Prebiotics and Probiotics for Constipation

It is common for those with endometriosis also to have irritable bowel syndrome (IBS) and experience symptoms such as bloating, abdominal pain, excessive gas, and constipation.

Constipation is defined as having fewer bowel movements than what is typical for you, as well as having difficulty passing stools. Having at least 1-3 bowel movements per day is healthy.

We need to pass bowel movements regularly to remove waste from our bodies.

Endometriosis, IBS, constipation and the microbiome

It is essential to have regular bowel movements if you have endometriosis, so excess hormones such as estrogen can be efficiently removed, as endometriosis is an estrogen-dependent condition.

On the other extreme, having too many bowel movements or loose stools may mean not absorbing nutrients from your food adequately.

Having constipation occasionally is common. It can be because of a range of reasons such as gut bacteria, travel, not eating enough fiber, dehydration, high-stress levels, medications, and thyroid hormone levels.

If you suffer from IBS and endometriosis, it can be challenging to pinpoint the exact reason. An approach that can help with IBS and constipation is influencing the gut microbiome and peristalsis, which is our body’s way of moving waste through the intestines.

Having a healthy gut microbiome can help us stay regular and has many other benefits.¹

What are prebiotics and probiotics?

Prebiotics are fibers broken down by the gut microbiome, our ecosystem of bacteria, and other microbes that live in our gut. The by-products of prebiotics are short-chain fatty acids, which positively affect the gut and other organs.²

Prebiotics are found in plant-based foods such as leeks, onion, garlic, oats, barley, konjac root, flaxseed, bananas, asparagus, Jerusalem artichoke, apples, dandelion greens, and chicory root.

Obtaining a therapeutic dose of prebiotics to treat IBS symptoms is often done through supplementation. There are different types of prebiotics that feed the gut microbiome, fueling beneficial species of bacteria and reducing less favorable species.

Common prebiotics used to treat constipation include:

• Partially Hydrolyzed Guar Gum
• Acacia Gum
• Pectin

There are many more prebiotic supplements. However, those mentioned above are low FODMAP and, therefore, more tolerated by those with endometriosis and IBS.

Probiotics are strains of bacteria or yeast that offer health benefits.

Studies of IBS patients have shown that they either experience small intestine bacterial overgrowth (SIBO) or an imbalanced microbiome, with reduced levels of Bifidobacterium, Lactobacillus, and Faecalibacterium prausnitzii.³

Probiotics that have shown improvements in treating constipation and abdominal pain include Bifidobacterium and Lactobacillus species.³

Specific strains of probiotics commonly used to treat IBS and constipation:

^3,4

• Escherichia coli Nissle 1917
• Lactobacillus plantarum 299 V
• Bifidobacterium lactis
• Lactobacillus casei
• Bifidobacterium longum BB536
• Lactobacillus rhamnosus HN001

Probiotic strains are often combined to treat constipation and can also be combined with prebiotics.

Identifying the best treatment strategy

Diet and supplementing with prebiotics and/or probiotics can be an effective strategy for treating IBS constipation.

Addressing other factors (such as adequate hydration, stress management, and regular movement) that can contribute to constipation will also assist in improving your symptoms.

Understanding the underlying cause of your symptoms will assist you in determining the best treatment approach; this will involve working with a health professional to rule out a range of other conditions that may be causing your constipation.