Can Prebiotics and Probiotics help relieve IBS symptoms?

May 19th, 2022

Prebiotics and probiotics are an interesting topic for people with gastrointestinal disorders, including irritable bowel syndrome (IBS). Researchers have conducted various studies regarding their influence on improving IBS symptoms. In this article, we will explain the different types of IBS and how prebiotics and probiotics may be beneficial in managing this chronic long-term condition.

What is IBS?

Irritable bowel syndrome (IBS) is a chronic condition that affects the quality of people’s lives and includes symptoms such as abdominal pain or discomfort, bloating, gas, constipation, and diarrhea [1].

Some studies have estimated that more than 9% of the worldwide population suffers from IBS, with women 1.5 to 3 times more likely to experience IBS symptoms [2].

To date, IBS causes are still unknown and some possible factors that are responsible for IBS, include physiological disturbances, genetics, and digestive motility [3]. Based on the abnormal manifestation of the bowel movements, IBS has four subtypes [4, 5].

1. IBS-C: Constipation prevailing
2. IBS-D: Diarrhea predominant
3. IBS-M: Mixed of Constipation and Diarrhea
4. IBS-U: Unspecified when a patient does not belong to one of these categories

Probiotics and IBS

Although the causes of IBS are still unknown, it has been suggested that an imbalance of the gut microbiota can be responsible for IBS development.

Probiotics are live microorganisms that confer a health benefit on the host by decreasing the harmful bacteria and supporting the gut’s natural bacteria [6]. If you want to increase the good bacteria in your body, various fermented foods and supplements include probiotics.

As it concerns food, a few suggestions might be yoghurt, tempeh, kombucha and kimchi , while supplements usually include beneficial strains like Saccharomyces Boulardii, Bifidobacterium Bifidum, Bifidobacterium Lactis, Lactobacillus Acidophilus, and Lactobacillus Plantarum.

Research has shown that IBS symptoms can be improved by the daily consumption of Probiotics, even if the exact mechanism is still not completely understood [7]. Probiotics can act in different ways depending on the type of IBS and other factors such as age and gender [8].

It is proposed that Probiotics may improve IBS symptoms by [9]:

• Inhibiting the colonisation of pathogens in the gut
• Enhancing the gut barrier function
• Boosting the immune system
• Improving digestive functions
• Reducing inflammation in the gut and gas formation

What are prebiotics?

Prebiotics are usually non-digestible fibre compounds that are fermented by the gut microbiota, stimulating the growth and/or activity of beneficial bacteria (probiotics) in the gut [10]. To classify these compounds as prebiotics, they need to comply with three requirements [11]:

• be non-digestible and resistant to breakdown by stomach acid and enzymes in the human gastrointestinal tract
• be fermented by living microorganisms in the gut
• stimulate the growth and/or activity of beneficial bacteria (probiotics)

It is possible to combine prebiotics with probiotics to create synbiotic dietary supplements. You can read more about that here.

Prebiotics and IBS

Research into the role of prebiotics in managing IBS symptoms is conflicting and shows that the beneficial effect may be subjective and depend on the IBS and type.

For example, some studies found that soluble fibres such as psyllium and inulin may provide significant pain relief for IBS patients with constipation and/or diarrhoea. In contrast, other studies found that the effect is limited.

Prebiotics act by stimulating the growth of a bacterium that produces lactic acid called Bifidobacterium. Interestingly, Bifidobacterium has been associated with improved gastrointestinal symptoms in people with IBS. More specifically, this genus lowers the pH to desirable levels for beneficial microbes and undesirable levels for pathogenic bacteria
[12].

The consumption of specific prebiotics such as arabinoxylans from wheat (AX) can increase the amount of Bifidobacterium in the colon.

In addition, there are also molecules with known prebiotic activity, such as citrus-derived flavonoids. Research has shown that these compounds can reach the colon without being digested and are metabolised by the gut microbiota, stimulating the growth of beneficial bacteria..

These prebiotic flavonoids are different from prebiotic fibres because they are not fermented but rather deglycosylated by the gut microbiota. Furthermore, their ability to work at low doses is associated with their high tolerance as opposed to fibres. Finally, the lack of fermentation avoids gas formation and the resulting feeling of bloating and flatulence.

Multiple studies have shown better protection of gut mucosa against colonisation by pathogens and viruses. Also, citrus flavonoids allow greater production of short chain fatty acids (SCFA) like butyrate and propionate, important compounds for the immune system and metabolic functions.

The bottom line

IBS is a chronic condition that affects a large part of the world’s population.

There is no known cure for this condition, but there are many treatment options to reduce or eliminate symptoms, such as dietary modifications, lifestyle changes, and prescription medications.

In many cases, probiotics and prebiotics may be beneficial in managing the IBS symptoms. However, the beneficial effect is subjective and depends on the IBS type. Therefore, it is essential to understand how dietary changes and supplementations affect the symptoms.