Probiotics are one of, if not the most, talked about and prescribed supplements for gut health as well as general health and wellbeing.  

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Probiotics can be taken in a variety of ways and with a wide range of options on the market, there can be confusion and questions about which is the best and most well-studied.

 

Let's explore the role probiotics play in health, how they work and the ones that can be considered in certain situations. In particular, how they can help with digestive issues such as bloating, IBS and IBD.

 

IBS (irritable bowel syndrome) is a common condition that affects the digestive system. It can cause stomach cramps, bloating and diarrhoea. It’s usually a lifelong condition but lifestyle changes and medicine can help. 

 

Inflammatory bowel disease (IBD) is a term used to describe conditions that cause severe tummy pain and diarrhoea.

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What are Probiotics and how do they work?
Probiotics are defined as “Live microorganisms, that when administered in adequate amounts, confer a health benefit on the host”. This is generally applied to probiotic supplements but also more loosely refers to fermented food as well. 

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One of the most common misconceptions is that probiotics simply add more “good bacteria” to the gut. This may be described as filling up a jar with more marbles. However, this is not the case with probiotics.  

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Probiotics are described as transient organisms. This refers to the fact that they travel through the gut but do not reside there. However, as they travel through the gut they interact with the body which then leads to health benefits.

 

Probiotics can therefore be considered ‘signalling molecules’ as when they adhere or stick to the gut lining for a brief period of time, they send a signal to the immune system along the gut lining. This is carried about based on the biological pattern of protein structure on the surface of the probiotic bacteria. 

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Depending on this biological pattern (which varies between different strains of bacteria) a different biological response may result. 

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These responses can include reducing inflammation or activating the body’s own antimicrobial response to kill less beneficial bacteria.

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The vast majority of probiotics on the market are focused on supporting the gut and digestive health issues.

 

Benefits of probiotics for gut health

​Depending on the strain of bacteria, different benefits may be seen.

 

This can be due to actions in the gut such as: 

• Reducing inflammation 

• Triggering the body’s own release of antimicrobial compounds (which help to balance the gut bacteria) 

• Supporting the health of the gut lining 

• Regulating the immune response 

 

Individual response to probiotics can depend on factors such as: 

• The balance of the gut microbiome 

• Degree of inflammation 

• Genetics 

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Digestive Health  

The most common implication of probiotics is their role in supporting digestive health and gut issues. They can be used to help with a wide range of gut-related issues such as: 

• Bloating 

• Abdominal pain 

• Diarrhoea 

• Constipation 

• SIBO 

• Heartburn  

 

Immune System Support - Boosting the immune response through gut health

​Probiotics can support the immune response in the gut as well as overall immune health. This may in part be that a healthy gut microbiome supports the entire immune system. 

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This is reinforced by research indicating that probiotics help to improve immune health and reduce the risk and duration of illnesses. 

Probiotics for gut–specific conditions 

Probiotics are used in a way that is mostly based on symptoms rather than test results. This relates to how probiotics are administered and tested in clinical trials. 

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During the trials for probiotics, strains are administered to patients with a range of digestive issues. Following a period of time on the probiotics, if specific symptoms improve, this strain of bacteria is then considered to be helped for those symptoms. 

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For example, suppose a significant percentage of patients have an improvement in their bloating while taking a specific strain of probiotic bacteria. In that case, this bacteria can then be considered a treatment consideration for this symptom. 

IBS

For IBS, a range of probiotics have been used and found to be helpful for the associated symptoms. 

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The common symptoms of IBS include: 

• Bloating 

• Distention 

• Abdominal pain 

• Food intolerances 

• Constipation  

• Diarrhoea 

• Flatulence 

 

The common underlying factors involved with IBS include changes in the gut bacteria, low-grade inflammation and activation of the immune response, probiotics can be considered. 

Inflammatory Bowel Disease 

Probiotics can also be considered in inflammatory bowel conditions such as Crohn’s disease and Ulcerative colitis. 

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While this is a distinctly different condition from IBS, some of the same strains have been found to be beneficial in addressing this condition.

SIBO 

Small intestinal bacterial overgrowth (SIBO) is the presence of excess colonic bacteria in the small intestine. As explored, probiotics are transited organisms and do not work in a way that fills the gut with more bacteria. This may be a common misunderstanding of the way in which probiotics work and lead to online concern about their use in SIBO treatment. 

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Since probiotic bacteria travel through the gut as transient organisms, they do not colonise the small intestine. But if they’re viewed in a way where their action is to trigger the production of natural antimicrobials from the small intestine, this is a way that probiotics can actually reduce the bacterial load in the small intestine. 

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Understanding probiotics in this way can lead to more confidence in their use in SIBO treatment.

Best sources of probiotics  

Probiotics can be administered in capsule, powder or liquid form.  From a clinical perspective, understanding which strain of bacteria is being used and the benefits it provides.

Foods rich in probiotics 

Fermented foods contain a wide range of bacteria as well as by-products of the fermentation process. This can further support the balance of the microbiome as well as the integrity of the gut lining. 

Fermented foods include: 

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• Yoghurt 

• Kefir 

• Sauerkraut 

• Kimchi 
   

Conclusion

Probiotics can be administered in ways that can be symptoms and condition-specific. Not only for gut health-related issues but also for general health and wellbeing. 

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The dose and duration of these can depend on the condition as well as other health issues or concerns. It can also be that probiotics are taken alongside other gut health supplements or dietary adjustments to see the desired change in symptoms. 

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Information source: https://ibsguthealthclinic.co.uk

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Issues to be aware of

If you're considering trying probiotics, there are a few issues you need to be aware of.

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Probiotics are generally classed as food rather than medicine, which means they don't go through the rigorous testing medicines do.

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Because of the way probiotics are regulated, we can't always be sure that:

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• the product actually contains the bacteria stated on the food label

• the product contains enough bacteria to have an effect

• the bacteria are able to survive long enough to reach your gut

 

There are many different types of probiotics that may have different effects on the body, and little is known about which types are best.

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You may find a particular type of probiotic helps with one problem. But this doesn't mean it'll help other problems, or that other types of probiotic will work just as well.

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And there's likely to be a huge difference between the pharmaceutical-grade probiotics that show promise in clinical trials and the yoghurts and supplements sold in shops.

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If you have an existing health condition or a weakened immune system, you should talk to a doctor before taking any probiotic supplements.

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