A comprehensive review of evidence suggests that probiotics may not provide relief for gut problems like bloating and digestive complaints. Probiotics, often referred to as “good” or “friendly” bacteria, are available in pill form or yogurt drinks and have received significant medical support for their potential to improve digestive health. The NHS and the British Society of Gastroenterology recommend probiotics for patients with irritable bowel syndrome (IBS), a condition that can cause symptoms such as stomach cramps, bloating, diarrhea, and constipation. However, an analysis of 82 previous trials involving over 10,000 volunteers found no solid evidence that probiotics offer relief for these symptoms.
Professor Alexander Ford, a consultant gastroenterologist at Leeds Teaching Hospitals NHS Trust and co-author of the study, explains, “People with IBS are often willing to spend their own money on treatments that could work. Because they are looking for a cure, they may be misled that probiotics are a panacea when they aren’t.”
Despite the lack of evidence, probiotic supplements are widely available in most supermarkets, making the UK’s probiotic market worth around £1.4 billion annually, with an expected growth of 20% over the next five years.
Advocates of probiotics claim that these supplements support the immune system, aid in weight loss, and prevent infections. Previous studies have suggested that certain types of probiotics can improve IBS symptoms, which affect approximately 13 million people in the UK. Probiotics contain live micro-organisms that are believed to restore the balance of gut bacteria, which plays a vital role in nutrient absorption. These micro-organisms also occur naturally in fermented foods such as yogurt, sourdough bread, and sauerkraut.
Having a diverse range of healthy gut bacteria has been linked to various benefits. Research has shown that specific combinations of gut bacteria can send signals of fullness to the brain, reducing hunger pangs, and increase the production of mood-boosting hormones.
Supposed improvements in IBS symptoms are thought to be due to several factors. Animal studies have indicated that certain strains of gut bacteria can reduce pain signals sent from the gut to the brain and prevent the immune system from releasing proteins that trigger gut inflammation.
However, a new review published in the journal Gastroenterology casts doubt on these connections. Researchers reviewed a mixture of international trials involving 60 different products (both drinks and pills), some of which are available for purchase in high street shops. They also analyzed studies on unbranded capsules containing bacterial strains commonly used in probiotics, such as Lactobacillus and Bifidobacterium. The review focused on specific IBS symptoms like pain, bloating, constipation, and diarrhea and found that the evidence supporting relief from these symptoms was unreliable.
According to Prof Ford, “Most of the products are tested on too few participants, leaving room for error.” He also notes that probiotics are often categorized as food supplements, exempting them from the rigorous investigations conducted on drugs. As these products are already on the market and generating profits, there is no incentive to carry out expensive high-quality trials.
Dietician Dr. Duane Mellor suggests that simple changes such as eating slower, maintaining proper posture during meals, and managing stress are more likely to alleviate IBS symptoms than probiotics, and they don’t come with a price tag.
On the other hand, Professor Glenn Gibson, a researcher in food microbiology at the University of Reading, remains optimistic. He states, “There are good studies showing that Bifidobacterium, which is found in many UK products, can ease IBS symptoms. Gastroenterologists are used to seeing significant benefits with drugs, so their expectations may be too high.”
Catherine Harland, a 53-year-old IBS sufferer from Newcastle, initially tried probiotics in 2021 after her daughter recommended them based on online research. However, she noticed no difference after a month of taking them. Following a severe flare-up in April of the same year, Catherine decided to try probiotics again, spending £65 for a month’s supply. Although she experienced slight improvement, she attributes most of it to cutting trigger foods from her diet. By February, Catherine’s gut problems resurfaced, leading her to conclude that the probiotics were a waste of money. Instead, she has found some relief by making changes to her daily routine, including reducing stress, engaging in regular walks in the countryside, eating a healthier diet, and limiting alcohol consumption.
Overall, while probiotics have been widely promoted for their potential digestive health benefits, the review suggests that the evidence supporting their effectiveness for gut problems like IBS is lacking. Simple lifestyle changes and stress management techniques may offer more relief than probiotic supplements, which can be costly.
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