Dragana Skokovic-Sunjic
Clinical Pharmacist
Desiree Nielsen
Registered Dietitian
Everyone experiences gastrointestinal distress from time to time and we all know how unpleasant and disruptive it can be. According to the Canadian Digestive Health Foundation, roughly 18% of the adult Canadian population suffers from irritable bowel syndrome (IBS). For this group, this diagnosis isn’t an occasional difficulty but an ongoing, debilitating fact of life.
“IBS is one of the most commonly diagnosed gastrointestinal conditions and it is defined by a group of symptoms that are caused by a dysfunctional digestive system,” explains pharmacist and probiotic expert Dragana Skokovic-Sunjic. “It comes in several subtypes, but IBS-D (diarrhea-predominant IBS) is the subtype with the greatest impact on patients’ quality of life.”
The primary symptoms of IBS include substantial abdominal bloating accompanied by discomfort and pain, fecal urgency, and changes in bowel movement frequency along with diarrhea, constipation, or both. For those who live with untreated IBS-D, life can be extremely frustrating and stressful.
This sudden onset impacts not only the opportunity to attend important life events, but also regular activities like work and school. “Symptoms can be severe and unpredictable and often people with IBS simply cannot function,” says Skokovic-Sunjic. “It can be particularly challenging for patients that these symptoms can disappear for days or even weeks and then suddenly come back.”
Probiotics make it possible to manage symptoms
Most medical IBS treatments focus solely on treating symptoms, instead of considering IBS as a functional disorder. So, patients with IBS-D are typically treated primarily for diarrhea. Unfortunately, these treatments don’t resolve the greater issues of IBS and can even worsen the other symptoms. As scientific research has advanced on the gut microbiome and the beneficial bacteria that can positively influence it, knowledge and standards of care are beginning to change.
“There are so many complex interactions between the gut microbiome and the symptoms of IBS-D that, in my practice, we don’t address nutrition without also addressing the microbiome,” says Registered Dietician Desiree Nielsen. “Current evidence suggests that probiotics as a category, particularly multi-strain probiotics, are a worthwhile part of IBS care. In my practice, I strongly recommend that clients use a probiotic with at least one clinical trial supporting it as opposed to spending their money on probiotics without the same research.”
Probiotics aren’t interchangeable
With so many different probiotics on the shelf, making an informed choice is critical. All probiotics aren’t created equally. “The most important thing to know is that probiotics aren’t just one thing,” says Nielsen. “Because they’re living organisms, each strain — or combination of strains — is a totally different thing with different potential effects. You can’t take the research on one probiotic and apply it to another.”
Today, for many with IBS-D, probiotics are providing welcomed relief from symptoms that have too long ruled their lives. But, it’s essential that people understand the difference between available probiotics before making a decision. To that end, Skokovic-Sunjic has authored the Clinical Guide to Probiotic Products, designed to help clinicians better advise their patients.
“It’s very important to talk with a health care provider for help choosing the right probiotic for your condition,” says Skokovic-Sunjic. “As a physician, you would never tell a patient, ‘Just go to the pharmacy and get a drug, any drug.’ The same specificity needs to be applied to probiotics.”
Get the Stats on IBS
18%
of the adult Canadian population suffers from irritable bowel syndrome (IBS).
40%
of all IBS cases are IBS-D.
37%
of patients don’t leave home while experiencing symptoms.
55%
report that they’ve avoided sexual activity because of their symptoms.
9
days per month, the average patient will experience lost work productivity.
