Here’s a quick timeline of the latest probiotic research that is setting off alarm bells for scientists around the globe: On June 19, a study was published linking probiotic use to brain fogginess and extreme belly bloating in some people. Another study, published on August 31, reported that consuming probiotics after taking antibiotics was linked to more severe intestinal infections in mice exposed to Cryptosporidium.  (For more see, "In a Brain Fog? Probiotics Could Be the Culprit" and "Unexpected Findings Cause Scientists to Rethink Probiotics.") 
Although these capsules are more expensive than other options on the market, if you suffer from ulcerative colitis, irritable bowel syndrome, or pouchitis, this probiotic will help manage your symptoms. VSL contains eight different probiotic strains (and more good bacteria than other brands) to alleviate symptoms such as bloating, cramping, and diarrhea. There are 60 capsules per bottle.
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.
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)

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.
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.
As the best-selling author of Happy Gut and a medical doctor who specializes in gut health and once suffered from IBS (irritable bowel syndrome), I have experienced for myself, as well as see on a daily basis, how a disrupted gut flora opens the door for unfriendly microbes to step in and take over, creating all sorts of pandemonium that causes patients to gain weight, feel sick and tired, and become more disease-prone.

Previous studies have been contradictory, with some yielding more positive results about the benefits of probiotics, but most of them looked at probiotics in stool samples, not directly in the gut itself. In the new research, the scientists used more invasive methods to take samples of gut bacteria directly from different areas of the digestive system.


What are the gut microbiota and human microbiome? Microbes are commonly associated with disease, but there are millions inside the human body, and some provide distinct benefits. The microbiota and microbiome of the human body have been researched intensively in recent years. Find out about what we now know about them and what they mean for health. Read now
The best probiotic manufacturers will list their potency (in CFUs) at the time of expiration, ensuring you get the dosage you’re paying for. Dr. David Perlmutter, board-certified neurologist, American College of Nutrition Fellow, and author of The New York Times bestsellers "Brain Maker" and "Grain Brain" puts it this way: “Avoid products that indicate a specific number of bacteria ‘at the time of manufacture,’ and instead look for products that, like other supplements, have a shelf life.” Each of our top picks clearly shows a specific “best by” or “expires on” date on its bottle.
A popular dish in Japan consisting of fermented soybeans, natto contains the extremely powerful probiotic bacillus subtilis, which has been proven to bolster your immune system, support cardiovascular health and enhance digestion of vitamin K2. Natto can also contain vitamin B12, which is usually lacking in vegan diets. It’s also one of the highest plant-based proteins.
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.
But sometimes you need a little help from outside sources in order to secure those benefits, which is why a lot of experts recommend getting an extra hit of probiotics through food. Fermented options — think keffir, sauerkraut, and kimchi — are a great place to start, says the International Scientific Association of Probiotics and Prebiotics, as are these other surprising foods with probiotics.
Until recently, testing of probiotics by ConsumerLab.com found that some products had far lower amounts of live organisms than claimed on the labels. But in 2018, it found that 17 out of 18 products tested contained the amounts listed; none exceeded limits for heavy metal contaminants. In contrast, in 2016, a study in Pediatric Research found that only one out of 16 Bifidobacterium longum supplements tested contained the species named on the label.

Large bodies of evidence suggest that probiotics are effective against several forms of diarrhea, including antibiotic-associated diarrhea, acute diarrhea, traveler’s diarrhea, infectious diarrhea and other associated diarrhea symptoms. They also help with constipation relief. Probiotics have also been found in meta-analyses to reduce the pain and severity of irritable bowel syndrome (IBS) symptoms, aid in the eradication of H. pylori and treat pouchitis, a condition that occurs after the surgical removal of the large intestine and rectum.


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.
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