain Probiotic Preparation Significantly Reduces Symptoms of Irritable Bowel Syndrome in a Double-Blind Placebo-Controlled Study.” International Journal of Clinical and Experimental Medicine, vol. 5, no. 3, 2012, pp. 238–44.
Dapoigny, Michel, et al. “Efficacy and Safety Profile of LCR35 Complete Freeze-Dried Culture in Irritable Bowel Syndrome: A Randomized, Double-Blind Study.” World Journal of Gastroenterology, vol. 18, no. 17, May 2012, pp. 2067–75, https://doi.org/10.3748/wjg.v18.i17.2067.
Ducrott&eacute, Philippe, et al. “Clinical Trial: Lactobacillus Plantarum 299v (DSM 9843) Improves Symptoms of Irritable Bowel Syndrome.” World Journal of Gastroenterology, vol. 18, no. 30, Aug. 2012, pp. 4012–18, https://doi.org/10.3748/wjg.v18.i30.4012.
Guglielmetti, S., et al. “Randomised Clinical Trial: Bifidobacterium Bifidum MIMBb75 Significantly Alleviates Irritable Bowel Syndrome and Improves Quality of Life –– a Double‐blind, Placebo‐controlled Study.” Alimentary Pharmacology & Therapeutics, vol. 33, no. 10, pp. 1123–32, https://doi.org/10.1111/j.1365-2036.2011.04633.x. Accessed 21 Aug. 2023.
Hong, Kyoung Sup, et al. Gut and Liver. 30 June 2009, https://www.gutnliver.org/journal/view.html?volume=3&number=2&spage=101&year=2009. Accessed 21 Aug. 2023.
Kamiya, T., et al. “Inhibitory Effects of Lactobacillus Reuteri on Visceral Pain Induced by Colorectal Distension in Sprague-Dawley Rats.” Gut, vol. 55, no. 2, Feb. 2006, pp. 191–96, https://doi.org/10.1136/gut.2005.070987.
Lacy, Brian E., et al. “Bowel Disorders.” Gastroenterology, vol. 150, no. 6, May 2016, pp. 1393-1407.e5, https://doi.org/10.1053/j.gastro.2016.02.031.
Ludidi, S., et al. “Randomized Clinical Trial on the Effect of a Multispecies Probiotic on Visceroperception in Hypersensitive IBS Patients.” Neurogastroenterology & Motility, vol. 26, no. 5, pp. 705–14, https://doi.org/10.1111/nmo.12320. Accessed 21 Aug. 2023.
Pedersen, Natalia, et al. “Ehealth: Low FODMAP Diet vs Lactobacillus Rhamnosus GG in Irritable Bowel Syndrome.” World Journal of Gastroenterology, vol. 20, no. 43, Nov. 2014, pp. 16215–26, https://doi.org/10.3748/wjg.v20.i43.16215.
Roberts, Lesley M., et al. “A Randomised Controlled Trial of a Probiotic ‘Functional Food’ in the Management of Irritable Bowel Syndrome.” BMC Gastroenterology, vol. 13, no. 1, Mar. 2013, pp. 1–10, https://doi.org/10.1186/1471-230X-13-45.
Saha, Lekha. “Irritable Bowel Syndrome: Pathogenesis, Diagnosis, Treatment, and Evidence-Based Medicine.” World Journal of Gastroenterology, vol. 20, no. 22, June 2014, pp. 6759–73, https://doi.org/10.3748/wjg.v20.i22.6759.
Sinn, Dong Hyun, et al. “Therapeutic Effect of Lactobacillus Acidophilus-SDC 2012, 2013 in Patients with Irritable Bowel Syndrome.” Digestive Diseases and Sciences, vol. 53, no. 10, Feb. 2008, pp. 2714–18, https://doi.org/10.1007/s10620-007-0196-4.
Sisson, G., et al. “Randomised Clinical Trial: A Liquid Multi‐strain Probiotic vs. Placebo in the Irritable Bowel Syndrome – a 12 Week Double‐blind Study.” Alimentary Pharmacology & Therapeutics, vol. 40, no. 1, pp. 51–62, https://doi.org/10.1111/apt.12787. Accessed 21 Aug. 2023.
Tana, C., et al. “Altered Profiles of Intestinal Microbiota and Organic Acids May Be the Origin of Symptoms in Irritable Bowel Syndrome.” Neurogastroenterology & Motility, vol. 22, no. 5, pp. 512-e115, https://doi.org/10.1111/j.1365-2982.2009.01427.x. Accessed 21 Aug. 2023.
Tap, Julien, et al. “Identification of an Intestinal Microbiota Signature Associated With Severity of Irritable Bowel Syndrome.” Gastroenterology, vol. 152, no. 1, Jan. 2017, pp. 111-123.e8, https://doi.org/10.1053/j.gastro.2016.09.049.
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