COMPARISON OF THE ROLES OF PROBIOTICS, PREBIOTICS, AND SYNBIOTICS IN THE MANAGEMENT OF IRRITABLE BOWEL SYNDROME: A REVIEW OF RECENT EVIDENCE

Maria Wieczorek; Wojciech Janikowski; Aleksandra Stępka; Lena Jaworowicz; Weronika Plichtowicz-Kordowska; Agnieszka Jóźwicka; Karina Lewandowska

doi:10.31435/ijitss.1(49).2026.4758

Authors

Maria Wieczorek Medical University of Warsaw, Poland https://orcid.org/0009-0000-9951-7509
Wojciech Janikowski Medical University of Warsaw, Poland https://orcid.org/0009-0008-4078-9698
Aleksandra Stępka Medical University of Warsaw, Poland https://orcid.org/0009-0007-5034-0037
Lena Jaworowicz Medical University of Warsaw, Poland https://orcid.org/0009-0008-4210-7216
Weronika Plichtowicz-Kordowska Medical University of Warsaw, Poland https://orcid.org/0009-0009-7713-8597
Agnieszka Jóźwicka Medical University of Warsaw, Poland https://orcid.org/0009-0008-1130-1518
Karina Lewandowska Medical University of Warsaw, Poland https://orcid.org/0009-0004-5298-1426

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.4758

Keywords:

Irritable Bowel Syndrome, IBS, Probiotics, Prebiotics, Synbiotics

Abstract

Irritable bowel syndrome (IBS) is a chronic disorder characterized by recurrent abdominal pain and altered bowel habits. Its heterogeneity has intensified interest in microbiota targeted therapies. This review summarizes evidence published between 2020 and 2024 on the use of probiotics, prebiotics, and synbiotics for the treatment of IBS. The search was limited to English language, full-text studies in humans and used the terms “probiotics”, “prebiotics”, “synbiotics”, “irritable bowel syndrome” and “IBS”. Studies indicate that improvements are strain and formulation specific rather than a class effect. Treatment duration and dose appear critical. Benefits are more likely with interventions lasting at least four weeks and daily doses around ≥10⁹ CFU. Signals for global symptom relief have been reported for Escherichia strains and Lactobacillus plantarum 299V, while reductions in abdominal pain have been observed with Saccharomyces cerevisiae CNCM I-3856, Bifidobacterium strains, and Bacillus coagulans. Overall comparisons across studies suggest outcome specific efficacy, with L. acidophilus DDS-1 and B. coagulans strains frequently showing favorable effects on symptom severity, abdominal pain, and stool related outcomes in IBS D. Some data suggest prebiotics can improve defecation frequency in IBS C. In contrast, prebiotics and synbiotics show more variable and product dependent effects. Overall, probiotics appear safe and potentially effective when appropriately selected, but heterogeneity across studies underscores the need for standardized endpoints, subtype stratified analyses, and precise reporting of strain identity, dose, and viability to guide individualized recommendations.

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