This resource was made possible due to the support of: Bio-K+.
Author: Desiree Nielsen, Registered Dietitian.
About the author: Desiree Nielsen is a registered dietitian and author based in Vancouver. She runs a nutrition consulting practice and has 10+ years of experienced in dealing with IBS. Desiree co-founded My Healthy Gut, the world’s first evidence-based nutrition self-management app for Celiac Disease and her anti-inflammatory cookbook, Eat More Plants, is a national bestseller.
Irritable bowel syndrome (IBS) is more common than you might think: an estimated 18% of Canadians have a functional digestive disorder, higher than the estimated global prevalence of 11%1. The ultimate brain-gut condition, IBS presents in many different ways; some researchers believe it may actually be a spectrum of conditions with multiple root causes2. Diet and lifestyle, particularly stress, contribute to symptoms as does bacterial dysbiosis, which is an imbalance in the normal gut flora2. In fact, it is well known that IBS can result from an acute gut infection such as food poisoning, strongly supporting the involvement of gut bacteria in the development of the condition2. Because gut bacteria are a suspected root cause, IBS is a prime candidate for using probiotics as part of a therapeutic nutrition program. It is important to select a probiotic that is clinically verified for use in IBS such as Bio-K+ IBS Control, which is Health Canada approved for IBS, and seen in the Clinical Guide to Probiotic Products Available in Canada.
Research suggests that probiotics may be effective in irritable bowel syndrome (IBS) but putting this information to use is more difficult than you might expect3. As a dietitian for over 11 years, one of the greatest challenges in selecting a probiotic for irritable bowel syndrome is that not all probiotics have the same therapeutic action. Each strain – and combinations of strains – of probiotics can have a positive, neutral, or negative effect for any specific condition. For example, a probiotic strain that may have been effective at improving IBS in a clinical trial may not even be available on the market3. Or, another combination that is helpful for ulcerative colitis may not be found effective in irritable bowel syndrome. What’s more, because of the gut-brain nature of the condition, it is not uncommon for the placebo (no treatment) group to improve over the course of a clinical trial, making it more difficult to assess the absolute effectiveness of probiotic treatments4.
For these reasons, product-specific research is super important when selecting a probiotic for irritable bowel syndrome. You want to know that the same probiotic you pick up off the shelf has been proven in human clinical trials for the correct condition. Happily, there is a tool to make this determination easier for health professionals and the public called the Clinical Guide to Probiotic Products Available in Canada.
The Clinical Guide contains a listing of the commercially available probiotics in Canada, alongside the level of evidence for each approved use, such as IBS or antibiotic-associated diarrhea. I always look for a probiotic that has Level 1 evidence, which means at least one properly designed clinical trial on the exact strain or formula for sale. We have known for quite some time that Bio-K+ is effective at helping to prevent the side effects of antibiotic use5; in fact, in Canada, Bio-K+ has two specific health claims from Health Canada for that use. However, frustrated by a lack of efficacy with other evidence-informed probiotics for IBS available at the time, I’ve also been using Bio-K+ myself and with my clients for over a decade for IBS with favourable results. We now have the first published evidence for using Bio-K+ in IBS, along with a specific health claim from Health Canada for improving quality of life in irritable bowel syndrome.
In one recent clinical trial published in the journal Beneficial Microbes, a 100 billion dosage of Bio-K+ was tested in individuals with irritable bowel syndrome6. It was found that not only did quality of life improve, but that symptoms improved in those with IBS-D6. Among those symptoms, improvements in both stool consistency and stool frequency – two of the most impactful to daily life – were improved by greater than 30%6. This is an interesting finding as our core nutritional therapy for IBS-D is the low FODMAP diet, which has been found to have a deleterious effect on the gut microbiota7. For this reason, in my practice I have always used Bio-K+ alongside a low FODMAP diet, which I believe is an important tool in ensuring long term symptom management and the health of the gut microbiota.
I also love that Bio-K+ is a Canadian brand with over 20 years of experience in manufacturing probiotics. Used in over 200 North American hospitals for the prevention of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea, it has a proven track record of safety and efficacy that is important to me and my clients.
In my opinion, probiotics are an important piece of an integrative approach to irritable bowel syndrome. Irritable bowel syndrome is a complex condition that is challenging to treat; however, I’ve seen that symptom management and reduction is absolutely possible in my practice. An effective strategy is one that uses individualized nutritional approaches alongside stress management and supporting the gut microbiota with a probiotic. However, it is not enough to simply take any probiotic – it is important to select a probiotic that is clinically verified for use in irritable bowel syndrome, such as Bio-K+ IBS Control.