Probiotic Use in Irritable Bowel Syndrome (IBS) Comprehensive Review

Abstract

Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal disorder linked to gut-brain axis dysfunction and intestinal dysbiosis. Probiotics, defined as live microorganisms with health benefits, have emerged as a prominent therapeutic strategy targeting this microbial imbalance. This comprehensive review synthesizes current evidence on the mechanisms, clinical efficacy, practical application, and future directions of probiotic therapy for IBS.A narrative synthesis of key meta-analyses, systematic reviews, and randomized controlled trials was conducted, with a focus on strain-specific effects and clinical guidelines. The pathophysiology of IBS involves visceral hypersensitivity, altered motility, low-grade inflammation, and dysbiosis. Probiotics are proposed to ameliorate symptoms by modulating the microbiota, enhancing epithelial barrier function, regulating immune responses, and influencing the gut-brain axis. Meta-analyses indicate a modest but significant benefit for probiotics over placebo in improving global IBS symptoms (RR 1.53) and reducing abdominal pain (RR 1.79), though the certainty of evidence is often low due to significant heterogeneity. Efficacy is strain-specific, with particular evidence for Bifidobacterium infantis 35624, Lactobacillus plantarum 299v, and Saccharomyces boulardii CNCM I-745. The most consistent improvements are seen in bloating and abdominal pain. Probiotics are generally safe for immunocompetent individuals and are positioned as a second-line or adjunctive therapy within a holistic management plan. Probiotic therapy represents a rational and moderately effective intervention for IBS, primarily for global symptom relief, pain, and bloating. Success depends on selecting strains with documented clinical evidence. Future research should focus on personalized approaches, long-term outcomes, and the development of symbiotic and postbiotics to better define and optimize the role of microbial therapeutics in IBS management.

Keywords: Irritable Bowel Syndrome; Probiotics; Dysbiosis; Gut-Brain Axis; Bifidobacterium; Lactobacillus; Microbiome.

Received Date: October 20, 2024

Accepted Date: November 11, 2025

Published Date: December 01, 2025

Available Online at: https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/518