Probiotics and bloating
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Probiotics and Abdominal Bloating: Clinical Evidence
Probiotics for Functional Abdominal Bloating
Several clinical trials have shown that probiotics can reduce both the frequency and severity of abdominal bloating. In a randomized controlled trial, patients with functional abdominal bloating who took a multi-strain probiotic experienced significantly less frequent and less severe bloating compared to those taking a placebo or colloidal bismuth subcitrate. Notably, 41.9% of patients in the probiotic group reported no bloating symptoms after treatment, compared to only about 12% in the other groups. Probiotics also reduced related symptoms like borborygmus (stomach rumbling) more effectively than other treatments .
Probiotics and Gas-Related Symptoms in Healthy Adults
Research in healthy adults has found that daily supplementation with Bacillus subtilis BS50 for six weeks led to a higher proportion of participants reporting improvements in bloating, burping, and flatulence compared to placebo. Specifically, 31.6% of those taking the probiotic reported improvement in bloating, versus 13.9% in the placebo group. The probiotic was well-tolerated and did not cause significant side effects .
Probiotics for Bloating in Specific Populations
In airline pilots with chronic non-atrophic gastritis, supplementation with Saccharomyces boulardii and Enterococcus faecium significantly reduced self-reported bloating and gastric pain compared to a control group. Both low and high doses were effective, but high-dose probiotics also showed potential benefits for gastric mucosa health .
Probiotics and Bloating in Irritable Bowel Syndrome (IBS)
Systematic reviews and meta-analyses of randomized controlled trials in IBS patients suggest that some probiotic strains and combinations may help with bloating, but the certainty of the evidence is generally low to very low. Bacillus coagulans, in particular, showed the highest probability of improving bloating and other IBS symptoms, while other strains like Lactobacillus plantarum and Bifidobacterium strains also showed some benefit. However, results across studies are inconsistent, and more research is needed to confirm which strains are most effective 45.
Probiotics and Bloating in Constipation and Healthy Adults
Meta-analyses indicate that probiotics can improve bloating in people with constipation and may increase stool frequency and improve stool consistency. However, for healthy adults, Bifidobacterium animalis subspecies lactis did not show significant improvement in bloating, though it did help with other gastrointestinal symptoms 69.
Safety and Adverse Effects
Most studies report that probiotics are safe and well-tolerated, with no significant increase in adverse events compared to placebo 24510. However, there are rare cases where probiotic use has been linked to small intestinal bacterial overgrowth (SIBO) and D-lactic acidosis, which can cause bloating and other symptoms. In these cases, stopping probiotics and using antibiotics led to symptom improvement .
Patient Perspectives on Probiotics for Bloating
Surveys show that many gastroenterology patients use probiotics specifically to address bloating, believing they improve overall gastrointestinal health. Bloating is a more common reason for probiotic use than diarrhea among these patients .
Conclusion
Probiotics can help reduce bloating in people with functional gastrointestinal disorders, IBS, and certain other conditions, though the effectiveness depends on the specific strains used and the population studied. Most people tolerate probiotics well, but rare adverse effects can occur. Patients often use probiotics to manage bloating, and clinicians should be aware of both the potential benefits and risks when advising on probiotic use.
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