PROBIOTICS AND BLOATING

Our “friendly bacteria” also known as probiotics are live microorganisms that are always here to help when we want our digestive system to work properly, and that includes bloating.

Bloating is one of the most common gastrointestinal problems in patients of all ages.

It is often associated with irritable bowel syndrome (IBS) and other functional gastrointestinal disorders.

The possible causes of bloating are various. Bloating can be caused by intestinal bacteria gas production ( gas builds up in the intestines which leads to bloating and discomfort), overeating, eating too much fatty fast foods, constipation, hypersensitivity of the patient’s gut, etc. 

There are studies that suggest that the number and type of bacteria could have something to do with gas production, and there are many studies and clinical trials that show that probiotic supplements may help in the gas reduction and bloating. Let’s see what the research has shown so far.

Evidence​

One study was conducted to see if patients with IBS have intestinal flora imbalance and if their gut flora can be modified by supplements.

The patients were randomized into two groups, a test group that received Lactobacillus plantarum and the placebo group.

  • Flatulence significantly reduced in the test group
  • Enterococci stayed unchanged in the test group and increased in the placebo group
  • Test group patients  maintained a better overall GI function than control patients

The results indicate that the administration of Lb. plantarum with known probiotic properties decreased IBS symptoms such as pain, bloating, and flatulence. (1)

Another study reported a significant beneficial effect of the specific probiotic treatment.

In this clinical study, patients consumed a test product containing Bifidobacterium lactis. Distension, bloating and other IBS symptoms were assessed. Results showed that the test product consumption significantly improved overall symptom severity and reduced distention. (2)

In one clinical trial, subjects in the group that consumed probiotic products had significant improvements. The Bacillus coagulans-based product was effective in improving the quality of life and reducing gastrointestinal symptoms. (3)

  • A combination of Lactobacillus acidophilus and Bifidobacterium lactis in one study showed that it may be helpful in easing bloating symptoms.

Results showed a significant decrease in bloating in the probiotic group in comparison to the placebo group,  both at 4 weeks and 8 weeks.

This change represents a 15% reduction in clinical bloating symptoms in the intervention group. (4)

Probiotics are not called “good bacteria” for no reason, however, the effects of probiotics may vary.

Specific probiotics will have different effects on different patients. A probiotic that works for one person or a specific symptom may not work for somebody else or a different indication or different symptom. This is all individual.

The important thing is that the product is taken in adequate doses on a regular basis.

How it works

“Good bacteria fights the bad.” The main job of probiotics is to maintain a healthy balance in your body. Probiotics have various mechanisms of action but the exact way in which they help is not fully understood. 

Probiotics achieve their beneficial effects through a variety of  mechanisms, which include :

– lowering of intestinal pH

– decreasing colonization and invasion by pathogenic organisms

– modifying the host immune response (5)

Probiotics produce bacteriocins, hydrogen peroxide, and biosurfactants to aid their survival in the gastrointestinal tract and can competitively prevent more pathogenic bacteria from attaching to the intestinal epithelium. (6)

There is a range of probiotic immune effects that have been described, but direct evidence for the immune mechanisms by which they achieve their beneficial effects is limited.

The mentioned immunologic effects of probiotics may occur through both:

  • actions on intestinal epithelial homeostasis
  • strain-specific effects on particular immune functions

Sources

  1. Nobaek, S., Johansson, M. L., Molin, G., Ahrné, S., & Jeppsson, B. (2000). Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. The American journal of gastroenterology, 95(5), 1231–1238. (PubMed)
  1. Agrawal A, Houghton LA, Morris J, et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Pharmacol Ther. 2009;29:104–14. (Wiley Online Library)
  1. Kalman DS, Schwartz HI, Alvarez P, Feldman S, Pezzullo JC, Krieger DR. A prospective, randomized, double-blind, placebo-controlled parallel-group dual site trial to evaluate the effects of a Bacillus coagulans-based product on functional intestinal gas symptoms. BMC Gastroenterol. 2009;9:85. (PMC)
  1. Ringel-Kulka, T., Palsson, O. S., Maier, D., Carroll, I., Galanko, J. A., Leyer, G., & Ringel, Y. (2011). Probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients with functional bowel disorders: a double-blind study. Journal of clinical gastroenterology, 45(6), 518–525. (PMC)
  1. Nancy Toedter Williams, Pharm.D., BCPS, BCNSP, Probiotics, American Journal of Health-System Pharmacy, Volume 67, Issue 6, 15 March 2010, Pages 449–458, (Oxford Academic)
  1. Robert J Boyle, Roy M Robins-Browne, Mimi LK Tang, Probiotic use in clinical practice: what are the risks?, The American Journal of Clinical Nutrition, Volume 83, Issue 6, June 2006, Pages 1256–1264, (Oxford Academic)