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Unlocking Relief for Irritable Bowel Syndrome: Assessing the Impact of Gut Treatments

Written by Andrew Le, MD

UpdatedMay 29, 2024

Gastrointestinal troubles plague many, and for those battling irritable bowel syndrome (IBS), finding relief can be a relentless quest. A chronic condition, IBS disrupts lives with bouts of bloating, abdominal pain, and altered bowel habits. Researchers, acknowledging the crucial role of gut microbiome balance in IBS, have probed various treatments. A comprehensive review and meta-analysis, now published in Alimentary Pharmacol Therapeutics and accessible via, sheds light on the efficacy of prebiotics, probiotics, synbiotics, and antibiotics in combating IBS symptoms.

The study, involving rigorous trials and objective measures, was helmed by gastroenterology authorities from several esteemed institutions. Prof. Alexander C. Ford led the team, and support came from the American College of Gastroenterology and the Canadian Institute for Health Research.

The Quest for Balance: Prebiotics, Probiotics, and Antibiotics

Through meticulous database analysis, the study unveiled over 4,000 references, narrowing down to a handful of randomized controlled trials. While prebiotics and synbiotics offered sparse data, the study's spotlight centered on probiotics and antibiotics.

Probiotic Promise: Strains and Combos

Probiotics have long been hailed for their gut-balancing prowess, and this study's findings echo that sentiment—certain strains and combinations may offer solace to the IBS-afflicted. Fifty-three trials encompassing over 5,500 patients uncovered beneficial effects on IBS symptoms and abdominal pain with specific probiotics.

Lactobacillus plantarum DSM 9843 emerged as a notable ally, with a considerable reduction in symptoms in some trials. Similarly, combinations of probiotics showed promise, but a definitive conclusion on their efficacy eluded researchers due to variabilities and potential publication biases.

Antibiotic Adjunct: Rifaximin for Non-Constipated IBS

The antibiotic rifaximin, already recognized as a treatment in the US, was scrutinized across several trials. Results provided a glimmer of hope for non-constipated IBS patients, with a modest yet consistent symptom improvement. But as with repeat treatments, long-term safety concerns necessitate further examination.

An Ongoing Investigation

The enigma of IBS demands continued exploration. Clarifying which probiotics or antibiotic regimens might benefit specific patient subgroups remains an ongoing mission. Adverse effects seemed minimal, yet the researchers caution sustained monitoring, particularly regarding repeated antibiotic use.

For those battling the chronic adversities of IBS, this analysis represents another step in unraveling the complex interplay between microbial manipulation and symptom management. Future research will further demystify treatment impacts on the gut's intricate ecosystem.

The investigation was built with the assistance of Buoy Health, committed to informing and engaging the general public in understanding IBS treatments better.


Ford, A. C., Harris, L. A., Lacy, B. E., Quigley, E. M. M., & Moayyedi, P. (2018). Systematic review with meta-analysis: The efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 48(10), 1044-1060.