New Guidelines Promote Probiotics for IBS

The use of probiotics (see Probiotics Learning Lab) as a possible treatment method for Irritable Bowel Syndrome (IBS) has gathered momentum this month, as the American College of Gastroenterology has released new guidelines for the treatment of IBS, which includes approval of probiotics.

IBS is estimated to affect 5-15% of the global population, and NHS statistics reveal that 10-20% of the UK population will experience some form of IBS during their lifetime. IBS is often hard to accurately diagnose as there is no standardised test and its symptoms can be very similar to other conditions. IBS can affect people of all ages but it is especially common for 20 to 30 year olds.

IBS sufferers generally experience symptoms such as diarrhoea, constipation, abdominal pain, bloating and cramps. Current UK guidelines suggest managing IBS through diet and lifestyle changes (including the addition of probiotics to the diet), increasing exercise, reducing stress, as well as possible medications such as antispasmodics, laxatives, antimotility medicines, and even antidepressants. The NHS also recommend supplementing with probiotics, but they don't give clear guidance on what to look for, and it seems that GPs haven't taken much initiative with this so far either, but things may change yet.

The American College of Gastroenterology has updated their guidelines as they say there's evidence to support more treatment methods such as probiotics for IBS. These treatments include:

• Fibre (especially psyllium)
• Probiotics
• Rifaximin (antibiotic)
• Medications known as linaclotide (Linzess) and lubiprostone (Amitiza)

Speaking about the guideline revisions, co-author Dr. Eamonn Quigley¹ commented, "There's a greater variety of approaches which reflect a greater understanding of the disorders. We now have a better opportunity to improve the lives of our patients."

Here in the UK, we've certainly seen an increase in the amount of GP recommendations of Optibac Probiotics, but it is with natural health practitioners, such as nutritionists, who've been most keen to recommend probiotics to those with IBS. We think it's great that the NHS has recognised probiotics as a viable option for IBS sufferers, but the relative lack of evidence for probiotics in comparison to big budget pharmaceuticals, has meant that they are rarely recommended by GPs. It is true that many probiotics are less researched than some medicines, but many specific strains of probiotics are incredibly well researched and can make significant impact on the quality of life of IBS sufferers.

Probiotics for IBS has increased their presence in the public eye over the last few years, appearing almost weekly in mainstream publications, and also on television shows such as Channel 4's 'The Food Hospital'. They've also been one of the hottest topics in modern medicine, as Dr. Quigley acknowledged in the revised American guidelines, as he stated there is much evidence to support their use, but more needs to be done to find the best strains available.

Reference

1. Quigley, E. et al (2014) Evidence-Based Systematic Review on Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation. The American Journal of Gastroenterology.