What is IBS?
IBS is one of the most frequently occurring GI disorders. It is a constellation of the following major clinical hallmarks:
- Abdominal pain
- Altered bowel habits
- Bloating
- Straining at the stools
- Urgency
- Flatulence
The bowel movements in IBS can follow either a pattern of constipation-predominant IBS (IBS-C) or diarrhea- predominant IBS. Constipation-predominant IBS is exasperating – incomplete defecation, straining at the stools, and bloated feeling all interfere with daily chores.
The story of IBS begins with the gut-brain axis!
Our emotions influence our gut functions. That is the reason why many people have butterflies in the stomach when they are apprehensive. Our gut microbiota communicates with the brain and alters behavior. IBS is common in people who already suffer from anxiety issues. Saying it the other way around, anxiety and/or a stressful life event can trigger IBS symptoms. This bidirectional communication coins the phrase – the gut-brain axis. When the gut and brain can’t communicate well, IBS is inevitable.
What’s actually in the gut that interacts with the brain?
It is the gut microbiome. This re-coins the phrase as mIcrobiota- gut-brain axis. In IBS, a lack of these desirable bacteria undermines the gastrointestinal, neurological and/or immune relationships, eventually leading to infirmity.
IBS and Probiotics
The healthy gut microbiota (probiotics) confers a myriad of health benefits in IBS.
- Probiotics assist in breaking down complex molecules ingested as part of the diet. This smoothes out the process of digestion and facilitates elimination of hard feces in IBS-C.
- As stated above, stress is a common precipitating factor for IBS; when taken during periods of stress, probiotics decrease the activation of the areas of the brain that tend to secrete stress hormones like cortisol. Hence, a decrease in the stress hormones calms the mind, the gut, and the associated IBS features. What’s more? Stress triggers gut leakiness, which is counteracted by probiotics. Leaky gut syndrome (enhanced intestinal permeability) also underlies IBS. [1]
- Probiotics are able to liberate short-chain fatty acids that are anti-inflammatory products. Gut inflammation at the microscopic level is present in IBS. In conjunction with other treatment modes, the good bacteria serve as a delivery vehicle for treatment loads that are liberated at various intestinal sites of inflammation. In addition, SCFAs diminish the sensitivity of gut receptors to pain in IBS and accelerate the waves of intestinal peristalsis in IBS-C.
- These favorable microbes generate bacteria-killing proteins, protecting your gut against harmful bacterial infections. Studies reveal that an infectious cause may be the culprit behind IBS. [2]
- Probiotics, specifically including Lactobacilli alleviate abdominal pain by relaxing the gut muscles. [3] Increased muscular contractions account for the abdominal pangs in IBS. Furthermore, it is found that the amounts of lactate-producing (Bifidobacterium and lactobacilli) beneficial microbes are considerably lower in people with functional constipation. This is in contrast to the higher numbers of methane-producing harmful bacteria found in the stools of these people, which slow down the transit of food through the intestine. [4] This represents a bonus reason to supplement probiotics in IBS-C.
A comprehensive scientific analysis that collected data from 24 clinical trials revealed a reduction in IBS symptoms and severity after the administration of probiotics. [5]
Summary
To conclude, IBS has a profound negative impact on your daily life. Probiotics are effective for functional constipation when combined with other therapies including lifestyle and dietary modifications.
Written by:
Dr. Rasheed Huma
References
- Rea K, Dinan TG, Cryan JF. The microbiome: A key regulator of stress and neuroinflammation. Neurobiology of Stress. 2016;4:23-33. doi:10.1016/j.ynstr.2016.03.001.
- Ghoshal UC, Ranjan P. Post-infectious irritable bowel syndrome: the past, the present and the future. J Gastroenterol Hepatol. 2011;26 Suppl 3:94-101. doi: 10.1111/j.1440-1746.2011.06643.x.
- Verdú EF, Bercík P, Bergonzelli GE et al. Lactobacillus paracasei normalizes muscle hypercontractility in a murine model of postinfective gut dysfunction. Gastroenterology. 2004;127(3):826-37.
- Choi CH, Chang SK. Alteration of Gut Microbiota and Efficacy of Probiotics in Functional Constipation. Journal of Neurogastroenterology and Motility. 2015;21(1):4-7. doi:10.5056/jnm14142.
- Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World Journal of Gastroenterology : WJG. 2015;21(10):3072-3084. doi:10.3748/wjg.v21.i10.3072.
