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Photo Credit: Christiann MacAuley

http://www.stickycomics.com

A systematic review last year by Ford and his colleagues (2014) looked at probiotics and their effectiveness for IBS, the conclusion the authors made after applying some statistical analysis was that probiotics in general were effective to treat IBS. However they also stated that recommendations for individual products were difficult to make because the studies were so different from each other and the products were also different (different strains, doses, and carrier food or tablet etc) this means that the evidence for a particular product is unclear. We have guidelines that suggest probiotics can be tried by people with IBS and they should be tried for one month at the dose the manufacturer recommends, but which one? This research by Ford and colleagues is good evidence of the fact that they are effective, but the information is not really that useful for people wishing to try a product. So what do you do when faced with the fact these products are recommended by guidelines but researchers are unable to specify a particular product? It is worth perhaps looking at which symptom of IBS bothers you the most and taking the pragmatic approach that it might be better to try products that have some level of effectiveness – even if this is limited. As such I have listed the products and the symptoms where some level of effectiveness has been found

Global symptoms Activia* (natural yoghurt), Alflorex, Align, Prosynbioflor 2, Pro-Viva, Symprove

Diarrhoea              Alflorex, Align

Constipation         Activia* (natural yoghurt)

IBS mixed              No papers (perhaps it would be best to choose the products in the global                                                     symptom list)

Abdominal Pain    Activia* (natural yoghurt), Alflorex, Align, Prosynbioflor 2, Pro-viva Synprove

Discomfort (lower degree of abdominal pain) Yakult (this was only viewed as an abstract but data looked promising)

Flatulence               Alflorex, Align, Lab 4, Pro-Viva, #VSL 3, Symprove, Yakult (this was only viewed as an abstract but data looked promising)

Bloating                  Alflorex, Align, #VSL 3,

Satisfaction with bowel habit   Symprove

Quality of life           Bioflor

*for people with more severe symptoms of IBS

It might be worth considering checking the product for fodmap content if you are following the low fodmap diet or have particular food intolerances, This data has come from the published data on these products – I will try to update this list as new developments occur.

Ford A, et al (2014) Efficacy of prebiotics, probiotics and synbiotics in irritable bowel syndrome and Chronic Idiopathic constipation: systematic review and meta analysis Am J Gastroenterol. 2014 Oct;109(10):1547-61

  

Julie

I am a state registered dietitian and advisor to The IBS Network, the UK charity for people with irritable bowel syndrome. My specialty is dietary treatment of gut disorders such as irritable bowel syndrome, crohns disease, ulcerative colitis, coeliac disease, lactose & fructose malabsorption and complex food intolerances. I also have experience in dietetic treatment of people who have bariatric surgery and weight management.

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