Probiotics, Prebiotics, and Irritable Bowel Syndrome
Probiotics are the same as or similar to microorganisms that naturally occur in the body, and, as such, are potentially beneficial and healthful. Probiotics modulate immune response throughout the mucosa-associated lymphoid tissue system.
Symbiotics contain both live organisms and material that fuels perpetuation of the organisms. The majority of probiotics available today are symbiotics.
Prebiotics are selectively fermented ingredients that allow specific changes both in the composition and/or activity in the GI microflora that confer benefits upon host well-being and health.
These nondigestible foods facilitate specific bacteria to grow and flourish. Prebiotics are typically specific nutrients, often nonabsorbable carbohydrates (fructo- and oligosaccharides) that are found naturally in whole grains, fruits, and legumes. Often members of the carbohydrate family, they keep beneficial bacteria healthy but are not bacteria. Prebiotics often work synergistically with probiotics.
The most widely used probiotics include Lactobacillus plantarum 299v, L rhamnosus LGG, L reuteri, L acidophilus, L casei, and Bifidobacterium infantis, B. lactis, or B. brevis. It is important to note that even within one species, the effects of one strain are likely to be different from the effects of another.
A systematic review of the use of probiotics to help treat Irritable bowel syndrome found that B. infantis 35624 was associated with significant improvement in the composite score for abdominal pain or discomfort, bloating or distention, and bowel movement difficulty compared with placebo in 2 well-designed trials.
Probiotics containing B. breve, B. longum, and/or L. acidophilus spp have been associated with improvements in pain. Abdominal distention was improved by probiotics containing B breve, B infantis,L casei, or L plantarum species.
Evidence from the Human Genome Project by the NIH demonstrates a much broader diversity of species in the guts of healthy persons compared with persons with IBS. Probiotics do not add diversity; rather, they typically only address 1 or, at most, a few specific microbes.
Edited from “Do Probiotics Have a Role in IBS” by Mark Pimentel, MD published in Medscape.