Probiotics are clearly incredibly supportive, but they can't do their work alone. To make sure that you're getting the most out of your microbes, it's important that you give them the support they need to work. You've got lots of options for supporting your gut health, from dietary changes to probiotic supplementation, but make sure you're at least covering the following bases.
Thankfully, most causes of constipation can be improved with dietary and lifestyle interventions. One of probiotics benefits is constipation relief. Probiotics of many kinds can help with constipation because they can keep the digestive contents moving along through different mechanisms such as short-chain fatty acid production, influences on the nerves of the digestive tract, electrolyte balance, pathogen control, and others. Think of probiotic foods and pills as an addition to other dietary and lifestyle interventions to relieve constipation and return your digestive system to its normal functions.
You also want to look at the guarantee fine print: If the CFU number is guaranteed at time of manufacturing, but not at the time of expiration, you could be taking a less potent dose of probiotics than you think because potency fades over time. I made this mistake when I was traveling once and went to the grocery store to pick up probiotics. On the bottle label it said guaranteed at 20 billion CFU at the time of manufacturing. This doesn’t tell you the CFU for when I was actually taking the probiotics. For instance, our probiotics are manufactured at 60 billion and 200 billion CFU, and guaranteed at 30 billion and 100 billion CFU, respectively, at time of expiration.
"Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," says Segal. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
Yes, they may help. Lebwohl says there are reputable studies that show a link between the use of probiotics and the reduction in IBS symptoms, citing this meta-analysis. It's estimated that 11 percent of the world population complains of symptoms like abdominal cramps, diarrhea, constipation, excessive gas and/or mucus in their stools. While for some the condition can be attributed to certain dietary triggers, others appear to be stress-related, which brings us to the heart of where many claims about the effectiveness of probiotics lie—in the gut-brain axis.
The scientists discovered that the probiotics successfully colonized the GI tracts of some people, called the "persisters," while the gut microbiomes of "resisters" expelled them. Moreover, the persister and resister patterns would determine whether probiotics, in a given person, would impact their indigenous microbiome and human gene expression. The researchers could predict whether a person would be a persister or resister just by examining their baseline microbiome and gut gene expression profile.
Among their numerous health benefits, research shows these friendly microorganisms help prevent bowel diseases, improve your immune system, reduce traveler’s diarrhea, help you maintain a healthy weight, heal various skin conditions, improve bloating and other uncomfortable GI symptoms, and even boost your mood, helping to reduce the effects of anxiety and depression.
Unlike many of the probiotics on the market today for women, Vitamin Bounty’s formula is fermented naturally and encased in a delayed-release capsule for more efficient digestion. Specifically, this capsule helps to protect the micro-organism strains from stomach acid, which can dissolve them before your gut has a chance to absorb all of their healthy goodness. With this Women’s Pro-Daily Probiotic design, you can expect more cultures and, as a result, fewer stomach upsets and feminine health problems!
Further, there’s still a lot we don’t know. A recent study published in Cell compared how the microbiome of the gut reconstituted itself after antibiotic treatment with and without probiotic administration. The researchers found that probiotics (which might have improved diarrhea symptoms) led to a significant delay in microbiome reconstitution, if it occurred at all. And — again — this study was with purified strains of bacteria, which is not what you’re getting in probiotic-containing food.
"I recommend supplementing with the species lactobacillus and bifidobacterium, and there are different strains within those species that are each beneficial. Garden of Life and Align probiotics contain bacteria that help the gut microbiome and maintain digestive balance, and 1MD's Complete Probiotics Platinum is one of the best probiotics with over 50 billion live cultures that help with gut and digestive health."
A diet high in vegetables, fruit, and fiber, along with probiotics for weight loss, supports a more diverse gut microbiome, which in turn helps weight loss. Instead of waiting for the next magical diet or weight-loss supplement to arrive, focus on improving your gut health with probiotic foods and drinks with live cultures, in addition to maintaining healthy lifestyle factors.
Other foods without substantial research: miso (fermented soybean paste); tempeh; sauerkraut; aged soft cheese; sourdough bread; sour pickles; gundruk (nonsalted, fermented, and acidic vegetable product); sinki (indigenous fermented radish tap root food); khalpi (fermented cucumber); inziangsang (traditional fermented leafy vegetable product prepared from mustard leaves); soidonis (widespread fermented product prepared from the tip of mature bamboo shoots)
Because there's a huge variety of probiotic products available on the market, many people struggle to find the right one for them. "There are many different strains of bacteria in different combinations within different probiotic supplements," explains Brooke Scheller, a clinical and functional nutritionist. "For example, a probiotic may contain a single strain of bacteria or many. It may also contain other vitamins, minerals, or other ingredients that may tout health benefits," she says. There are many different dosages, delivery systems (powder, tablets, capsules), and formulations (refrigerated vs. shelf-stable), and some probiotics also contain prebiotics, which basically act as fertilizer for the probiotics. (Related: Why Your Probiotic Needs a Prebiotic Partner)
Once GI experts realized there is more to the lower gut than first assumed, the push to understand the diverse roles these bacteria play became urgent. Many mysteries still need solving, but clinical evidence increasingly indicates that people in good health should optimize lower gut bacteria. You can accomplish this by eating prebiotics to encourage the growth of your existing gut microbes, and probiotics to add to the ones that are already there.
As far as effectiveness, keep in mind that unlike medications, dietary supplements do NOT need to be approved by the FDA. This means that manufacturers can sell supplements simply with "claims" of safety and effectiveness. Currently, researchers are undecided if probiotic supplements are effective. Some say probiotics are effective; others believe they offer no benefit whatsoever. It also remains unclear which probiotics (or combination of probiotics) work to treat certain diseases. Despite these issues, some studies have shown positive results. Still, more research is needed to confirm that probiotics are safe and effective.
You experience that afternoon slump and reach for a candy bar or a sugar-laden coffee. Or maybe you go through your day, starting with a breakfast of doughnuts or sugary cereal, and then proceed to sodas for drinks, cookies to snack on, dessert after dinner, and finally to a nighttime snack of ice cream. You know that feeling; it’s that I-have-to-have-something-sweet-and- I-have-to-have-it-NOW feeling.
There’s good and bad bacteria in there (fascinating fact: an estimated 100 trillion bacteria live inside your digestive tract): When the good outweighs the bad, your immune health soars; when the bad overpowers good, you get sick. You have diarrhea. Your immune system tanks. Your IBS, lactose intolerance, and other gut problems are exacerbated. It throws your entire system out of whack.
Step No. 1 is consume more sour foods — it’s the top way probiotics benefits can be accessed. Embrace what I call “the power of sour” with sour foods like apple cider vinegar and fermented vegetables. They contain some probiotics, but also they contain certain types of acids like gluconic acid and acetic acid, healthy acids that support the function of probiotics (even functioning like prebiotics in some cases).
Bacteria die out over time. Some supplements list the potency when they were manufactured (before they rode in a truck, sat on the shelf at the grocery store, or hung out in the kitchen cupboard for a few months). In this case, there could be dramatically fewer viable bacteria by the time you consume them than when they were first encapsulated, and good bacteria are no good to you dead.
The above line of probiotics is also a favorite of Engelman. "I like Nerium International's new Prolistic Pre & Probiotic Plus Vitamins ($45) because it combines prebiotics, probiotics, and vitamins," Engelman explains. "It supports overall health while targeting digestive function. It contains two types of prebiotics and two strains of probiotics to help enhance levels of beneficial microflora and balance levels of healthy bacteria in the digestive system. Additionally, it contains B vitamins, vitamin C, and vitamin D, which work to enhance the body's immune system and support natural energy production."
For example, yogurt is made with two “starter” bacterial cultures — Streptococcus thermophilus and Lactobacillus bulgaricus — but these bacteria are often destroyed by your stomach acid and provide no beneficial effect, Dr. Cresci explains. Some companies, though, add extra bacteria into the product, so check the labeling and choose products with bacteria added to the starter cultures, she advises.
Since the bulk of your natural flora exists in your gut, it makes sense that this is the part of your body that feels it most when bacteria become imbalanced. Women, in particular, can experience all kinds of digestive problems, particularly during hormone fluctuations. These are just some of the digestive symptoms a high-quality probiotic can help reduce and even treat:

According to Bonnie Taub-Dix, MA, RD, CDN, founder of Better Than Dieting and author of Read It Before You Eat It, “We have more bacterial cells in our body than actual tissue, so you want as much “good” bacteria to be on your side. But not all probiotics are alike, and how your body reacts to them will not be the same as someone else who takes them.”
Oral health. An increasing number of probiotic lozenges and gums are promoted for oral health—to reduce periodontal disease, throat infections, and bad breath, for example. There’s preliminary evidence that certain strains may have some benefits, but commercial products may not have the same strains and formulations as those tested in published studies.
Taking a probiotic every day is a good way to help prevent getting sick and having to go on antibiotics in the first place. Preventative measures, of course, are preferred. Another that is believed to help is upping your vitamin D intake when your immune system needs a boost. Diet is also huge in terms of preventing sickness. Studies show that you can change your microbiome within hours of adjusting your diet. If you’re not into sauerkraut, even just cutting back on sugar and eating more whole foods can make a difference.
Most people with diverticulosis have few if any symptoms at all. When people do experience signs and symptoms of diverticulosis (diverticular disease) they may include abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Treatment methods for diverticulitis includes prescription medications, and in some cases, diverticulitis surgery.
To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
Another study by Elinav and his colleagues suggests that not everyone’s gut reacts the same way to probiotic pills. They studied samples of microbiomes from antibiotic users before and after they took supplements for four weeks. The good bacteria were found in the digestive tracts of some people. But in others, the bacteria were present only in stool samples, not in their digestive tracts, where they’re thought to be needed to improve health.
But what if investigators could design probiotics to treat specific individuals? Many researchers think personalized probiotics are the most promising path forward for patients with compromised gut microbiomes. Last year Jens Walter of the University of Alberta and his colleagues published a study that gives a glimpse of this potential future. The researchers decided to see what it would take to get the bacteria in a probiotic to successfully colonize the intestines of 23 volunteers. They chose a particular strain of Bifidobacterium longum that earlier studies had indicated could survive in the human intestine. In the study, the volunteers consumed either a drink containing 10 billion live B. longum bacteria or a placebo in the form of a glucose-based food additive (maltodextrin) each day for two weeks. Periodic fecal samples revealed higher than typical levels of B. longum in participants who did not consume the placebo.
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.

Known as the most clinically proven effective probiotic strain, Lactobacillus rhamnosus GG (otherwise known as “LGG”) has been clinically proven to maintain healthy numbers of bacteria and yeast for optimal digestive health. This powerful probiotic is also paired with some of the best probiotic strains for feminine health, making it an ideal choice for any woman that is looking for complete care from her probiotic.
Topping the probiotic market numbers at 100 Billion CFU divided between 34 probiotic strains, Garden of Life’s Ultimate Care probiotic was definitely a contender for our Best Probiotic of 2018. Free from preservatives and additives, RAW scored impressive marks across the board. Although this shortens the lifespan of the probiotics strains somewhat, buying in small quantities can easily solve this problem and – honestly – at CHR we always prefer purity to additives.
We have to give a nod to the most famous probiotic food: yogurt. Whether you love Greek or regular, low-fat or full-fat, look for the phrase "live active cultures" on the label. And although choosing a plain yogurt has less added sugar than the flavored kinds, Tallmadge gives you the okay to choose a fruit-infused flavor if that's the only way you'll eat it. Just be sure to aim for fewer than 15 grams of the sweet stuff per serving; sugar can feed the bad bugs in your gut.
In a food allergy, there is an immediate immune reaction to the offensive food. Classic allergic symptoms such as tingling lips, burning/tightness in the mouth/throat, gastrointestinal upset, difficulty breathing, rashes, hives, and even anaphylaxis may be present. Although any food can cause an allergic reaction, the most common offenders are peanuts, tree nuts, dairy, fish, shellfish, eggs, soy, and wheat.
In the new study, the researchers analyzed information from 15 healthy volunteers who took either a probiotic product containing 11 strains of bacteria, or a placebo, for four weeks. The participants also underwent colonoscopies and upper endoscopies before they took the probiotics or the placebo, and again after the four-week treatment period. (An upper endoscopy looks at the upper part of the digestive tract.) During these procedures, the researchers took samples from inside participants' guts.
In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric.
×