Can probiotics help treat IBS?
❚ Q: What is the difference between prebiotics and probiotics and do they assist irritable bowel syndrome (IBS)? Thanks, Julia. A: Probiotics and prebiotics are often confused, yet they play two very different roles for gut health. Probiotics are beneficial bacteria, whereas prebiotics are essentially food that feed these bacteria.
You don’t necessarily need probiotics for healthy gut function however, there is encouraging evidence to suggest they can be beneficial in the treatment of irritable bowel syndrome and in the treatment of diarrhoea, especially following a course of certain antibiotics. Probiotics are typically taken in supplement form however, some fermented foods are rich in beneficial bacteria. The question though, is do they survive digestion to be able to take up residence in the large bowel?
Prebiotics are non-digestible carbohydrates that act as food for probiotic bacteria. They pass through the gastrointestinal tract undigested, which stimulates the growth and/or activity of certain ‘good’ bacteria in the large intestine.
While all prebiotics are considered ‘fibre’, not all fibre has prebiotic effects.
When it comes to the management of IBS a popular and scientifically proven dietary treatment is the FODMAP diet. FODMAPs are a collection of short chain carbohydrates and sugar alcohols found in foods naturally or as food additives. FODMAPs include fructose (when in excess of glucose), fructans, galacto-oligosaccharides (GOS), lactose and polyols (for example, sorbitol and mannitol). Because certain FODMAPs have prebiotic effects, namely GOS and fructans, a low FODMAP diet restricts the intake of prebiotic fibres. Prebiotics are found in bananas, onions, garlic and artichokes to name a few foods.
If you have been advised to follow a low FODMAP diet by a qualified health professional for IBS, studies and our experience show that this can be highly beneficial. However, work must continue to be done on the gut and digestion to help improve its function, as a low FODMAP diet is not considered a ‘lifetime’ or a curative diet. A prebiotic-rich diet is considered beneficial for the general population (without IBS), and there are concerns that the restriction and/or elimination of these are not beneficial for gut health long-term.
Diets rich in prebiotic fibres may encourage a healthy balance of gut bacteria strains, potentially benefiting digestion and the absorption of vitamins and minerals.
Q: Bone broth, do you use or recommend it? I’m a breastfeeding mum. It’s in a recipe I want to make and they Email your questions for Dr Libby to ask.drlibby@fairfaxmedia.co.nz. Please note, only a selection of questions can be answered. say how nutritious it is. Thanks, Gen.
A: When it comes to nutrients the right balance is key as too much of a particular nutrient can often be just as detrimental as too little. Bone broth is a rich source of vitamins and minerals, and for an adult, can be a wonderful addition to a diet filled with nutrient-dense real foods. It is very easy to make and I would certainly encourage you use organic bones.
If you are breastfeeding, taking good care of yourself and consuming a wide variety of nutrient-dense foods is a beautiful way to help nourish your baby, as your nutritional stores can impact the nutritional composition of your breast milk. ❚ Dr Libby is a nutritional biochemist, best-selling author and speaker. The advice contained in this column is not intended to be a substitute for direct, personalised advice from a health professional. Visit drlibby.com.