What You Should Know About IBS, Probiotics, and How to Use Them

The Science Behind Using Probiotics for IBS

An IBS probiotics capsule broken open to reveal the powder inside

Key Takeaways

  • Five separate meta-analyses have shown that probiotics are likely an effective treatment for IBS, with very few side effects.
  • The most important probiotic strategy for IBS (or any digestive problem) is to include a diversity of high-quality probiotics.

If you’re one of the 20% of Americans with Irritable Bowel Syndrome (IBS) [1] you’ll be happy to know that probiotic supplements may help you feel better. Many studies show probiotics to be effective and safe for IBS symptoms, without side effects. Let’s talk about why you likely want to use probiotics for IBS.

What is Irritable Bowel Syndrome (IBS)?

IBS, or irritable bowel syndrome, is one of the most common gastrointestinal disorders. It is more of a broad collection of gut symptoms, than a specific disease.

Common symptoms of Irritable Bowel Syndrome include:

  • Bloating
  • Abdominal pain
  • Cramping
  • Gas and flatulence
  • Frequent diarrhea, constipation, or both

Non-digestive symptoms of Irritable Bowel Syndrome include:

IBS is categorized as either IBS-D (when diarrhea is the predominant symptom), IBS-C (when constipation is the primary symptom), or mixed (when diarrhea and constipation alternate). General practitioners and gastroenterologists often diagnose IBS when they don’t know how else to categorize your digestive symptoms or when there is no clear cause.

What Causes IBS?

There is no single proven cause of IBS, and the root cause varies from patient to patient. However, there is a close association between IBS and small intestinal bacterial overgrowth (SIBO) and other types of gut infections. [7 Trusted SourcePubMedGo to source] One meta-analysis reported an average of 38% of people with IBS tested positive for SIBO. [8 Trusted SourcePubMedGo to source]

Certain dietary habits, such as a diet too high [9 Trusted SourcePubMedGo to source] or too low in fiber [10 Trusted SourcePubMedGo to source], or high in FODMAP foods [11 Trusted SourcePubMedGo to source], can contribute to symptoms of IBS too. These are likely not the root cause of the problem, but reducing these foods can help reduce IBS symptoms. What is also clear is that probiotics help improve IBS.

What Are Probiotics?

Probiotic bacteria are live microorganisms in your digestive system that have beneficial effects on your health. Probiotics have been shown in many recent studies and double-blind clinical trials to improve IBS symptoms. [12 Trusted SourcePubMedGo to source, 13 Trusted SourcePubMedGo to source]

Collectively, probiotics have been shown to:

This is great news because there’s no effective conventional treatment of irritable bowel syndrome.

Probiotics Improve Irritable Bowel Syndrome

IBS probiotics: A woman doubled over from stomach pain

Though some doctors continue to insist that there is no evidence that probiotics are beneficial for irritable bowel syndrome, the evidence speaks for itself. Multiple high quality meta-analyses and clinical trials show that various types of probiotics improve IBS symptoms.

Overall IBS Symptoms

Five separate meta-analyses (the highest quality scientific evidence) have shown the efficacy of probiotics as a likely effective treatment of IBS, with very few side effects. [19 Trusted SourcePubMedGo to source, 20 Trusted SourcePubMedGo to source, 21 Trusted SourcePubMedGo to source, 22 Trusted SourcePubMedGo to source, 23 Trusted SourcePubMedGo to source]

Across these studies, people given probiotic supplements showed significant improvement in IBS symptoms and quality of life compared to a placebo group. This included improvements in:

  • Diarrhea, or loose stools
  • Constipation
  • Bloating and abdominal pain
  • Flatulence or gas
  • Fatigue and difficulty sleeping

Here is a summary of the research about the most common IBS symptoms.

Bloating and Abdominal Pain

Bloating, abdominal pain, and cramping are three of the most bothersome IBS symptoms for patients. Probiotics have been shown to be particularly effective at reducing abdominal pain.

A meta-analysis noted that “Probiotics were…associated with less abdominal pain compared to placebo,” [24 Trusted SourcePubMedGo to source] and a randomized controlled trial showed that probiotics significantly reduced abdominal pain and distention in IBS patients. [25 Trusted SourcePubMedGo to source] Several other studies reached similar conclusions. [26 Trusted SourcePubMedGo to source, 27 Trusted SourcePubMedGo to source, 28 Trusted SourcePubMedGo to source, 29 Trusted SourcePubMedGo to source]

Diarrhea

Diarrhea can be a debilitating IBS symptom. Fortunately, there is evidence that probiotics can help relieve IBS-related diarrhea.

Two studies showed that Bacillus species probiotics reduced diarrhea and stool frequency in IBS patients. [30 Trusted SourcePubMedGo to source, 31 Trusted SourcePubMedGo to source]In one more study, small intestinal bacterial overgrowth (SIBO) patients saw their diarrhea improve from probiotic supplements. [32 Trusted SourcePubMedGo to source]

Constipation

Patients who experience constipation often find the symptom to be tenacious. Probiotics have been shown to help improve stool frequency and regularity in patients with constipation. [33 Trusted SourcePubMedGo to source, 34 Trusted SourcePubMedGo to source] In one study, participants had less constipation even months after supplementation stopped. [35 Trusted SourcePubMedGo to source]

IBS Symptoms in Inflammatory Bowel Disease Patients

Many patients with Inflammatory Bowel Disease (IBD) have IBS symptoms as part of their clinical picture. Though one systematic review found probiotics do not help maintain symptom remission for IBD patients, [36 Trusted SourcePubMedGo to source] probiotics have been shown to improve IBD treatment outcomes. [37 Trusted SourcePubMedGo to source]

The best evidence is for ulcerative colitis. Several systematic reviews and meta analyses found that VSL#3, a brand-name probiotic, appeared to encourage remission of ulcerative colitis, but didn’t show a benefit for Crohn’s patients. [38 Trusted SourcePubMedGo to source, 39 Trusted SourcePubMedGo to source, Trusted SourcePubMedGo to source40 Trusted SourcePubMedGo to source] Another showed remission or improvement of ulcerative colitis symptoms from the use of probiotics, especially in pediatric patients. [41 Trusted SourcePubMedGo to source]

Probiotics also appear to improve the effectiveness of certain anti-inflammatory drugs used for treating ulcerative colitis [42 Trusted SourcePubMedGo to source] or may in some cases be as effective as the drugs alone. [43 Trusted SourcePubMedGo to source]

How Probiotics Heal IBS

Probiotics don’t work like medications. It’s not necessary to use specific strains to improve your IBS symptoms or any other health condition. Instead, all probiotics provide general health benefits to your gut environment by:

As probiotic supplements help create these general changes to your digestive health, your IBS symptoms improve. For example, as inflammation decreases, diarrhea may improve. As your gut microbiota becomes more balanced, bloating and abdominal pain may decrease.

Using Probiotics for IBS

IBS probiotics: A hand holds a variety of probiotic pills

Along with an anti-inflammatory diet, such as the Paleo or low FODMAP diet, using a combination of probiotics is one of the primary approaches I recommend for IBS patients.

As I discuss more fully in my book Healthy Gut, Healthy You, the most important probiotic strategy for IBS (or any digestive problem) is to include a diversity of high-quality probiotics. 

Though there are hundreds of probiotic supplements on the market, most probiotics fall into one of these three categories:

Using one type of probiotic is good, but using all three different probiotics together allows them to work synergistically to improve your gut health. Probiotic strains from all three categories have been shown to help IBS symptoms.

The three types of probiotics work together like the legs of a three-legged stool. If the stool only has one or two legs, it’s likely to be unstable. With three legs, the stool is able to stay upright.

IBS probiotics: An infographic showing the benefits of using three strains of probiotics together

Choosing the Best Probiotics for IBS

Probiotic manufacturing is not highly regulated by the U.S. Food and Drug Administration (FDA) and some label claims do not stand up to scrutiny. In one study of 26 commercial probiotics, none fully supported their label claims, and some of them contained unacceptable microorganisms. [57]

You don’t need to purchase the most expensive probiotic supplements, but you should be wary of quality. Here are some tips for choosing high-quality probiotic supplements.

Choose Probiotic Supplements With:

  • A clearly stated list of species
  • A clearly stated number of colony-forming units (CFUs) in the billions
  • A manufacture date and/or expiration date
  • Labeled free of common allergens and other substances you may wish to avoid (e.g. gluten-free, non-GMO, vegan)
  • Good Manufacturing Practices (GMP) certification
  • Lab-verified for probiotic species and potency by third-party analysis (independent lab testing)

Are Probiotic Foods and Prebiotics a Good Idea for IBS?

Probiotic or fermented foods are healthy and beneficial for the digestive system, but they generally have a much smaller number of good bacteria than probiotic supplements. If you’re trying to use probiotics to address IBS, probiotic foods likely won’t be enough. 

Similarly, many recommend using prebiotics for gut health. But prebiotics are fiber supplements that feed gut bacteria and may irritate IBS symptoms for many IBS patients. Prebiotics are best left alone until you have recovered from your IBS.

The Bottom Line

Probiotics have been shown to improve many IBS symptoms, including bloating, abdominal pain, diarrhea, constipation, and more. Including probiotics and an anti-inflammatory diet in your regular routine is likely to reduce your IBS symptoms and leave you feeling better. Include one high-quality product from each probiotic category, and experience the results for yourself.

➕ References
  1. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71-80. Published 2014 Feb 4. doi:10.2147/CLEP.S40245
  2. Hausteiner-Wiehle C, Henningsen P. Irritable bowel syndrome: relations with functional, mental, and somatoform disorders. World J Gastroenterol. 2014;20(20):6024-6030. doi:10.3748/wjg.v20.i20.6024 Trusted SourcePubMedGo to source
  3. Frändemark Å, Jakobsson Ung E, Törnblom H, Simrén M, Jakobsson S. Fatigue: a distressing symptom for patients with irritable bowel syndrome. Neurogastroenterol Motil. 2017;29(1):10.1111/nmo.12898. doi:10.1111/nmo.12898 Trusted SourcePubMedGo to source
  4. Chakiath RJ, Siddall PJ, Kellow JE, et al. Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis. Syst Rev. 2015;4:175. Published 2015 Dec 10. doi:10.1186/s13643-015-0162-8 Trusted SourcePubMedGo to source
  5. Berstad A, Undseth R, Lind R, Valeur J. Functional bowel symptoms, fibromyalgia and fatigue: a food-induced triad?. Scand J Gastroenterol. 2012;47(8-9):914-919. doi:10.3109/00365521.2012.690045 Trusted SourcePubMedGo to source
  6. Nilholm C, Roth B, Ohlsson B. A Dietary Intervention with Reduction of Starch and Sucrose Leads to Reduced Gastrointestinal and Extra-Intestinal Symptoms in IBS Patients. Nutrients. 2019;11(7):1662. Published 2019 Jul 20. doi:10.3390/nu11071662 Trusted SourcePubMedGo to source
  7. Schmulson M, Bielsa MV, Carmona-Sánchez R, et al. Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome: an evidence-based review. Rev Gastroenterol Mex. 2014;79(2):96-134. doi:10.1016/j.rgmx.2014.01.004 Trusted SourcePubMedGo to source
  8. Chen B, Kim JJ, Zhang Y, Du L, Dai N. Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. 2018;53(7):807-818. doi:10.1007/s00535-018-1476-9 Trusted SourcePubMedGo to source
  9. Baştürk A, Artan R, Yılmaz A. Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: A randomized controlled trial. Turk J Gastroenterol. 2016;27(5):439-443. doi:10.5152/tjg.2016.16301 Trusted SourcePubMedGo to source
  10. Christodoulides S, Dimidi E, Fragkos KC, Farmer AD, Whelan K, Scott SM. Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults. Aliment Pharmacol Ther. 2016;44(2):103-116. doi:10.1111/apt.13662 Trusted SourcePubMedGo to source
  11. Marsh A, Eslick EM, Eslick GD. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr. 2016;55(3):897-906. doi:10.1007/s00394-015-0922-1 Trusted SourcePubMedGo to source
  12. Yuan F, Ni H, Asche CV, Kim M, Walayat S, Ren J. Efficacy of Bifidobacterium infantis 35624 in patients with irritable bowel syndrome: a meta-analysis. Curr Med Res Opin. 2017;33(7):1191-1197. doi:10.1080/03007995.2017.1292230 Trusted SourcePubMedGo to source
  13. Tiequn B, Guanqun C, Shuo Z. Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis. Intern Med. 2015;54(3):243-249. doi:10.2169/internalmedicine.54.2710 Trusted SourcePubMedGo to source
  14. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-1562. doi:10.1038/ajg.2014.202 Trusted SourcePubMedGo to source
  15. Rogha M, Esfahani MZ, Zargarzadeh AH. The efficacy of a synbiotic containing Bacillus Coagulans in treatment of irritable bowel syndrome: a randomized placebo-controlled trial. Gastroenterol Hepatol Bed Bench. 2014;7(3):156-163. Trusted SourcePubMedGo to source
  16. Majeed M, Nagabhushanam K, Natarajan S, et al. Bacillus coagulans MTCC 5856 supplementation in the management of diarrhea predominant Irritable Bowel Syndrome: a double blind randomized placebo controlled pilot clinical study. Nutr J. 2016;15:21. Published 2016 Feb 27. doi:10.1186/s12937-016-0140-6 Trusted SourcePubMedGo to source
  17. Yuan F, Ni H, Asche CV, Kim M, Walayat S, Ren J. Efficacy of Bifidobacterium infantis 35624 in patients with irritable bowel syndrome: a meta-analysis. Curr Med Res Opin. 2017;33(7):1191-1197. doi:10.1080/03007995.2017.1292230 Trusted SourcePubMedGo to source
  18. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008;14(17):2650-2661. doi:10.3748/wjg.14.2650 Trusted SourcePubMedGo to source
  19. Yuan F, Ni H, Asche CV, Kim M, Walayat S, Ren J. Efficacy of Bifidobacterium infantis 35624 in patients with irritable bowel syndrome: a meta-analysis. Curr Med Res Opin. 2017;33(7):1191-1197. doi:10.1080/03007995.2017.1292230 Trusted SourcePubMedGo to source
  20. Tiequn B, Guanqun C, Shuo Z. Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis. Intern Med. 2015;54(3):243-249. doi:10.2169/internalmedicine.54.2710 Trusted SourcePubMedGo to source
  21. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008;14(17):2650-2661. doi:10.3748/wjg.14.2650 Trusted SourcePubMedGo to source
  22. Whelan K. Probiotics and prebiotics in the management of irritable bowel syndrome: a review of recent clinical trials and systematic reviews. Curr Opin Clin Nutr Metab Care. 2011;14(6):581-587. doi:10.1097/MCO.0b013e32834b8082 Trusted SourcePubMedGo to source
  23. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-1562. doi:10.1038/ajg.2014.202 Trusted SourcePubMedGo to source
  24. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008;14(17):2650-2661. doi:10.3748/wjg.14.2650 Trusted SourcePubMedGo to source
  25. Martoni CJ, Srivastava S, Leyer GJ. Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABla-12 Improve Abdominal Pain Severity and Symptomology in Irritable Bowel Syndrome: Randomized Controlled Trial. Nutrients. 2020;12(2):363. Published 2020 Jan 30. doi:10.3390/nu12020363 Trusted SourcePubMedGo to source
  26. Whelan K. Probiotics and prebiotics in the management of irritable bowel syndrome: a review of recent clinical trials and systematic reviews. Curr Opin Clin Nutr Metab Care. 2011;14(6):581-587. doi:10.1097/MCO.0b013e32834b8082 Trusted SourcePubMedGo to source
  27. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-1562. doi:10.1038/ajg.2014.202 Trusted SourcePubMedGo to source
  28. Rogha M, Esfahani MZ, Zargarzadeh AH. The efficacy of a synbiotic containing Bacillus Coagulans in treatment of irritable bowel syndrome: a randomized placebo-controlled trial. Gastroenterol Hepatol Bed Bench. 2014;7(3):156-163. Trusted SourcePubMedGo to source
  29. Khalighi AR, Khalighi MR, Behdani R, et al. Evaluating the efficacy of probiotic on treatment in patients with small intestinal bacterial overgrowth (SIBO)–a pilot study. Indian J Med Res. 2014;140(5):604-608. Trusted SourcePubMedGo to source
  30. Rogha M, Esfahani MZ, Zargarzadeh AH. The efficacy of a synbiotic containing Bacillus Coagulans in treatment of irritable bowel syndrome: a randomized placebo-controlled trial. Gastroenterol Hepatol Bed Bench. 2014;7(3):156-163. Trusted SourcePubMedGo to source
  31. Majeed M, Nagabhushanam K, Natarajan S, et al. Bacillus coagulans MTCC 5856 supplementation in the management of diarrhea predominant Irritable Bowel Syndrome: a double blind randomized placebo controlled pilot clinical study. Nutr J. 2016;15:21. Published 2016 Feb 27. doi:10.1186/s12937-016-0140-6 Trusted SourcePubMedGo to source
  32. Khalighi AR, Khalighi MR, Behdani R, et al. Evaluating the efficacy of probiotic on treatment in patients with small intestinal bacterial overgrowth (SIBO)–a pilot study. Indian J Med Res. 2014;140(5):604-608. Trusted SourcePubMedGo to source
  33. Ibarra A, Latreille-Barbier M, Donazzolo Y, Pelletier X, Ouwehand AC. Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: A double-blind, randomized, placebo-controlled, and dose-ranging trial. Gut Microbes. 2018;9(3):236-251. doi:10.1080/19490976.2017.1412908 Trusted SourcePubMedGo to source
  34. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-1562. doi:10.1038/ajg.2014.202 Trusted SourcePubMedGo to source
  35. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-1562. doi:10.1038/ajg.2014.202 Trusted SourcePubMedGo to source
  36. Naidoo K, Gordon M, Fagbemi AO, Thomas AG, Akobeng AK. Probiotics for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2011;(12):CD007443. Published 2011 Dec 7. doi:10.1002/14651858.CD007443.pub2 Trusted SourcePubMedGo to source
  37. Derwa Y, Gracie DJ, Hamlin PJ, Ford AC. Systematic review with meta-analysis: the efficacy of probiotics in inflammatory bowel disease. Aliment Pharmacol Ther. 2017;46(4):389-400. doi:10.1111/apt.14203 Trusted SourcePubMedGo to source
  38. Derwa Y, Gracie DJ, Hamlin PJ, Ford AC. Systematic review with meta-analysis: the efficacy of probiotics in inflammatory bowel disease. Aliment Pharmacol Ther. 2017;46(4):389-400. doi:10.1111/apt.14203 Trusted SourcePubMedGo to source
  39. Ganji-Arjenaki M, Rafieian-Kopaei M. Probiotics are a good choice in remission of inflammatory bowel diseases: A meta analysis and systematic review. J Cell Physiol. 2018;233(3):2091-2103. doi:10.1002/jcp.25911 Trusted SourcePubMedGo to source
  40. Jia K, Tong X, Wang R, Song X. The clinical effects of probiotics for inflammatory bowel disease: A meta-analysis [published correction appears in Medicine (Baltimore). 2019 Feb;98(5):e14429]. Medicine (Baltimore). 2018;97(51):e13792. doi:10.1097/MD.0000000000013792 Trusted SourcePubMedGo to source
  41. Ganji-Arjenaki M, Rafieian-Kopaei M. Probiotics are a good choice in remission of inflammatory bowel diseases: A meta analysis and systematic review. J Cell Physiol. 2018;233(3):2091-2103. doi:10.1002/jcp.25911 Trusted SourcePubMedGo to source
  42. Hedin C, Whelan K, Lindsay JO. Evidence for the use of probiotics and prebiotics in inflammatory bowel disease: a review of clinical trials. Proc Nutr Soc. 2007;66(3):307-315. doi:10.1017/S0029665107005563 Trusted SourcePubMedGo to source
  43. Kruis W, Fric P, Pokrotnieks J, et al. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut. 2004;53(11):1617-1623. doi:10.1136/gut.2003.037747 Trusted SourcePubMedGo to source
  44. Leblhuber F, Steiner K, Schuetz B, Fuchs D, Gostner JM. Probiotic Supplementation in Patients with Alzheimer’s Dementia – An Explorative Intervention Study. Curr Alzheimer Res. 2018;15(12):1106-1113. doi:10.2174/1389200219666180813144834 Trusted SourcePubMedGo to source
  45. Wang F, Feng J, Chen P, et al. Probiotics in Helicobacter pylori eradication therapy: Systematic review and network meta-analysis. Clin Res Hepatol Gastroenterol. 2017;41(4):466-475. doi:10.1016/j.clinre.2017.04.004 Trusted SourcePubMedGo to source
  46. García-Collinot G, Madrigal-Santillán EO, Martínez-Bencomo MA, et al. Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis. Dig Dis Sci. 2020;65(4):1134-1143. doi:10.1007/s10620-019-05830-0 Trusted SourcePubMedGo to source
  47. Greco A, Caviglia GP, Brignolo P, et al. Glucose breath test and Crohn’s disease: Diagnosis of small intestinal bacterial overgrowth and evaluation of therapeutic response. Scand J Gastroenterol. 2015;50(11):1376-1381. doi:10.3109/00365521.2015.1050691 Trusted SourcePubMedGo to source
  48. Sanders ME. Impact of probiotics on colonizing microbiota of the gut. J Clin Gastroenterol. 2011;45 Suppl:S115-S119. doi:10.1097/MCG.0b013e318227414a Trusted SourcePubMedGo to source
  49. Toribio-Mateas M. Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions. Microorganisms. 2018;6(2):35. Published 2018 Apr 25. doi:10.3390/microorganisms6020035 Trusted SourcePubMedGo to source
  50. Stenman LK, Lehtinen MJ, Meland N, et al. Probiotic With or Without Fiber Controls Body Fat Mass, Associated With Serum Zonulin, in Overweight and Obese Adults-Randomized Controlled Trial. EBioMedicine. 2016;13:190-200. doi:10.1016/j.ebiom.2016.10.036 Trusted SourcePubMedGo to source
  51. Frei R, Akdis M, O’Mahony L. Prebiotics, probiotics, synbiotics, and the immune system: experimental data and clinical evidence. Curr Opin Gastroenterol. 2015;31(2):153-158. doi:10.1097/MOG.0000000000000151 Trusted SourcePubMedGo to source
  52. Leblhuber F, Steiner K, Schuetz B, Fuchs D, Gostner JM. Probiotic Supplementation in Patients with Alzheimer’s Dementia – An Explorative Intervention Study. Curr Alzheimer Res. 2018;15(12):1106-1113. doi:10.2174/1389200219666180813144834 Trusted SourcePubMedGo to source
  53. Toribio-Mateas M. Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions. Microorganisms. 2018;6(2):35. Published 2018 Apr 25. doi:10.3390/microorganisms6020035 Trusted SourcePubMedGo to source
  54. Mujagic Z, de Vos P, Boekschoten MV, et al. The effects of Lactobacillus plantarum on small intestinal barrier function and mucosal gene transcription; a randomized double-blind placebo controlled trial. Sci Rep. 2017;7:40128. Published 2017 Jan 3. doi:10.1038/srep40128 Trusted SourcePubMedGo to source
  55. Sindhu KN, Sowmyanarayanan TV, Paul A, et al. Immune response and intestinal permeability in children with acute gastroenteritis treated with Lactobacillus rhamnosus GG: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2014;58(8):1107-1115. doi:10.1093/cid/ciu065 Trusted SourcePubMedGo to source
  56. Lamprecht M, Bogner S, Schippinger G, et al. Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial. J Int Soc Sports Nutr. 2012;9(1):45. Published 2012 Sep 20. doi:10.1186/1550-2783-9-45 Trusted SourcePubMedGo to source
  57. Viktoria Yonkova Marinova, Iliyana Kirilova Rasheva, Yoana Krasimirova Kizheva, Yordanka Dimitrova Dermenzhieva & Petya Koitcheva Hristova (2019) Microbiological quality of probiotic dietary supplements, Biotechnology & Biotechnological Equipment, 33:1, 834-841, DOI: 10.1080/13102818.2019.1621208
➕ Links & Resources

Need help or would like to learn more?
View Dr. Ruscio’s additional resources

Get Help

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!