Is it safe to use probiotics for IBS-D?

Question

Hello doctor,

I have diarrhea predominant-irritable bowel syndrome (IBS-D), and usually, after I eat, I have gas and need to pass stool immediately. My stomach feels big and bloated after meals, but the pain is not too bad. Should I take probiotics alone for this or stick to a dietary supplement? I read that IBS-D has something to do with abdominal obesity, and sometimes my belly feels heavy. Is it safe to take probiotics for just gas problems? I am not sure if it will help my digestion or if there is something else I should take instead of a supplement.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Let us understand what irritable bowel syndrome (IBS) is. I have seen that a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet helps, along with self-checking food tolerance. Initially, one can start with a FODMAP diet, then gradually change in quantity and add preferred foods along with supplements recommended by a physician.

Irritable bowel syndrome (IBS) is an uncomfortable disorder characterized by dramatic changes in bowel movements. Some people experience diarrhea, while others have constipation, cramps, and abdominal pain, but not majorly abdominal obesity you might be bloated.

Dietary allowance.

Eat more fiber if constipated. Fiber may improve constipation in IBS because it makes stool soft and easier to pass.
Consume soluble fiber like oats, boiled or steamed fruits and vegetables
Drink plenty of fluids.
Eat regular meals. Be sure to eat breakfast every day. Do not skip meals.

Things not to be done include:

Restrict intake of caffeinated drinks (for example, tea, coffee or cola).
Avoid skin, pips and pith from fruit and vegetables.
Avoid foods high in fat, such as chips, fast foods, burgers and sausages, crisps and cakes.
If you are lactose intolerant, reduce the amount of lactose you consume. Milk and paneer are lactose containing foods.
Try not to have alcohol every day and then have no more than 2 units a day.
Limit insoluble fibre intake from whole grain breads, bran, cereals, nuts and seeds (except golden linseeds).
Limit intake of foods high in resistant starches like sweetcorn, green bananas and muesli that contains bran.

In IBS every person may respond to different foods differently. It is important to try and test foods (see body's response) and then become liberal with their use in daily routine.

Guidelines to be followed include:

Low FODMAP Fruits include

Blueberries.
Cantaloupe/Rockmelon (1/2 cup).
Coconut- desiccated (1/2 cup).
Grapes, all types.
Honeydew melon (1/2 cup).
Kiwi fruit (2 small).
Lemons & Limes (including juice).
Mandarins.
Oranges.
Passion fruit.
Pineapple (1 cup).
Raspberries.
Strawberries.
Papaya.
Fresh dates.

Low FODMAP Vegetables include:

Ladies Finger.
French beans.
Carrot.
Tomato.
Bottle gourd.
Ridge gourd.
Snake gourd.
Ivygourd.
Pumpkin.
Drumstick.
Cucumber.
Capsicum.

The spices to be used are

Ginger.
Turmeric.
Jeera powder.
Coriander Powder.
Mint leaves.
Coriander leaves.

Avoid green chilly, red chilly, garlic, onion, shallots.

High FODMAP Fruits to be avoided include:

Apples
Apricot
Avocado (very small quantities may be tolerated)
Bananas.
Blackberries.
Cherries.
Grapefruit.
Mango.
Nectarine.
Peaches.
Pears.
Plums.
Raisins.
Watermelon.
Dry fig & dry dates.

Foods to be avoided include:

Vegetables: Beets, broccoli, brussel sprouts, corn, lima beans, onions, parsnips, peppers, potato skins, spinach, winter squash, spring onion, shallots.

Cereals:

Brown rice, wild rice, red Rice.
Cereals containing nuts, dried fruit, or seeds.
Multi-grain breads or crackers.
Whole-wheat bread, wheat Roti.
Barley, Bran, couscous, gnocchi, granola, muesli, muffins, rye, semolina, spelt, wheat-based bread, cereal & pasta.

Pulses: Black chana, rajma, chickpea, lima bean, urad dal.
Vegetables and legumes: Onions, asparagus, beans (broad, cluster, lima, soya), cauliflower, cabbage, savoy, mushrooms, peas, scallions or spring onions (white part).
Nuts: Cashews and pistachio.
Milk: Cow milk, goat milk, rice milk, sheep's milk, soy milk made with soybeans.
Dairy products: Cream, custard, ice cream, sour cream, cream cheese and ricotta cheese.
Drinks: Apple juice, pear juice, mango juice, sodas with high-fructose corn syrup (HFCS), herbal tea (strong).
Condiments: Jam (mixed berries), pasta sauce (cream-based), relish and tzatziki dip.
Sweeteners: Agave, high fructose corn syrup (HFCS), honey, inulin, isomalt, maltitol, mannitol, sorbitol & xylitol.

I hope this helps.

Thank you.