The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.


Also, it’s important to understand that probiotics are not a new idea. Throughout history, cultures have thrived on probiotics found in fermented foods and cultured foods, which were invented for food preservation long before the refrigerator. The process of fermentation has been lost in recent years, as it is no longer needed to preserve foods, meaning that we now lose out on those vital probiotics benefits.
Unless you have a perfect gut and are already eating lots of fermented foods—which is rare, although you can work up to this point—it’s difficult to get all the probiotics you need from diet alone. Most of us don’t have perfect guts—everything from antibiotics to high-carbohydrate diets to being born via a C-section can compromise the balance of bacteria in our microbiome. Supplementing with a probiotic can help to restore imbalances, and it’s also just a great preventative health measure, helping to keep your microbiome in balance and your immune system healthy to ward off illnesses.
D-Mannose can be naturally found in citric fruits like cranberries and has been found to be extremely beneficial in the prevention and relief of urinary tract infections. However, unless you are growing your own cranberries or spending hours in the kitchen measuring out portions, it can be extremely difficult (if not impossible!) to know how much D-Mannose you are ingesting by eating alone. That’s why HyperBiotics cut out the middle man and includes the D-Mannose compound directly in its probiotic blend.

Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT." Cell (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047
According to a 2014 meta-analysis, probiotics benefit diabetics by improving insulin sensitivity and decreasing the autoimmune response found in diabetes. The authors suggest that the results were significant enough to conduct large, randomized, controlled trials (the “gold standard” of scientific studies) to find if probiotics may actually be used to prevent or manage diabetes symptoms. Combining probiotics with prebiotics may also help manage blood sugar, particularly when blood sugar levels are already elevated. (87)
Renew Life Ultimate Flora offers 30 billion CFUs with 10 scientifically studied strains of Bifidobacterium and Lactobacillus, which according to current scientific research, are the two most prevalent good bacteria found in a healthy gut. In other words, you might choose these if you’re seeking a careful balance designed to re-establish proper immune health and digestive equilibrium.
Probiotics have also been researched for how they support the immune system. Studies suggest that probiotics can improve how the immune system functions such as by decreasing upper respiratory tract infections in adults and reducing the need for antibiotics. Studies in children show that a regular diet including probiotics reduces colds and flu-like symptoms and improves attendance in preschool and day care settings.
In addition to the prophylactic effect of stocking your gut with good bacteria, there are some probiotic strains that have also shown promise in treating symptoms of autoimmune disorders, including L. Paracasei and L. Acidophilus. Others, like B. Lactis, could help prevent respiratory infections. Renew Life Flora Extra Care has all three targeted bacteria strains at 30 billion CFUs per serving.
Some foods are made by adding bacteria — yogurt, pickles, cottage cheese, kombucha, and sauerkraut are good examples. Those foods work to provide the same probiotic benefits as supplements. However, most foods are so processed and pasteurized that it’s unlikely you’ll see the same benefits, let alone the right strains, as you would with a supplement. Regardless, it can’t hurt to get extra probiotics through your diet.
The probiotic industry is booming, but the benefits of probiotic products and the quantity of viable bacteria they contain can vary. So, instead of adding bacteria from an outside source, you might be better off consuming prebiotics, like fermentable fiber, which support your own beneficial bacteria, Dr. Cresci says. Good dietary sources of prebiotics include dried beans and other legumes, garlic, asparagus, onions, leeks, certain artichokes, green bananas and wheat. Prebiotic supplements are available, as well.
Kefir: This could be the most ideal probiotic dairy product because it contains both bacteria and yeast working together to provide the numerous health benefits. In a recent eight-week study, people with diabetes were given kefir milk containing Lactobacillus casei, Lactobacillus acidophilus, and bifidobacteria vs. conventional fermented milk. The hemoglobin A1C levels were significantly lower in the group consuming the kefir.
"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav said in a statement. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects." Segal added, "This opens the door to diagnostics that would take us from an empiric universal consumption of probiotics, which appears useless in many cases, to one that is tailored to the individual and can be prescribed to different individuals based on their baseline features."
Remember that dietary supplements are not tested by the U.S. Food and Drug Administration like medications. And the probiotic strains in the supplements may not be specific for the condition you're looking to treat. You may want to consult with a practitioner, like a registered dietitian, who is familiar with probiotics. Always tell your physician what you are doing that may affect your health.
Scientists are investigating probiotics, and their combined effects, by trying to classify the probiotic benefits of ingesting specific probiotic strains and understanding their role in the digestive tract. At present, the methodological and ethical limitations of human studies still make it difficult to fully understand the mechanisms of action of probiotics, but some explanations are available. Nevertheless, benefits linked to the consumption of probiotic strains have already been suggested (e.g. helping to support the immune system, help support digestive health), and others are still being investigated.

Best Probiotic chose iFlora Multi-Probiotic by Sedona Labs as one of the best probiotic supplements. It is a blend that works well in both the large and small intestines and it can survive stomach acid to maintain effectiveness. According to Sedona Labs’ website, iFlora delivers 32 billion active cells through 16 probiotic strains, plus probiotic fiber.
Bottom line: Probiotics are a promising field of research and may one day be used to treat or help prevent many disorders. But there’s not enough solid evidence to recommend their widespread use. Vague claims that probiotics "support good digestive health" are meaningless. Larger, longer and better studies are needed to test specific strains for specific conditions and to determine the proper doses and regimens.
However, a 2003 pilot study and 2011 randomized, controlled trial both reported that RA activities remained unchanged, but the subjects treated with probiotics reported statistically significantly higher levels of “subjective well-being.” One suggested reason for this was that the trials were too short to establish changes in the observable changes in the internal earmarks of RA.
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A 2014 review by Cochrane—an independent network of experts who serve as rigorous arbiters of medical research—found that probiotics may be particularly useful in a hospital's neonatal intensive care unit. The addition of beneficial bacteria to a nutritional regimen seems to significantly reduce the likelihood of developing necrotizing enterocolitis, which is a devastating, poorly understood and often fatal gut disease that primarily afflicts preterm infants—especially the smallest and most premature among them. Researchers think that many cases of the disease begin with an opportunistic bacterial infection in the not yet fully developed intestine of an infant. As the illness progresses, gut tissue becomes increasingly inflamed and often starts to die, which can, in turn, rupture the intestine and flood the abdominal cavity with pathogenic microbes that proliferate to dangerous levels. Researchers estimate that 12 percent of preterm infants weighing less than 3.3 pounds will develop necrotizing enterocolitis and that 30 percent of them will not survive. Standard treatment involves a combination of antibiotics, feeding via intravenous tubes, and surgery to remove diseased and dead tissue. Probiotics probably prevent the disorder by boosting the numbers of beneficial bacteria, which may deter the harmful ones.
The prebiotic comes before and helps the probiotic, and then the two can combine to have a synergistic effect, known as synbiotics. A prebiotic is actually a nondigestible carbohydrate that acts as food for the probiotics and bacteria in your gut. The definition of the effect of prebiotics is the selective stimulation of growth and/or activity(ies) of one or a limited number of microbial genus(era)/species in the gut microbiota that confer(s) health benefits to the host. The health benefits have been suggested to include acting as a remedy for gastrointestinal (GI) complications such as enteritis, constipation, and irritable bowel disease; prevention and treatment of various cancers; decreasing allergic inflammation; treatment of nonalcoholic fatty liver disease (NAFLD), and fighting immune deficiency diseases. There has also been research showing that the dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase calcium absorption as well as bone calcium accretion and bone mineral density. The benefits for obesity and type 2 diabetes are growing as recent data, both from experimental models and from human studies, have shown particular food products with prebiotics have influences on energy homeostasis, satiety regulation, and body weight gain.

Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.
"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," co-senior author Eran Segal, a computational biologist at the Weizmann Institute, said in the statement. "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."
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT." Cell (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047
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