Last Updated: 09 February 2023

Are Probiotics Helpful For IBS? 13 Expert Organizations Compared

Researched & Written By:
In this guide we look at the recommendations of 13 international organizations on probiotics for IBS. As you'll see there is no consensus among them, as they each deliver differing opinions on the usefulness of probiotics for IBS. To make this guide even more useful for you, where probiotics are recommended by an organization, we list out the specific strains they believe have the most potential to help with IBS symptoms.
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Comparison Table

Organization

Country

Year

Statement Summary

Recommendation Level

Evidence Quality Rating

Conclusion

American College of Gastroenterology (ACG) Clinical Guideline: Management of IBS<span class="ref">1</span>

USA

2021

“We suggest against probiotics for the treatment of global IBS symptoms.”

Conditional

Very low

Recommends against probiotic use in IBS

American Gastroenterological Association (AGA)<span class="ref">2</span>

USA

2020

“In symptomatic children and adults with irritable bowel syndrome, we recommend the use of probiotics only in the context of a clinical trial.”

No recommendation

N/A

No recommendation or does not advise routine probiotic use in IBS

Experts of Yale Workshop on Probiotics<span class="ref">3</span>

USA

2015

Recommended 4 probiotics, but no summary statement was provided. The recommended strains included:

-Bifidobacterium infantis 35624

-VSL #3

-B. animalis

-L. plantarum 299v

N/A

Each recommended strain was given an effectiveness letter ranking of either a B or C, though the meaning of these rankings was not explicitly stated

Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations

The Asian Neurogastroenterology and Motility Association (ANMA) – Second Asian Consensus <span class="ref">4</span>

Asia

2019

“The effectiveness of probiotics has not been fully validated in IBS.”

No recommendations

moderate

No recommendation or does not advise routine probiotic use in IBS

British Society of Gastroenterology<span class="ref">5</span>

UK

2021

“Probiotics, as a group, may be an effective treatment for global symptoms and abdominal pain in IBS, but it is not possible to recommend a specific species or strain. It is reasonable to advise patients wishing to try probiotics to take them for up to 12 weeks, and to discontinue them if there is no improvement in symptoms.”

Weak

Very Low

Probiotic use may be considered in IBS. Probiotic response and trials should be assessed within a certain time frame or aimed at specified symptoms

British Dietetic Association (BDA)<span class="ref">6</span>

UK

2016

“Probiotics are unlikely to provide substantial benefit to IBS symptoms. However, individuals choosing to try probiotics are advised to select one product at a time and monitor the effects. They should try it for a minimum of 4 weeks at the dose recommended by the manufacturer. Taking a probiotic product is considered safe in IBS.”

Grade B

(The meaning of grade rankings was not explained)

N/A

Probiotic use may be considered in IBS. Probiotic response and trials should be assessed within a certain time frame or aimed at specified symptoms

Canadian Association of Gastroenterology<span class="ref">7</span>

Canada

2019

“We suggest offering IBS patients probiotics to improve IBS symptoms.”

Conditional

Low-quality

Advises probiotic use in IBS but with no strain-specific recommendations

German Society for Digestive and Metabolic Diseases<span class="ref">8</span>

Germany

2011

Probiotics recommended in most/some IBS patients with pain and diarrhea, constipation and bloating/abdominal distension/meteorism/flatulence:

Bifidobacterium infantis 35624

Bifidobacterium animalis ssp . lactis DN-173 010

Lactobacillus casei Shirota

Lactobacillus plantarum 299v

Lactobacillus rhamnosus GG (only in children)

E. coli Nissle 1917

Level A


Meaning for physicians:

Different decisions are appropriate for different patients, depending on the patient’s situation but also on personal opinions and preferences.

Meaning for patients:

The majority of patients (> 50%) would decide in favor of the intervention, but many would not.

Strong consensus

Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations

Japanese Society of Gastroenterology (JSGE)<span class="ref">9</span>

Japan

2021

“Probiotics are effective in treating IBS. Probiotics are recommended for IBS.”

Strong recommendation

Level A (High)

Advises probiotic use in IBS but with no strain-specific recommendations

Korean Society of Neurogastroenterology and Motility (KSNM)<span class="ref">10</span>

Korea

2018

“Probiotics may be considered to relieve global symptoms, bloating, and flatulence in irritable bowel syndrome patients.”

Weak (2)

Low Quality (C)

Probiotic use may be considered in IBS. Probiotic response and trials should be assessed within a certain time frame or aimed at specified symptoms

Polish Society of Gastroenterology<span class="ref">11</span>

Poland

2018

“We suggest using certain strains or combinations of probiotic strains tested for their efficacy in IBS, rather than probiotics as a group to reduce overall symptoms of IBS as well as bloating and diarrhea in patients with IBS…

It is not possible to determine the efficacy of individual strains included in combined preparations or the efficacy of other configurations (blends) of the aforementioned strains”


Monostrains:

– Bifidobacterium bifidum MIMBb75

– Bifidobacterium infantis 35624

– Bifidobacterium lactis – Escherichia coli DSM17252

– Lactobacillus acidophilus SDC 2012, 2013

– Lactobacillus plantarum 299v


Strains tested in selected populations, or an effect covering only a part of symptoms:

– Bacillus coagulans GBI-30, 6086

– Bifidobacterium animalis

– Saccharomyces boulardii CNCM I-745


Blends:

– Combined preparation: Lactobacillus rhamnosus NCIMB 30174, L. plantarum NCIMB 30173, L. acidophilus NCIMB and Enterococcus faecium NCIMB 30176

– Combined preparation: Lactobacillus animalis subsp. lactis BB-12, L. acidophilus LA-5, L. delbrueckii subsp. bulgaricus LBY-27 and Streptococcus thermophilus STY-31; Bifidobacterium animalis DN-173 010 in fermented milk (together with Streptococcus thermophilus and Lactobacillus bulgaricus)

– Combined preparation: Lactobacillus rhamnosus GG, L. rhamnosus LC705, Propionibacterium freudenreichii subsp. shermanii JS DSM 7067 and Bifidobacterium animalis subsp. lactis Bb12 DSM 15954

– Combined preparation Pediococcus acidilactici CECT 7483, Lactobacillus plantarum CECT 7484 and L. plantarum CECT 7485

– Combined preparation: Streptococcus thermophilus DSM24731, Bifidobacterium longum DSM24736, Bifidobacterium breve DSM24732, Bifidobacterium infantis DSM24737, Lactobacillus acidophilus DSM24735, Lactobacillus plantarum DSM24730, Lactobacillus paracasei DSM24733 and Lactobacillus delbrueckii ssp. bulgaricus DSM24734

Weak quality of evidence

Very Low

Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations

Romanian Society of Neurogastroenterology<span class="ref">12</span>

Romania

2021

“In patients with IBS, we recommend the use of probiotics as an alternative therapy in trials of limited duration.”

Weak

B (Several studies available, at least one of high quality, others with limitations; trustworthy)

Advises probiotic use in IBS but with no strain-specific recommendations

World Gastroenterology Organisation (WGO)<span class="ref">13</span>

Global

2017

“A reduction in abdominal bloating and flatulence as a result of probiotic treatments is a consistent finding in published studies; some strains may ameliorate pain and provide global relief. The literature suggests that certain probiotics may alleviate symptoms and improve the quality of life in patients with functional abdominal pain.”


Recommended strains and Blends:

-Bifidobacterium bifidum MIMBb75 (3)

-Lactobacillus plantarum 299v (DSM 9843) (2)

-Escherichia coli DSM17252 (2)

-Lactobacillus rhamnosus NCIMB 30174, L. plantarum NCIMB 30173, L. acidophilus NCIMB 30175, and Enterococcus faecium NCIMB 30176. (2)

-Lactobacillus animalis subsp. lactis BB-12®, L. acidophilus LA5®, L. delbrueckii subsp. bulgaricus LBY-27, Streptococcus thermophilus STY-31 (3)

-Saccharomyces boulardii CNCM I-745 (2)

-Bifidobacterium infantis 35624 (2)

-Bifidobacterium animalis DN-173 010 in fermented milk (with Streptococcus thermophilus and Lactobacillus bulgaricus) (2)

- Lactobacillus acidophilus SDC 2012, 2013 (3)

-Lactobacillus rhamnosus GG, L. rhamnosus LC705, Propionibacterium freudenreichii subsp. shermanii JS DSM 7067, Bifidobacterium animalis subsp. lactis Bb12 DSM 15954 (2)

-Bacillus coagulans GBI-30, 6086 (3)

-Pediococcus acidilactici CECT 7483, Lactobacillus plantarum CECT 7484, L. plantarum CECT 7485 (3)

N/A

Numerical evidence quality rankings were ascribed to each strain. All rankings for IBS probiotics were either a 2 or a 3 (see parenthesis next to strains in statement summary section).


Evidence level of 2:

Randomized trial or observational study with dramatic effect


Evidence level of 3:

Nonrandomized controlled cohort / follow-up study

Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations

IBS ebook

Which Foods Really Trigger Your IBS?

Discover exactly which foods you should and shouldn’t eat using our IBS Food Journal.

  1. Lacy, Brian E. PhD, MD, FACG; Pimentel, Mark MD, FACG; Brenner, Darren M. MD, FACG3; Chey, William D. MD, FACG; Keefer, Laurie A. PhD; Long, Millie D. MDMPH, FACG (GRADE Methodologist); Moshiree, Baha MD, MSc, FACG ACG Clinical Guideline: Management of Irritable Bowel Syndrome The American Journal of Gastroenterology 116(1):p 17-44, January 2021.

  2. Grace L. Su Cynthia W. Ko Premysl Bercik Yngve Falck-Ytter Shahnaz Sultan Adam V. Weizman Rebecca L. Morgan AGA Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders Published:June 09, 2020

  3. Floch, Martin H. MD; Walker, W. Allan MD; Sanders, Mary Ellen; Nieuwdorp, Max MD; Kim, Adam S.; Brenner, David A.; Qamar, Amir A.; Miloh, Tamir A. MD; Guarino, Alfredo MD; Guslandi, Mario MD; Dieleman, Levinus A. MD; Ringel, Yehuda MD; Quigley, Eamonn M.M. MD; Brandt, Lawrence J. MD on behalf of Experts of Yale Workshop on Probiotics Recommendations for Probiotic Use—2015 Update

  4. Kok Ann Gwee, Sutep Gonlachanvit, Uday C Ghoshal, Andrew S B Chua, Hiroto Miwa, Justin Wu, Young-Tae Bak, Oh Young Lee, Ching-Liang Lu, Hyojin Park, Minhu Chen, Ari F Syam, Philip Abraham, Jose Sollano, Chi-Sen Chang, Hidekazu Suzuki, Xiucai Fang, Shin Fukudo, Myung-Gyu Choi, Xiaohua Hou, and Michio Hongo Second Asian Consensus on Irritable Bowel Syndrome PMCID: PMC6657923 PMID: 31327218 Published online 2019 Jul 30.

  5. Dipesh H Vasant, Peter A Paine, Christopher J Black, Lesley A Houghton ,Hazel A Everitt, Maura Corsetti, Anurag Agrawal,Imran Aziz , Adam D Farmer, Maria P Eugenicos, Rona Moss-Morris,
    Yan Yiannakou, Alexander C Ford, British Society of Gastroenterology guidelines on the management of irritable bowel syndrome Accepted 6 April 2021

  6. Y A McKenzie, R K Bowyer, H Leach, P Gulia, J Horobin, N A O’Sullivan, C Pettitt, L B Reeves, L Seamark, M Williams, J Thompson , M C E LomerBritish Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults PMID: 27272325 2016 update

  7. Paul Moayyedi, MD, Christopher N Andrews, MD, Glenda MacQueen, MD, Christina Korownyk, MD, Megan Marsiglio, MD, Lesley Graff, MD, Brent Kvern, MD, Adriana Lazarescu, MD, Louis Liu, MD, William G Paterson, MD, Sacha Sidani, MD, Stephen Vanner, MD Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS) Published: 17 January 2019

  8. P Layer 1, V Andresen, C Pehl, H Allescher, S C Bischoff, M Classen, P Enck, T Frieling, S Haag, G Holtmann, M Karaus, S Kathemann, J Keller, R Kuhlbusch-Zicklam, W Kruis, J Langhorst, H Matthes, H Mönnikes, S Müller-Lissner, F Musial, B Otto, C Rosenberger, M Schemann, I van der Voort, K Dathe, J C Preiss Irritable bowel syndrome: German consensus guidelines on definition, pathophysiology and management PMID: 21287438

  9. Shin Fukudo, Toshikatsu Okumura, Masahiko Inamori, Yusuke Okuyama, Motoyori Kanazawa, Takeshi Kamiya, Ken Sato, Akiko Shiotani, Yuji Naito, Yoshiko Fujikawa, Ryota Hokari, Tastuhiro Masaoka, Kazuma Fujimoto, Hiroshi Kaneko, Akira Torii, Kei Matsueda, Hiroto Miwa, Nobuyuki Enomoto, Tooru Shimosegawa & Kazuhiko Koike Evidence-based clinical practice guidelines for irritable bowel syndrome 2020 Published: 04 February 2021

  10. Kyung Ho Song, Hye-Kyung Jung, Hyun Jin Kim, Hoon Sup Koo, Yong Hwan Kwon, Hyun Duk Shin, Hyun Chul Lim, Jeong Eun Shin, Sung Eun Kim, Dae Hyeon Cho, Jeong Hwan Kim, Hyun Jung Kim, and The Clinical Practice Guidelines Group Under the Korean Society of Neurogastroenterology and Motility Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition PMCID: PMC5885719 PMID: 29605976 Published online 2018 Apr 1

  11. Anna Pietrzak,Barbara Skrzydło-Radomańska,Agata Mulak,Michał Lipiński,Ewa Małecka-Panas,Jarosław Reguła,Grażyna Rydzewska Gastroenterology Review/Przegląd Gastroenterologiczny Publish date: 2018/09/19

  12. Dan L Dumitrascu Adriana Baban Ion Bancila Oana Bărboi Simona Bataga Alexandra Chira Ioan Chirila Cristina Cijevschi Prelipcean Lidia Ciobanu Anamaria Cozma-Petruț Liliana David Mircea Diculescu Daniela Dobru Anca Dimitriu Eugen Dumitru Mihaela Fadgyas Stanculete Cristian Gheorghe Georgiana-Emmanuela Gilca-Blanariu Adrian Goldis Simona Grad Melania Macarie Cristina Sabo
    Miere Doina Laurentiu Nedelcu Anca Negovan Cristina Pojoga Andrei Vasile Pop Popa Stefan-Lucian Paul J Porr Flaviu Rusu Andrada Seicean Ioan Sporea Tudor Stroie Teodora Blaga-Surdea Cristina Tocia Anca Trifan Ciprian Brisc Vasile Drug Romanian Guidelines for Nonpharmacological Therapy of IBS May 2021 Journal of gastrointestinal and liver diseases: JGLD 30 DOI:10.15403/jgld-3581 LicenseCC BY-NC-ND 4.0

  13. Francisco Guarner (Chair, Spain), Mary Ellen Sanders (Co-Chair, USA), Rami Eliakim (Israel), Richard Fedorak (Canada), Alfred Gangl (Austria), James Garisch (South Africa), Pedro Kaufmann (Uruguay), Tarkan Karakan (Turkey), Aamir G. Khan (Pakistan), Nayoung Kim (South Korea), Juan Andrés De Paula (Argentina), Balakrishnan Ramakrishna (India), Fergus Shanahan (Ireland), Hania Szajewska (Poland), Alan Thomson (Canada), Anton Le Mair (The Netherlands) World Gastroenterology Organisation Global Guidelines February 2017

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