Advice on probiotics for 79-year-old Mum with IBS-D

[LadyGrey72]

Hi everyone - new member here. I've joined in some desperation to help my elderly Mum whose IBS-D is escalating with great detriment to her quality of life. She is probiotic-naive and has managed her IBS to date by limiting her diet and with judicious use of loperamide for flares, that's it. She has had a number of colonoscopies in recent years, had antibiotics a year ago for whooping cough, and takes lansoprazole among a number of other medications; so she has several risk factors for dysbiosis.

Based on my research so far the probiotic products which seem most likely to be efficacious (ie contain Lactobacillus and Bifidobacterium strains) are Visbiome GI Care (112 billion CFU/capsule) and Seed DS-01 daily synbiotic (37 billion AFU), both refrigerated products. The daily dose of strains for each of these seems quite high though and am a bit concerned about worsening her symptoms and putting her off before she can complete an initial 4-week trial. But I could be overthinking it.

So my questions are: 1) do you have any experience with these products and can you recommend them, 2) are these products appropriate for the elderly or should I be looking at lower-potency products - if so which ones, 3) do you have any other comments or recommendations based on the above.

Thank you so much for any advice you can give.

[Starfush]

Probiotics are quite a gimmick, I tried them. What sounds like need is a good quality amount of magnesium and calcium

[HelNel7 in reply to Starfush]

Magnesium might work for IBS C but I wouldn't recommend for IBS D, it acts as a laxative.

[Starfush in reply to HelNel7]

Magnesium as food supplement will only cause laxative if you take too much for body to handle same as eating loads, but you'll get full before then, or if your calcium levels are low. Ive tried every form in high doses, with and without calcium, and I get normal stools, you can say they counteract each other down there, but I also have other symptom relief from both of them.

[HelNel7 in reply to Starfush]

Glad it worked for you. I took a magnesium supplement for another health condition and it caused me such a problem that I had to discontinue it. Some forms of magnesium are more likely to cause D than others, but I would still advise caution to anyone considering taking a magnesium supplement. As with everything, something than can be a game changer for one person will be a nightmare for others.

[Starfush in reply to HelNel7]

You have to take it in balance with calcium, as I mentioned. Ive done this myself, ive taken high doses 3-4 'doses' every 3-4 hours and been fine. Magnesium is required for the human body in 300 process. The French scientist discover the ideal ratio is Calcium 2:1Magnesium elemental. There's other factors like if your body is low in magnesium absorption will increase, also calcium absorption is much diminished if your low in vitamin D 10-15% from 30-40%. Ive taken very high doses of multiple forms, with and without calcium+1000IU vitamin D and without the other two I could barely tolerate a tablet, if the others I can take the 'laxative' make of oxide 3-4 a day!.

[LadyGrey72 in reply to Starfush]

Thanks Starfush - my understanding at the moment (am still learning) is that some individual studies have shown benefit from probiotics but the overall body of evidence is inconclusive. IBS seems to be such an individual experience it makes sense that certain interventions will work in some but not others. This is not an easy field to get your head around. I hope you managed to find something that has helped you. Will look into the role of Mg/Ca as am not familiar with that. All best to you.

[Starfush in reply to LadyGrey72]

Probiotics are just repopulating bacteria, as I have tried. I see it as individual because its normally a base cause, the human body only works one way, ive never restricted any food I eat anything, healthy or unhealthy, the only constant ive found is magnesium and balancing it out with calcium.

[HelNel7]

Probiotics have not been shown to help in the management of IBS symptoms so personally I wouldn't bother. I did give it a go briefly and my D symptoms worsened.

[LadyGrey72 in reply to HelNel7]

That's HelNel - noted. Hope you are feeling better.

[HelNel7 in reply to LadyGrey72]

Much better, thank you! Key for me was doing the FODMAP diet, which enabled me to discover my food triggers. I then made adjustments to my normal diet (cutting out most sugars and eating lots of gut-friendly foods such as good quality blue cheese and organic kefir yoghurt) and my IBS is now very well controlled.

[LadyGrey72 in reply to HelNel7]

That's awesome - need to look into FODMAP too - another one for the list! Great that you are better ☺️

[HelNel7 in reply to LadyGrey72]

Although IBS can't be cured, it can be well managed *if* you can find your triggers (and food isn't a trigger for everyone with IBS, but the FODMAP diet is a good way to find that out, and for me it was a massive help).

Gut-directed hypnotherapy is another treatment that has good outcomes for many people with IBS.

I have other health issues (COPD and peripheral neuropathy), so life is still a bit of a challenge sometimes, but at the moment everything is under control, and I am hugely grateful for the fact that I am able to live a more or less normal life at the moment!

[LadyGrey72 in reply to HelNel7]

Thanks for the further advice HelNel - all good suggestions I will look into. Sorry to hear about your other diagnoses - my Mum also has a number of background conditions, she is disabled and doesn't get out much, but the added burden of unpredictable diarrhoea is now affecting her quality of life the most. Very pleased that at least your IBS is manageable now - wishing you good health and happiness. x

[HelNel7 in reply to LadyGrey72]

I hope your mum finds something that works for her. She is very fortunate indeed to have you to look out for her and research possible solutions x

[Hawkswon3 in reply to LadyGrey72]

Daily balance. CFU counts not so high and reasonably priced. She could also try Greek yogurt you buy at the store.

[Hawkswon3 in reply to HelNel7]

Kefir (yogurt) ARE probiotics. Live active culture.

[HelNel7 in reply to Hawkswon3]

Sure, but I was referring to the bottles of capsules/powders, which often contain fillers like inulin which don't agree with my digestion at all

[Misspomfrey]

I used to take 15 strains in probiotics then realised it was making me worse and my IBS was most IBS D. for the last 6 months or so, I have been taking only 6 strains with lower doses in each strain and I have suffered no diarrhoea. My bowel habits are more regular and normal with the occasional blip, of course I have to watch my diet constantly.

[LadyGrey72 in reply to Misspomfrey]

Hi Misspomfrey - you raise an interesting point that I was concerned about - this question of whether fewer probiotic strains are preferable in IBS than multiple strains. I think, given my Mum's age and general frailty, I am tending towards fewer strains and taking a slow and gradual approach to introducing probiotics. Happy that you are feeling better! Would you be open to sharing what specific probiotics you take? All the best.

[Misspomfrey in reply to LadyGrey72]

I'm afraid I can't give you any brand names and I would be reluctant to recommend any in particular because of your mothers age and everyone reacts differently to probiotics. What I will say is I have only come across 2 brands with 6 strains. One I find suits me better than the other. I believe I am Histamine intolerant which worsens my IBS and the strains I am taking do not produce high histamine. If you research more, you may find that Histamines could be playing a part in your mothers condition. GPs may not normally pick up on this.

[Floristell]

I recommend symprove. I had a similar case and this was the only thing that worked.

[LadyGrey72 in reply to Floristell]

Thanks very much Floristell - I will look into Symprove. Appreciate the advice.

[xjrs]

I have tried many probiotics over the years and Alflorex has worked best for me and has helped many others, though not all since every person's IBS is different. It has been scientifically studied for IBS, only contains 1 strain of Bifdobacterium, which is passed from mother to baby during a natural birth to prime the gut's defences, so it is good at kicking bad bugs into touch. It also contains only 1 billion CFU when many contain 10 million plus. Studies show that IBS sufferers fare better on lower CFU products (less than 10 million). I have found that is has greatly improved my food tolerance and significantly reduced my IBS pain.

I tried a high CFU multi-strain probiotic once and had a vomiting episode. I think my body thought it was under attack. I had no side effects with Alflorex and started getting benefits after 1 week. However, some people have a bedding in period, when symptoms may get exacerbated for a couple of weeks, which hopefully settle. The ideal trial length is 3 months.

[LadyGrey72 in reply to xjrs]

Hi xjrs - thanks very much for this. Am seeing Alflorex mentioned by a number of IBS sufferers and will investigate further. I like the idea of low CFU/single strain for the reasons discussed above and it is interesting that you noted there is some scientific evidence to support that approach in IBS. Appreciate you - hope you are keeping well.

[Bracondale]

I would strongly suggest you look into Elixa probiotics (very high dose six day course). The website has very useful articles/short videos, and explains the rationale underpinning the product/approach. Karl who founded the company is very knowledgeable, intelligent and helpful. It's well worth contacting him for advice (I know that he recommends half dose for children). I am a little underweight, nearly 65 and have had a chronic illness for 20 years...and only noticed a slight headache and tiredness for first couple of days (stools were already loose). (I'd preceded my course with 21 days of Saccharomyces boulardii as it happens). It may be that a course of Elixa probiotics would prove to me no more debilitating than the symptoms that your mother is already experiencing.

The other item that may be worth considering/researching and maybe trying first, is Tributyrin. It decreases inflammation in the colon and helps the cells lining the colon to work better, so absorbing more fluid and decreasing the liquidity of the stools. It worked very well for me, and as my situation (D) has improved I have decreased from 3 capsules per day to one every three days!

Wishing your mother well, and you too of course in your endeavour to help her!

[LadyGrey72 in reply to Bracondale]

Hi Bracondale - thanks for all the information - really interesting! I will look into Elixa and Tributyrin - thank you. Sounds like you have done a lot of research into this and am very glad you found an approach that helped. Thanks for the kind words about my Mum too x

[lowraind]

Have you spoken with her doctor?

[LadyGrey72 in reply to lowraind]

Hi lowraind - thanks for asking - yes but without much specific help or advice being offered by the GP. The attitude was pretty much 'this can be a really difficult long-term condition to manage *shrug*'. But she did refer my Mum to a dietician who was able to offer advice on nutrition and common triggers. One of the challenges with the GP's recommendation of the usual measures - basically loperamide for flares - is that my Mum is pretty sensitive to it and she then enters a constipation/diarrhoea cycle that just perpetuates symptoms. It's really vexing. Hope you are ok and keeping well yourself.

[Luisa22]

I have never taken probiotics. For some reason, my "gut feeling" (pun intended!) said "no". I have no idea why. I have however, made some improvement in the past 4-5 years, and again, I have no idea why really.

I just keep a tightrope balance with responding to whatever is happening daily with my gut using basically a dietary approach... but there must be some other reason going on, why I have made some tentative improvement.

There has been stress, owing to issues with a family member and a lot of disruption, so basically that shouldn't make sense. Sometimes I do find stress bothers me, but other times not so, as far as my gut is concerned.

I also took homeopathic remedies given to me by a qualified practitioner. I improved so much but very very gradually. Now I have put her on "standby", because my condition doesn't warrant monthly treatments. At least, at the moment. She also gave me a "microbiome support" remedy (no idea what it contained)!! That's trust -hey? But it's possible it contributed to my improvement. I don't know. It certainly did me no harm. It didn't contain probiotics, but a combination of plant remedies and homeopathics.

I do hope your Mum finds some relief and something helps her. I do feel for what she must be going through. IBS D is horrible. I wonder if experimenting with the dosage of loperamide might stop the awful swings between constipation and the eventual diarrhoea? A pill cutter might come in handy. Or crushing the tablets to make smaller doses, so she might find a perfect balance?