Probiotics for Bloating

There is a wellness revolution going on, and some of the major players in this movement are the probiotics that coexist alongside us in our guts, and make up what is known as the microbiome.    

So, why is this microbiome important?  

The gut is made up of trillions of live organisms, collectively known as the microbiome. This ecosystem of bacteria plays a huge role in keeping us healthy and happy. You can learn more about these fascinating bacteria by reading: The microbiome - all you need to know. If you’ve done some reading about the gut, you might also have heard about probiotics. Probiotics are live microorganisms that have co-evolved alongside humans. They have been shown in research to help with gut related issues such as bloating¹, anxiety², and immune health³.

Bacteria are no longer the enemy. Research shows that by restoring balance in your microbiome with probiotics, you may be one step closer to getting to the root cause of your bloating and other related symptoms, such as gas and constipation.

What causes bloating in the stomach?

Bloating is the result of a buildup of gas in the digestive system and can lead to pain and that uncomfortable, heavy feeling after eating. Some people experience this occasionally, or for some this can be a daily occurrence.  

The gut microbiome is made up of many different strains (types) of bacteria, and is influenced daily by our individual environmental and lifestyle exposures. We play host to this army of bacteria, including beneficial probiotics, which are essential for our health and wellbeing. You may like to read: Are all types (strains) of friendly bacteria the same?

How do my lifestyle choices affect my gut bacteria and lead to bloating?

Dysbiosis

A well-balanced microbiome is essential in maintaining strong, healthy digestive and immune systems. Dysbiosis occurs when there is a loss of beneficial bacteria, an overgrowth of potentially pathogenic bacteria, and an overall reduction in species diversity. An imbalance in certain species may lead to bloating as beneficial bacteria help to digest fibre-rich foods.  

Research has shown that an imbalance of good and bad bacteria in the gut (dysbiosis) can result in a number of digestive health conditions such as constipation, diarrhoea, flatulence, and bloating⁴. Some bacterial groups are more prone to gas production than others, including Enterobacteriaceae and Clostridia⁵.

Dysbiosis can be caused by a number of factors. These include poor diet, high sugar levels (as sugar feed pathogens in the gut), antibiotics, stress and genetics. If you think your bloating is a symptom of dysbiosis, taking a probiotic supplement may be a positive step towards rebalancing your body's good bacteria. By influencing the environment within your gut, you can help restore it to a healthy balance. 

Diet

Are you following a wholefood, plant-based diet? Diet is one of the most important factors in regulating the gut microbiome. The modern ‘convenience diet’ is high in refined sugars, and low in gut-supporting fibre and general variety. This can lead to an imbalance in bacteria – lower levels of good Prevotella and higher levels of potentially bad Firmicutes and Proteobacteria⁶. Research has shown that by increasing your consumption of high-fibre fruits, vegetables and wholegrains, you can increase your levels of beneficial butyrate. Butyrate is a short-chain fatty acid which is thought to have highly protective functions in the body. It’s found in higher levels in those that follow a plant-based diet. Find out more by reading: Do vegans and vegetarians have healthier gut bacteria? 

Food allergies

Bloating can be caused by intolerances to certain food types in your diet such as wheat, gluten, dairy and sugar. Ongoing exposures to these foods can drive bacterial imbalances and impair the gut lining leading to more symptoms and discomfort. You may like to read: Could probiotics help with allergies?

Stress

You might not know that stress and gut health are actually closely connected. This is due to the relationship between your gut and brain, also known as the gut- brain axis. You may like to read our in-depth article on the gut-brain axis. When we are stressed, the body perceives this as a threat. As the fight-or-flight response is activated, our digestive system is effectively shut down. In this state, your digestion becomes compromised as food is not broken down as effectively. This can lead to symptoms such as bloating, abdominal pain, gas, and constipation. 

SIBO

Small Intestinal Bacterial Overgrowth (SIBO) is a condition in which an abnormally large number of bacteria are found in the small intestine. This migration of bacteria interferes with normal digestion, as they feed on the undigested food. SIBO sufferers often experience bloating, and this condition is also implicated in conditions such as Irritable bowel Syndrome (IBS). Up to 78% of IBS is thought to be SIBO-related, due to the high prevalence of certain bacteria in the small intestine⁷. Healthcare professionals can read more about Small Intestinal Bacterial Overgrowth on the Probiotics Professionals site.

Constipation

Gut motility is so important for reducing symptoms of bloating. If you aren’t eliminating waste, then it can lead to a buildup of bacteria in the small intestine. This in turn can lead to SIBO. Stimulating digestion and the movement of food along the digestive system is important for reducing symptoms of bloating related to sluggish bowels. Healthcare professionals can read more about Probiotics for constipation on the Probiotics Professionals site. 

What relieves bloating?

To relieve bloating in the stomach, we need to address diet and lifestyle factors that could be contributing to the symptoms. We must also think about ways in which we can support our gut health. Here are some top tips for you to consider:

1. Don’t overeat – reduce snacking to promote emptying of the bowel and to reduce fermentation of food that could potentially lead to SIBO.
2. Test for allergies/intolerances – investigate and rule out any potential allergies/food intolerances that could be exacerbating the problem. Keep a food diary or eliminate common triggers such as gluten, dairy, sugar, eggs and see if symptoms improve.
3. Try a low-FODMAP diet – FODMAP stands for Fermentable Oligo-, Di-, Monosaccharides And Polyols. These specific carbohydrates are found in a variety of foods, and can be a problem for some people with dysbiosis. This is because they feed gut bacteria and encourage them to proliferate. A diet high in starches and complex sugars may aggravate SIBO, due to fructose malabsorption. As a result, sufferers might experience excessive gas, bloating, and abdominal pain. A diet with low levels of fermentable foods can decrease the chance of bacterial overgrowth, by creating a less favourable environment for bacteria. 
4. Reduce your sugar intake – this includes refined white sugars and carbohydrates, as these may potentially feed pathogenic bacteria in the gut and cause dysbiosis. 
5. Reduce stress – easier said than done, we know, but try to address your lifestyle and see what might be stressing you out. We know that stress negatively impacts the microbiome and slows digestion. The gut is directly linked to the brain via the gut-brain-axis, so your emotional landscape will directly impact the health of your gut.
6. Try a well-researched probiotic – look at specific strains to support bloating and digestive enzyme output, to help you break down your food.
7. Increase soluble fibre intake – this will help to feed good bacteria and relieve constipation, by supporting regular bowel movements.
8. Try a prokinetic – these help to increase gut motility. Examples include ginger tea, magnesium, or 5HTP supplements between meals or before bed. Cleansing the bowel will also prevent buildup of bacteria within the small intestine.

Probiotics and bloating

Probiotics are often referred to as your body's 'good bacteria’, and they have a commensal relationship with their host – us!  The most common probiotic species and the ones with the most research are Lactobacillus and Bifidobacteria. Within these species there are many strains with different modes of action. It’s important to remember that different probiotic strains have different effects, and so must be chosen carefully for the desired benefit. Find out more about why probiotic strains matter.

Research indicates that probiotics can help those with symptoms such as gas and bloating⁸. As gut testing becomes more prevalent, you are now able to personalise your probiotics even more, too. Finding out which species you are lacking in and which are in abundance can help you to decide which probiotic is best for you. Companies such as Viome, Atlas Biomed, and Healthpath all offer gut testing, and for long-standing issues it may be a good place to start.

Which probiotics are best for bloating?

Probiotics can be consumed through the food we eat or by taking a probiotic supplement. Most people are familiar with probiotic yoghurt drinks, but these often contain lots of sugar. Fermented foods, such as kimchi, sauerkraut, kombucha, kefir, plain yoghurt, and miso provide an excellent, low-sugar source of probiotics. You might also consider prebiotics, which are fibres that act as ‘food’ for probiotic bacteria. Prebiotic foods include garlic, onions and leeks. Learn more: What are prebiotics?

Having your probiotics in supplement form goes one step further. This offers a more targeted therapeutic intake that can be tailored to your individual gut needs. As I stated above, this is the best way to get the most out of your probiotics. 

It is advisable to avoid probiotics that contain prebiotics initially, as these can aggravate certain symptoms such as bloating. I recommend probiotic strains that have been well researched for bloating, specifically including Lactobacillus acidophilus NCFM^® 8, Bifidobacterium lactis HN019⁹, Bifidobacterium lactis Bi-07⁸, Lactobacillus plantarum LP299v^® 10, Bifidobacterium infantis 35624¹¹, Bacillus Coagulans¹², and Saccharomyces cerevisiae CNCM I-3856¹³. Healthcare professionals can explore the research behind Lactobacillus acidophilus NCFM^®, Bifidobacterium lactis HN019, Bifidobacterium lactis Bi-07, Lactobacillus plantarum LP299v^® and Bifidobacterium infantis 35624 on the Probiotics Database. 

Health professionals can head on over to Probiotic Professionals to find out more about using probiotics to support gut health.  

You may also be interested in reading the following:

Which Probiotics for IBS?

Why consider probiotic supplements over yoghurts?

Stress and bloating: Can one cause the other?

References:

1. Hungin, A. P. S., et al. (2018). Systematic review: probiotics in the management of lower gastrointestinal symptoms - an updated evidence-based international consensus. Aliment Pharmacol Ther, 47(8), pp. 1054–1070. doi: 10.1111/apt.14539 
2. Gilliard, L, et al. (2017). Anxiety, Depression, and the Microbiome: A Role for Gut Peptides. Neurotherapeutics, 15: pp. 36-59.
3. Montalban-Arques, A, et al. (2015). Selective Manipulation of the Gut Microbiota Improves Immune Status in Vertebrates, Frontiers in Immunology, 6(5): pp. 12.
4. Menees, S., & Chey, W. (2018). The gut microbiome and irritable bowel syndrome. F1000Research, 7, F1000 Faculty Rev: pp.1029. https://doi.org/10.12688/f1000research.14592.1
5. Chang, L, et al. (2011). Review article: the treatment of functional abdominal bloating and distension. Aliment Pharmacol Ther, 33: pp. 1071–1086.
6. DeGruttola, J. K., et al. (2016). Current Understanding of Dysbiosis in Disease in Human and Animal Models. Inflammatory Bowel Diseases, 22(5): pp. 1137–1150.
7. Ghoshal et al. (2017). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut and Liver, 11(2): pp. 196-208.
8. Ringel, K. T., et al. (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. J Clin Gastroenterol, 45(6): pp. 518-25.
9. Ibarra, A., et al. (2018). Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: A double-blind, randomized, placebo-controlled, and dose-ranging trial. Gut Microbes, 9(3): pp. 236-251.
10. Niedzielin, K. et al. (2001). A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol, 13(10): pp. 1143-7.
11. Whorwell, P. J., et al. (2006). Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol, 101(7), pp.1581-90.
12. Larysa, H. (2009). Original Research: Bacillus coagulans Significantly Improved Abdominal Pain and Bloating in Patients with IBS. Postgraduate Medicine, 121: pp.119-124
13. Spiller, R., et al. (2016). Randomized double blind placebo-controlled trial of Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: improvement in abdominal pain and bloating in those with predominant constipation. UEG Journal, 4(3): pp. 353–362.