Question

Having read about the new research which is looking at the possibility that the gut may be involved in ME/CFS, is there any point in using probiotics as a form of treatment? I have a number of bowel symptoms that my doctor says are due to irritable bowel syndrome – but I haven’t had much success with the treatment he has recommended so far.

Answer

Probiotics are ‘friendly bacteria’ that come in the form of yoghurt, drinks and supplements. They help to restore the normal balance of gut bacteria. In relation to irritable bowel syndrome, probiotics may help with pain, flatulence and bloating in some people. But the evidence so far is not of high quality.

The key bacteria here are bifidobacteria and lactobacilli. Products that may be worth trying include Activia (contains bifidobacteria – for constipation and pain) and VSL3 (contains bifidobacteria and lactobacillus – for flatulence). It can take a month of regular use to decide if a probiotic is helping. And it may be worth switching to another brand – as the types of bacteria vary – before concluding that probiotics are not effective.

In relation to using probiotics as a treatment for ME/CFS, this is very speculative in our current state of knowledge. As you say, there is some interesting research being carried out at the moment in both the UK and USA that is looking at what is called the microbiome in ME/CFS. This is the name given to all the bacteria that inhabit the gut and the research is aiming to identify if there is any imbalance or abnormal composition of gut bacteria or viruses in people with ME/CFS.

At the moment, this is all very theoretical and there is no firm evidence of any significant abnormality in the microbiome in ME/CFS. If it does turn out that the microbiome is involved in ME/CFS then probiotics would need to be assessed in proper clinical trials. In the meantime it would be a very speculative approach to treatment.

More information

• Stomach and Irritable Bowel Symptoms.
• Research: 2009: A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome.
• The Association of British Dietiticians: Probiotics and gut health: Food Fact Sheet.
• Please let us know what happened if you have used probiotics for irritable bowel type symptoms, and which product was used: feedback@meassociation.org.uk

See also:

• Website Blog: Studies Find Microbiome Changes May Be Signature For ME/CFS | February 2023
• Website Blog: Research Roundup: 31 January – 6 February 2023.
• Medical Matters: Faecal Microbiota Transplantation.