Irritable Bowel Syndrome (IBS)

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By Lawrence Hoberman, M.D.

Dedicating a month to raising greater awareness about Irritable Bowel Syndrome (IBS) says a lot about the complicated and little-understood disorder that plagues an estimated 30 to 45 million people in the U.S. alone. Typically characterized by unexpected urgent bouts of abdominal pain, diarrhea, or constipation, IBS is understandably uncomfortable for many to discuss, even with their doctor. Perhaps even more difficult to digest is that many view IBS as a trivial condition instead of a medically recognized disorder.

In order to dispel myths, misconceptions and taboos about the disorder, the International Foundation for Gastrointestinal Disorders (IFFGD) designated April as IBS Awareness Month with hopes of bringing silent sufferers help with diagnosis, treatment, and quality of life issues.

Could I have IBS?

The National Institute of Health describes IBS symptoms as stomach pain before or after a bowel movement, changes in bowel movements such as diarrhea or constipation, bloating, and the presence of whitish mucus in the stool.

While causes remain unclear, several factors can contribute to gut dysbiosis, or compromised microbial function, and consequently lead to intestinal disorders such as IBS. Western diets that are reliant on animal protein and highly processed, fiber-deplete foods have been linked to impaired colonization of healthy bacteria. Bacterial infections, overgrowth of bacteria in the small intestine, food sensitivities, and even genetics may increase susceptibility to developing IBS.

Because IBS is classified as a functional gastrointestinal condition ─ those involving how the brain and gut work together ─ this gut-brain connection can cause IBS symptoms in different people in different ways, or occur in conjunction with stress, depression, and anxiety. Psychosocial factors can trigger real chemical responses that can cause pain that is not “all in your head.”

Treating IBS usually involves multiple approaches, including following a fiber-rich, Mediterranean diet, as well as engaging in regular exercise, mitigating stressful life situations, and getting more sleep. Probiotics, or beneficial bacteria, offer a natural remedy that, unlike oft prescribed antidiarrheals, antibiotics and antidepressants, bring no harmful side effects.

Role of Probiotics in Treating IBS

The January 2020 Portuguese Journal of Gastroenterology abstract “Gastrointestinal Microbiome-What we Need to Know in Clinical Practice,” cites numerous studies confirming that IBS sufferers, in general, have less diverse gut bacteria and that probiotics can enhance traditional medical approaches for treating IBS by rebalancing gut microbiota. 

Lactobacillus Casei (L.casei), Bifidobacterium Breve (B.breve), and Lactobacillus Plantarum (L.plantarum) are the best bacterial strains for targeting IBS for their comprehensive sweeping help in relieving abdominal pain, bloating, constipation and diarrhea.

Prebiotics ─ nondigestible starches that are fermented in the colon ─ support the growth of healthy bacteria, and so combining probiotics with a prebiotic brings added benefit. The prebiotic FOS (Fructooligosaccharides) is a good partner for Bifidobacteria and Lactobacilli strains. 

Considering different bacterial strains provide different benefits, a multi-species, multi-strain probiotic that works symbiotically is best for overall gut health. Studies show that the most effective daily dose of probiotics is between 10 and 20 billion CFUs (colony forming units); however, 20 billion CFUs are ideal for promoting the growth of beneficial bacteria in the intestinal tract and relieving the symptoms of IBS.

Evidence continues to show that quality of life in IBS patients is markedly improved with probiotic supplementation.

Dr. Lawrence Hoberman is a board-certified gastroenterologist and founder of Medical Care Innovations. During his 40-plus years practicing internal medicine and gastroenterology, Dr. Hoberman has worked with microbiologists to identify beneficial bacteria for treating gastrointestinal disorders naturally.

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