Can pro­bi­otics help treat IBS?

The Napier Mail - - YOUR HEALTH - Q: What is the dif­fer­ence be­tween pre­bi­otics and pro­bi­otics and do they as­sist ir­ri­ta­ble bowel syn­drome (IBS)? Thanks, Ju­lia. A: 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 Dr Libby is 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. Email your ques­tions for Dr Libby to ask.dr­libby@fair­fax­me­ Please note, only a se­lec­tion of ques­tions can be an­swered.

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.

The is en­cour­ag­ing ev­i­dence that sug­gests pro­bi­otics can be help­ful with the treat­ment of ir­ri­ta­ble bowel syn­drome.

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