Irritable bowel syndrome (IBS) leads to symptoms like abdominal pain, bloating, diarrhea, and constipation. This common gastrointestinal disorder can be challenging not only for those living with it but also for health care professionals seeking effective management strategies.

Among the various treatments explored, probiotics have gained attention for their potential to improve gut health. Probiotics and probiotic supplements, which contain beneficial bacteria, are thought to help restore the natural balance of the gut microbiome (the different microorganisms living in the digestive system). This action could potentially ease IBS symptoms for some people.

Despite the interest in probiotics for IBS symptoms, it’s important to approach their use with caution. The effectiveness of probiotics can vary greatly among individuals. Also, supplements are regulated less vigorously than pharmaceuticals, raising questions about product quality and consistency. Moreover, although probiotics are generally safe, they can sometimes cause side effects and may interact with other medications.

When looking at the role of probiotics in managing IBS, it’s crucial to consider potential benefits and limitations. This article will discuss how probiotics work in the body, what foods contain them, and whether probiotics may be beneficial for IBS. Before using any new type of therapy, always consult your health care provider, who will tailor your treatment to your specific needs.

How Do Probiotics Work for IBS?

We often think of bacteria as dangerous. However, the human body naturally contains many types of bacteria and other microorganisms, such as yeasts. This mix of microorganisms is called the microbiome. Your body needs several types of beneficial bacteria to help with digestion and stay in good health.

These helpful bacteria fight off disease-causing bacteria that can cause illnesses. They also produce B vitamins and vitamin K. A healthy balance of the right strains of bacteria is especially important for your gut because these good neighbors aid digestion and help prevent food poisoning.

Because gut bacteria — also known as gut microbiota – are so important to intestinal health, probiotics may be especially helpful in managing IBS symptoms. For example:

• Beneficial bacteria help restore the natural balance of the gut microbiota, which is often disrupted in people with IBS. This imbalance can contribute to IBS symptoms like stomach pain, bloating, constipation, and diarrhea.
• Probiotic bacteria can improve gut health by helping the intestinal barrier function properly.
• Beneficial bacteria may influence gut motility and sensitivity, potentially making IBS symptoms less severe.

The Evidence for Probiotics in IBS

There’s been a lot of research on probiotics and health. For IBS specifically, a 2018 systematic review that summarized the results of 53 studies found that probiotics might help IBS symptoms like stomach pain. However, the researchers also pointed out common drawbacks of research on probiotics, like the difficulty in understanding which specific probiotics might be helpful.

According to the National Center for Complementary and Integrative Health, there’s not enough evidence to know whether probiotics help IBS symptoms specifically. In 2021, the American College of Gastroenterology also said there’s not enough evidence on using probiotics to help IBS symptoms and that they couldn’t recommend their use.

Some myIBSteam members don’t notice a difference when taking probiotics, but others do. One member said, “I take two probiotics each day — has helped control the explosive diarrhea.”

Probiotic Foods

Because probiotics can help maintain a healthy gut microbiome, you may choose to add them to your diet. Be sure to speak with your doctor before making any changes in your diet.

One way to increase your levels of beneficial bacteria is by incorporating probiotic foods into your diet. Fermented foods, like yogurt and cottage cheese, are full of probiotics because of the bacterial process of fermentation.

Lactose is a sugar naturally found in milk. Lactose can trigger symptoms such as diarrhea, gas, and abdominal pain in some people. For those who are lactose intolerant, the following nondairy foods also contain lots of probiotics:

• Kimchi (Korean pickled vegetables)
• Tempeh (fermented soybeans)
• Refrigerated sauerkraut
• Miso (fermented soybean paste)
• Soy or coconut-based yogurt

Certain drinks, like kombucha and kefir, also contain probiotics.

Another way to increase probiotic levels is to encourage the growth of the helpful bacteria that are already in your body. “Fermentable fiber” refers to a type of dietary fiber that can be broken down, or fermented, by the bacteria in the colon. The gut microbiome is nourished by fermentable fiber, and you can add fermentable fiber into your diet by eating prebiotic foods. Prebiotic foods include:

• Dried beans
• Garlic
• Onion
• Leeks
• Asparagus
• Whole grains

Members of myIBSteam have discussed using prebiotics and probiotics for their IBS symptoms. “Switched to a new probiotic that also contains a prebiotic — seems to tackle abdominal cramping better,” said one member.

You can buy prebiotic supplements, which are usually safe for adults. Even so, it’s a good idea to talk with your doctor before you start taking them.

Choosing a Probiotic Supplement

Probiotics can also be taken as dietary supplements. Certain strains of bacteria are cultivated and then sold in powder, liquid, pill, or capsule form. Most probiotic supplements aren’t tested for effectiveness by the U.S. Food and Drug Administration (FDA), so finding probiotic supplements that work for IBS may be difficult.

Look for products that contain at least 1 billion colony-forming units. The most researched types of probiotic strains include lactobacillus, bifidobacteria, and Saccharomyces boulardii.

Probiotics are often marketed as a beneficial aid for managing IBS. It’s important to remember that, despite advertising, probiotics are not approved by the FDA as treatments for IBS, and no clinical studies have explored how well probiotics work for IBS.​

Side Effects and Safety of Probiotics

Probiotics generally don’t have severe side effects. You might experience an upset stomach, diarrhea, bloating, and gas when you begin taking them. However, some people develop allergic reactions, so probiotics aren’t recommended for people who might have weakened immune systems, such as those who have just had surgery or who are undergoing chemotherapy.

Some myIBSteam members have noticed the side effects of probiotics. “I take a probiotic drink in the morning. Some days I am OK, and other times I get gas, which is not very pleasant,” one member shared.

Just as with any supplement, talk to your health care provider before beginning to use probiotics. Remember that the use of probiotics doesn’t replace any prescription medication you’re taking for IBS.​

Find Your Team

By joining myIBSteam, you gain a community of more than 25,000 people who understand the challenges of living with IBS. Members support each other and share the tips they’ve found best for managing and preventing symptoms.

Have you taken probiotics for IBS? Do you have a favorite food or supplement that has helped ease your symptoms? Post your thoughts in the comments below or on your Activities page.