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. 

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.

This is one of the newer areas of probiotic research. Described as the “gut-brain axis,” researchers believe that the communication between the gut and the brain affects not just physical but also mental health and behavior. For example, a recent study found that probiotics can reduce anxiety, relieve stress and improve mental outlook. Another study found that the probiotics L. helveticus and Bifidobacterium longum reduced depression, anger, hostility and self-blame and improved problem-solving ability. Another study showed a difference in brain activity between women consuming yogurt and those consuming a placebo. More research needs to be done to confirm the effect of probiotics on mental and emotional health.

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.


Probiotics are bacteria that help keep the natural balance of organisms (microflora) in the intestines. The normal human digestive tract contains about 400 types of probiotic bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system. The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus, found in yogurt with live cultures, is the best known. Yeast is also a probiotic substance. Probiotics are also available as natural health products.
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.
Probiotics are live bacteria that are present in yogurt, other fermented foods, and in pills. They are promoted as a benefit to the human digestive system. Normally you have trillions upon trillions of bacteria within the colon. Normally we ingest bacteria every time we swallow. Many of these swallowed bacteria may be beneficial while most are simply innocuous and cause no problems. The question for everyone who takes a probiotic much beyond yogurt is whether they really are a health benefit. Here is what we know medically about probiotics.

The large intestine is home to hundreds of trillions of bacteria. Fortunately, most are neutral or even beneficial, performing many vital body functions. For example, they help keep “bad” bacteria at bay, play a role in immunity, help us digest food and absorb nutrients and may even have anticancer effects. But will consuming them as probiotics in foods or capsules make a notable difference to your health—especially if you are already healthy? Here’s a look at the evidence.
Probiotics are found in everything from chocolate and pickles to hand lotion and baby formula, and millions of people buy probiotic supplements to boost digestive health. But new research suggests they might not be as effective as we think. Through a series of experiments looking inside the human gut, researchers show that many people's digestive tracts prevent standard probiotics from successfully colonizing them. Furthermore, taking probiotics to counterbalance antibiotics could delay the return of normal gut bacteria and gut gene expression to their naïve state. The research publishes as two back-to-back papers on September 6 in the journal Cell.
Overall, Align Probiotic is one of the better “daily” probiotics out there.  It’s easy to take, comes in convenient packaging and doesn’t require refrigeration.  And it has some research showing it helps with gas, bloating and constipation, especially in women with IBS.  Lots of things to like about this probiotic!  Read the full review here… or click here to go buy it now!
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.
Remember, while bacteria gets a bad rap, not all bacteria is bad: As New York City-based certified dietitian-nutritionist Gina Keatley tells Allure, plenty of microorganisms, including probiotics, actually help your body function. "Probiotics may help stabilize the protective barrier in our gut so bad microorganisms don't take root, stimulate the immune response, and aid in production of vitamins, such as vitamin K," she says. Sonya Angelone, a registered dietitian and Academy of Nutrition and Dietetics spokeswoman, adds that while we have more to learn about the role of probiotics, beneficial bacteria is understood to help crowd out harmful bacteria in our bodies. This good bacteria may also help lower cholesterol, aid in reducing colds and acute respiratory infections, and reduce the occurrence of vaginal yeast infections, she says.
It has been suggested that probiotics be used to treat problems in the stomach and intestines. But only certain types of bacteria or yeast (called strains) have been shown to work in the digestive tract. It still needs to be proved which probiotics (alone or in combination) work to treat diseases. At this point, even the strains of probiotics that have been proved to work for a specific disease are not widely available.

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.
Eating more foods that are naturally rich in probiotics, like yogurt, kimchi and kefir, can help restore balance in your gut and create more “good” bacteria to fight off inflammation from “bad” bacteria. But what about food products that have probiotics infused into them? Indeed, manufacturers are banking on a new crop of gut-friendly products. From chocolates and granola bars to juices and tonics, nut butters, bottled water and even air sprays, you can’t escape the probiotic movement.

Lebwohl says IBS isn’t just about intestinal distress. For many IBS sufferers, it’s about the way our brain receives messages about pain. He describes the human colon as “almost reptilian” in the way that it contracts and relaxes throughout the day, but says these contractions are usually happening way below our threshold of consciousness, so we don’t even notice. In people with IBS, the neurotransmitters in our gut (yes, we have them in there too) may be sending severe distress signals to the brain about benign contractions happening in digestive tract.
Lacto-bacillus plantarum: If you’ve ever heard of the beneficial effects of fermented foods (pickles, sauerkraut, kimchi, etc.), then you’ve heard of this powerful probiotic, which may help improve the symptoms of IBS, gluten intolerance, soy allergies, and Crohn’s disease. This is also one of the most antibiotic-resistant probiotics, which is especially important if you have taken antibiotics recently.
If you are seeking non-dairy yogurt options, there are several that contain live probiotic cultures. Yogurts made from rice, soy and coconut milk are available on the market and also contain added probiotics that can provide the same benefits. Other alternative sources of probiotics include eating fermented foods like Brewer’s yeast, miso, sauerkraut, or micro algae. Whatever the source, always look for “live and active cultures” on the label.

Probiotic bacteria actually compete against unfriendly flora for bacterial binding sites on the inside lining of your intestines, further protecting you from these harmful pathogens. One way to repopulate your gut with probiotics to restore harmony and get all their many benefits is with the right foods, which can support the growth and proliferation of good bacteria that crowd out the bad ones.
These statistics are staggering, yet poor gut health actually affects much greater numbers than these statistics illustrate because your digestive health affects every physiological system in your body. How is this such a complex system? Well, for one, the human microbiome contains 360 times more protein-coding genes than human genes themselves contain.

“Highly recommend –There are quite a few probiotics manufactured specifically for women. Some are decent while others are not so good. For me, I require one on a daily basis to maintain my feminine health. When I try a new probiotic that is made specifically for women, it makes me a bit nervous because I will end up with yeast or bladder infection if it is not effective. With AZO, I am happy to report it is a great probiotic and highly recommend it to all women! It works great.” – Vicki

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.


Then, study participants were divided into one group that consumed a standard probiotic strain available in commercial supplements and a control group that was given a placebo. After two months of treatment, the researchers found that some people were so-called “resisters” who expelled the gut microbiomes in probiotics; others were identified as “persisters” who successfully colonized the generic probiotic strains in their GI tracts.
"When certain types of probiotics are placed in contact with skin cells, they calm the parts of the cells that may want to react to the presence of bad bacteria that they see as a threat. These healthy signals produced by the probiotics stop the skin cells from sending 'attack' messages to the immune system that result in flares of acne or rosacea."
Inside your body bacterial and other microbial cells live in close contact with your own cells, and in healthy conditions the thing that separates them from you is a layer of mucus. Between that layer of mucus and the inside of you is a layer of skin-like cells one-cell thick. One thing you have to understand about your gastrointestinal (GI) tract is that although it resides within you, it is really connected to the outside world, from your lips to your anus, and the things that protect you from the outside world are the mucus; the skin-like layer of cells with immune, nervous, and endocrine cells below it; and the beneficial microbes. At least 70 percent of your immune system is in your GI tract! This is why taking probiotics benefits the immune system greatly.
Make sure dosages are listed in CFU, colony forming units. (Most brands list CFU in billions now: so 30 billion CFU, 100 billion CFU, and so on.) For one, this means that the bacteria strains are living, which is essential. When you’re looking at the cost of products, be sure to look at the cost per unit. I spoke to a woman the other day who had bought probiotics that had 2 billion CFU per capsule. In comparison, to get the 30 billion CFU I recommend, she’d have to take essentially half of her bottle to get the same dosage as one of our capsules.
Many Lactobacillus and Bifidobacterium species are naturals at protecting and improving gut health. Additionally, research in animals and humans has shown that probiotics decrease scores on depression assessments, thereby alleviating depression. As a matter of fact, there is a new term, psychobiotics, for these microbes that influence mental health conditions like depression.
When I polled friends and family about their personal experiences with probiotics, I got a real mixed bag of responses. Some called them a lifesaver and others felt no effects whatsoever. I put the anecdotes aside and talked to Ben Lebwohl, gastroenterologist and director of clinical research at Columbia University’s Celiac Disease Center, to get the straight poop on whether probiotics are miracle or myth.
Unfortunately, many commercial brands don’t measure up. They are unstable in stomach acid. Quality control measures aren’t intact, including ensuring supplements have been handled correctly and maintain their freshness. Moisture slipping into probiotic supplements can reduce their efficacy. Companies that use bioshield capsules produce higher quality probiotic supplements that are able to endure the stomach acid, releasing their contents within the small intestine, where a more alkaline environment ensures the survival of the bacteria.
Notably, after someone was tagged a “persister” or “resister” clear patterns emerged on how probiotics would impact his or her indigenous microbiome and gut bacteria profile. "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," Eran Segal said in a 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. These results highlight the role of the gut microbiome in driving very specific clinical differences between people." 

Yet that’s how probiotics are often offered. They can be distributed in the United States as food, supplements or drugs. The regulations for each are very different. Most people looking for probiotics don’t see the distinctions. Ideally, the ways in which we use and consume probiotics would conform to the data and evidence that back them up. That rarely happens.
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.
Even if you’re not sensitive to dairy, though, probiotics that require refrigeration can be inconvenient; but there are now some that don’t need to be kept cold. For example, our probiotics are sealed in nitrogen blister packs to protect them from heat, as well as moisture and oxygen because the air can’t get in. Look for probiotics that are individually packed to protect the live cultures. If they just come in a bottle they could be losing potency from air getting in.
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.
If you decide to use a probiotic supplement and get clearance from your doctor for doing so, be sure to read the label carefully. You want to be sure that the supplement contains live strains of the bacteria or yeast, and that the life of these strains is guaranteed at the time of use, and not at the time of manufacture. Other points of comparison are the number of bacteria strains and the number of colony-forming units, although this does not necessarily guarantee results.
Update: I think this product is being smeared by a competitor! Look at all the reviews in April. Suddenly, a butt ton of not just negative but 1 star reviews. It's uncanny. So, what would compel a competitor to do such a thing? Well, it was the only 50 CFU, enteric coated & 20 strain probiotic on Amazon & it cost about 15 bucks. That, while products far inferior to it were priced for - often times - 2 or 3x as much.
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