In the future, we may be able to tailor probiotics recommendations for each individual, based on their symptoms and their unique gut bacteria ‘DNA’. However, until we have more evidence and better tools for analysis, it’s a gamble as to which product, if any, will work for you. Do not use probiotics to delay a proper health assessment, if you suspect something is ‘wrong’. Your health professional may recommend a more suitable treatment, such as a low FODMAP diet for Irritable Bowel Syndrome. If you are using probiotics and it’s ‘working’, be prepared to commit to long-term use, or risk a return of symptoms.
More than a century ago, a Russian scientist named Elie Metchnikoff first introduced the concept of probiotics, and the ability to manipulate gut flora by replacing harmful microbes with helpful ones.
The first probiotics identified where in fermented milk products, including lactobacilli. Yakult, established in 1935 in Japan, was one of the first companies to isolate, bottle and sell lactobacilli. Now, thousands more probiotic species have been identified, isolated and sold as capsules, liquids or in food products worldwide. All promise improved gut health, easy digestion, reduced bloating and enhanced immunity. In particular, probiotics have been touted as the cure, or at least an important part of it, with regards to Irritable Bowel Syndrome (IBS). But the question still remains – do they actually work?
The good news: Advances in food processing make it likely that probiotics actually survive bottling, and the acidic environment of our stomach, to make it to our large intestine intact. That’s if they are ‘in-date’, and stored at the correct temperature (some require refrigeration). Also, they are very unlikely to do harm in healthy adults. Many people swear by the benefits of probiotics, claiming effective relief from diarrhoea, constipation and even the common cold!
The bad news: Despite a romantic story and a big sales push, there remains little scientific proof that probiotics actually ‘work’. This lack of evidence, however, is a reflection of the low numbers of quality testing and clinical trials, rather than a conclusion that probiotics have no effect. Also, we know from the studies to date that individuals can respond differently to various strains, so what works for one person may not work for another. Finally, it seems that probiotics are a life-long commitment – to maintain any potential benefits, you must continue to use them long term, maybe forever.
Due to this uncertainly, I don’t recommend probiotics often. There are often more effective and proven treatment pathways available. For example, a low FODMAP diet has been shown to alleviate symptoms of bloating, constipation and diarrhoea in 75% of people with IBS. Hypnotherapy is also extremely effective, and supported by science.
If you are experiencing gut symptoms, make sure you have a proper health assessment with a GP, Specialist or Dietitian before turning to probiotics, in order to rule out anything sinister.