# Which probiotic?



## distressed (Jan 7, 2009)

I have tried so many different probiotics...same strains different brands, different strains...combinations, single strains at a time etcSachyromces Boulardii has been some help....but I still have terrible gas.... Align is probably the only one mentioned that I havent had as its not available in Australia, but VSL3 is and that didnt help me...actually just gave me bad reflux!Any suggestions? advice about experience of what strains help with what etc? I realise its all about balance...but how the hell does one work out that!I have the option of using vancomycin...but I;d rather avoid that and treat with good rather than bad stuff...specially in the absence of a pathology result.


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## Kathleen M. (Nov 16, 1999)

Really other than trial and error I don't have a good idea how to guess which strain is the right one for you.Some probiotics have FOS or other prebiotics in them which can bother some IBSers for the first few days they take it.If you have given several different probiotics a good 3-4 week trial and none of them help, maybe probiotics is not the right answer for you.No one treatment for IBS (or any other disease on the planet) works for 100% of the people. You don't know if you are going to respond well until you try, but you can't assume that probiotics must absolutely work for you even if they work well for at least about 1/2 the IBSers that take them. Even when you see really good statistical differences between the people that took something and the placebo it is rare for the whatever it is to help more than 70-80% of people. Nothing works for everyone, and if you really have given it a fair shot it may be time to move on to something else. Gas volume may not be a big trigger for you and gas volume is the main thing probiotics help with.


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## distressed (Jan 7, 2009)

Yeh I get what you are saying....the prbiotics definitely arent helping with my gas volumes though....theyre just getting bigger and fouler!


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## Kathleen M. (Nov 16, 1999)

The foul may be better helped with pepto bismol (or other bismuth containing deodorant or anti diarrheal available locally).The probiotics may reduce some volume from carbs but don't tend to do a lot for the sulfur reducing bacteria making foul odors from protein.If it is mostly an odor issue you might look at how much protein you eat and see if getting only 2-4 ounces per meal helps. Also look at how much sulfur containing foods like eggs or onions you tend to eat.The only problem with the bismuth is it tends to be mildly constipating and some people don't need that, but they did do a small clinical trial and people were able to take up to 8 pepto bismol tablets a day and get good odor control. I don't think probiotics tend to alter the internal balance between methane producing and sulfur reducing bacteria and that balance tends to determine how much odor there is. Even a small volume of the sulfurous gases makes a huge smell.


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