Probiotics for digestive woes

Don’t assume that all probiotics provide relief for every GI problem.

Probiotics sellers can make vague claims like “supports digestive health,” but does that mean you can expect relief from your GI problem? A single strain may not cover all the bases. Here’s a snapshot of the evidence on which probiotic strains may help with which digestive issues.

(For a refresher on what probiotics are, what they aren’t, and what to look for when choosing one, check out our Probiotics 101 post).

Constipation

Only two probiotics have helped (slightly) with constipation in more than one study.

Don’t expect more than modest help.

Among 126 Chinese women reporting fewer than three bowel movements a week, those who ate yogurt containing 12.5 billion cells of Bifidobacterium lactis DN-173 010 (the probiotic in Dannon Activia) for two weeks averaged 1½ more bowel movements during the second week than those who drank a placebo beverage.1 (How much DN-173 010 is in Activia? “Billions,” was all Dannon, which funded the study, would tell us.)

And among 1,248 Europeans who reported two to four bowel movements a week, those who took daily capsules with 1 billion Bifidobacterium lactis BB-12 for four weeks averaged about one more bowel movement every 18 days than those who took a placebo.2

World J. Gastroenterol. 14: 6237, 2008.
Br. J. Nutr. 114: 1638, 2015.

Minor Digestive Complaints

“Activia’s billions of probiotics help take care of what’s inside so we can be our best self and face all of life’s challenges,” says the Dannon Activia website. (Maybe that claim sells better than Activia’s old regularity claims did.)

GanedenBC30? Yes. Healthy? Not with 220 calories and 7 grams of sat fat in just 1/3 cup.

Activia, which contains Bifidobacterium lactis DN-173 010—the company calls it Bifidus Regularis—helps relieve minor digestive annoyances like bloating, gas, rumbling, and discomfort, says Dannon. Yet the only two studies of people with those kinds of complaints (both funded by Dannon) didn’t find much to crow about.

In Germany, 100 women ate two servings of Activia every day, while 97 similar women ate a placebo yogurt. After four weeks, 41 percent of the Activia consumers reported that their GI symptoms had improved, versus 34 percent of the placebo takers.1 In a similar study in France, Activia was no better than a placebo in relieving GI symptoms in 162 women.2 Dannon hasn’t done a third study to see which of the first two was a fluke.

Another probiotic, GanedenBC30, “supports a healthy digestive system,” according to its manufacturer’s website.

GanedenBC30 (aka Bacillus coagulans GBI-30, 6086) is arguably the most-used probiotic in the world. It’s in everything from granola to tea bags to chocolate bars.

The food industry’s fondness for GanedenBC30 is partly due to the microbe’s hardiness. Unlike most other probiotics, it’s surrounded by a tough spore that allows it to survive heating, freezing, and long storage at room temperature.

In Ganeden’s small company-sponsored study of seven adults in Miami and 54 in the Dominican Republic, those who took 2 billion GanedenBC30 bacteria every day for four weeks reported slightly less abdominal pain, but no less gas, bloating, or distension, than placebo takers.3 So don’t expect much, if any, relief.

1 Br. J. Nutr. 102: 1654, 2009.
2 Neurogastroenterol. Motil. 25: 331, 2013.
3 BMC Gastroenterol. 9: 85, 2009.

Antibiotic-Associated Diarrhea

Taking antibiotics? Don’t count on yogurt to ward off diarrhea.

The best evidence? The yeast Saccharomyces boulardii.

Two bacteria—Lactobacillus bulgaricus and Streptococcus thermophilus—turn milk into yogurt. Only one study has tested yogurt with just those two bacteria in adults. Those who ate 5 oz. of the yogurt every day for 12 days after starting antibiotics were just as likely to have diarrhea
as those who ate no yogurt.1

In another study, a yogurt that also contained Lactobacillus acidophilus lowered the risk of diarrhea due to antibiotics.2 But the authors didn’t say which strain they used, and neither do most yogurts that add Lactobacillus acidophilus, so that’s not much help.

The probiotic with the best evidence: a yeast called Saccharomyces boulardii.3 To get it, you’ll need to pick up a supplement like Florastor.

Lactobacillus rhamnosus GG, which is in supplements like Culturelle, also seems to cut the risk of diarrhea.4

1 Br. J. Gen. Pract. 57: 953, 2007.
2 Dig. Dis. Sci. 48: 2077, 2003.
3 Aliment. Pharmacol. Ther. 42: 793, 2015.
4 Aliment. Pharmacol. Ther. 42: 1149, 2015.

Irritable Bowel Syndrome

Two probiotics may offer some relief from the symptoms of irritable bowel syndrome (recurring abdominal pain, gas, bloating, diarrhea, and constipation without any known cause). At least that’s what studies largely funded or conducted by industry show.

May help relieve IBS symptoms.

Bifidobacterium infantis 35624 (sold as Align). In two trials of roughly 440 adults with IBS, probiotic takers reported more improvement in abdominal pain, distension, and (in one of the studies) gas than placebo takers.1,2

Lactobacillus plantarum 299v (in Good Belly drinks and some supplements). In Indian and Polish IBS sufferers, the probiotic reduced pain and (in the Indian study) bloating more than a placebo.3,4 In a study in Sweden, the probiotic helped only with gas.5

The Swedish and Polish studies gave 20 billion live cells a day for four weeks; the Indian study 10 billion a day. (Good Belly claims to have 20 to 50 billion.)

1 Gastroenterol. 128: 541, 2005.
2 Am. J. Gastroenterol. 101: 1581, 2006.
3 World J. Gastroenterol. 18: 4012, 2012.
4 Eur. J. Gastroenterol. Hepatol. 13: 1143, 2001.
5 Am. J. Gastroenterol. 95: 1231, 2000.

 

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8 Replies to “Probiotics for digestive woes”

  1. So what probiotics are ” right” to consume? I was told by my doctor that I need to take them but not sure why. I’m not constipated. Well maybe . I average 1-2 movements a day. More like 0-1. My Dr. also told me to take peptbismol chewable capsules. I’m just trying to get educated on probiotics and what one may work best for me ( once I figure out what the problem is). Currently I’m taking a chewable probiotic I purchased from Mom’s Organic store. According to the ingredients I did not see any of the ones mentioned in this article.

    1. The right probiotic will depend on the issue you’re trying to address. There isn’t evidence to support the need for a general probiotic that isn’t being taken for a specific health concern. You should have a discussion with your doctor about why he/she thinks you need one and ask specifics about what strain they suggest you take. Keep in mind that a lot of probiotic products don’t list the strains on the label (You’ll know they list the strain if there are three names. For example,”bifidobacterium lactis DN-173″ tells you everything whereas “bifidobacterium lactis” only tells you the genus and species, but not the strain). We recommend only buying products that include the strain name. Also, many products contain multiple strains, but those combination probiotic products are very rarely tested together, so there’s no way of knowing if the strains work with each other or against each other.

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