The best probiotic for an older woman with IBS
Two things decide it for Dr. Martin, and neither is the brand on the front. Breadth, meaning a range of strains rather than one, and dose, meaning billions rather than millions. Then a third thing that matters just as much, which is whether the bacteria are hardy enough to survive the trip through your stomach.
With IBS specifically, he pairs that with a food change most women have never been offered, and it runs the opposite way to the usual advice.
What IBS looked like in his clinic
A listener writes in with atrophic gastritis, IBS and diverticulosis all at once. His reply is that she does not have three problems.
Dr. Martin, The Doctor Is In, Episode 1624When I was in practice, I saw a lot of Theresa's like that.
Not thousands of Theresas, he says, but thousands of other names over the years with that same combination. Then the picture he used in the office.
Dr. Martin, The Doctor Is In, Episode 1624You got the sunburn of your gut.
He explains it in the next breath. Irritated all the way through, from the stomach to the bowel to the colorectal area. That is why he does not treat the diagnoses one at a time. If the whole length of it is raw, everything you put into it lands on raw tissue.
"You got the sunburn of your gut."
Dr. Martin, The Doctor Is In, Episode 1624Why billions is the number that matters
Asked about parasite cleanses, he says he is much bigger on probiotics, because a broad spectrum probiotic does that job anyway. Then he sets the dose.
Dr. Martin, The Doctor Is In, Episode 1624You need billions and billions and billions of bacteria.
His next line is that you are not going to overdose on a probiotic. That is worth knowing, because the instinct with a sore gut is to go carefully and take a little. His position is that a little is the one amount that will not do anything.
It is also why he reads the number on a label rather than the word probiotic on the front. Millions and billions are both big words. Only one of them is the number he is after.
The strains he looks for
Dr. Martin on what he wants in the bottle:
Dr. Martin, The Doctor Is In, Episode 1624I love a broad spectrum probiotics with L reuteri, L rhamnosus and others that are really, really anti-parasitic.
Broad spectrum is the operative phrase. He names L reuteri and L rhamnosus, but he names them as part of a range rather than as the two to hunt for on their own. His reason is that a gut is not one organism doing one job, so a single strain is answering a question nobody asked.
That is also his argument against reaching for a cleanse first. He says the research on broad spectrum probiotics doing that work is pretty clear, and that given the choice he would take the probiotic route.
There is a longer version of this argument, on how the strains are grown, in are your probiotics soil based.
Why stomach acid is part of the story
This is the piece that connects the gastritis to the IBS, and he draws it out on the same episode.
When you get gastritis, he says, the pH of your stomach has moved. Not alkaline exactly, but more alkaline than it should be, when your stomach is supposed to be more acidic than a lion's. He says your stomach was designed for eggs, meat and cheese, and that inflammation of the stomach usually follows from not eating the food it was built for.
Two things follow from that. A stomach that has lost acidity does a worse job of breaking food down, which is why he adds digestive enzymes. And a probiotic still has to cross that stomach to reach where it is needed, which is why he cares whether the strains are hardy rather than only how many there are.
What he did about fiber while the gut settled
This is where he loses the room, and he knows it. He says patients used to look at him like he had two heads.
Dr. Martin, The Doctor Is In, Episode 1624Complete elimination of fiber, complete elimination of roughage and probiotics, you need the digestive enzymes.
His reasoning is an animal joke with a real point inside it. You are not a cow. A cow eats grass all day and needs four stomachs to get through salad. You have one. With a gut already sunburnt, roughage is sandpaper on a graze.
Alongside the elimination he names bone broth, and Gut-Ease, which he picks for the mucilages in it, the soothing part rather than the scrubbing part.
Report that for what it is. It is what he did with patients in front of him, over a defined stretch, while things settled. It is not a permanent diet, it is not a diagnosis, and if you have diverticulosis or gastritis your own doctor needs to be in this conversation.
He also prefers finding your own triggers by elimination rather than by an expensive allergy panel, which he says comes back reading allergic to everything when the gut is leaky anyway. More on that in all disease starts in the gut.
Common questions
What is the best probiotic for older women with IBS?
In Dr. Martin's terms, a broad spectrum one in the billions, with strains hardy enough to get through the stomach. He names L reuteri and L rhamnosus among them.
How many probiotic bacteria do you need?
Billions and billions, in his words, and he adds that you are not going to overdose on a probiotic. A small dose is the one he does not expect to do anything.
Should I eat more fiber with IBS?
He goes the other way. With an irritated gut he took people off fiber and roughage completely while it settled, and added probiotics, digestive enzymes and bone broth instead.
Why does a probiotic need to survive stomach acid?
Because the bacteria have to reach the gut to do anything. He also points out that gastritis shifts the stomach's pH, which is part of why he pairs probiotics with digestive enzymes.
Read next: What Is Really Behind Bloating After 60 and Gut Health For Women Over 60: Where Dr. Martin Starts.
Where Probiotic Complex fits
Martin Clinic's Probiotic Complex carries 50 billion live probiotics across 11 clinically selected strains, with stomach acid resistant cultures, which is the shape of what he describes.
60-day money-back guarantee. The soothing side he names is Gut-Ease Formula, with marshmallow root and slippery elm.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
