Would you, as a doctor, recommend probiotics for irritable bowel syndrome (IBS), and why?

Doctor's Answer

Photo of Dr Wai Leong Quan
Dr Wai Leong Quan

Gastroenterologist

Irritable Bowel Syndrome (IBS), is a functional disturbance of the digestive tract with a spectrum of presentations ranging from:

  1. abdominal pain,
  2. constipation
  3. to diarrhoea

As definitive diagnostic tests are not available for IBS, clinical criteria are frequently used to arrive at the diagnosis. To put it in a different way, patients with IBS remain a mixed-group recognised mainly by their symptoms.

The symptoms of IBS have been hypothesized to be related to:

  1. rhythmic upset
  2. inflammation
  3. gut hypersensitivity
  4. and possibly small bowel bacteria overgrowth

Probiotics have been used to alter gut bacteria flora and have been showing promising results in antibiotic-related diarrhoea and specific form of inflammatory bowel disease (IBD). As such, it may help in relieving symptoms of IBS in some cases.

The issue in using probiotics is the limited knowledge of the actual bacteria strains, the dose and the dosing interval that will work on IBS. There is also a standardisation issue in the manufacturing process with too many brands to choose from in the market.

So my take on this is in the absence of reasons to avoid probiotics, (e.g. on chemotherapy) a trial of treatment for IBS would probably do you very little or no harm but may help some of your symptoms such as bloating. You can try different brands and adjust the dose to see if it works for you.

Please consider seeking proper advice from your doctor should your symptoms persist to avoid missing out on sinister signs and symptoms you are not aware of.

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