Are Probiotics for Constipation a Good Idea?

You may have seen commercials about probiotics for constipation. Usually, however, other constipation treatments, including drugs like laxatives, are almost always mentioned in mainstream sources to provide relief for constipation. Probiotics usually are not considered the first constipation treatments option. Why is that?

It’s important to understand that although some probiotics are sold as drugs just like laxatives, probiotics are naturally-occurring phenomena and there's not as much money to be made in telling you to eat sauerkraut! As dietary supplements or as natural parts of food and drink products, probiotics are not meant to treat or cure disease. Only drugs can do that, according to the FDA.

But since this site is about being healthy with probiotics, I want you to know that the use of probiotics for constipation is just one of their many health benefits.

In general, probiotics work best as preventative agents, not as quick "cures". But keep reading because you may find quick relief with probiotics for constipation!

If you haven't read the pages on deciding if you have constipation or what causes constipation, you may want to start with those pages.

What Does Research Show About Probiotics for Constipation?

As of January 2010, the use of probiotics for constipation was considered to be investigational, meaning that it showed promise, but the required large-scale clinical trials to define which ones and in what amounts had not been completed yet. However, new research is occurring which may change that status.

One recent (October, 2012), provisionally-published pilot study (meaning not the gold standard of a large-scale, placebo-controlled, double-blind study) with 20 pregnant women using a product called Ecologic Relief containing 4 billion CFU of a mixture of probiotics showed that the product was effective as a constipation treatment.

It increased stool frequency, decreased the sensation of incomplete evacuation, decreased the sensation of an obstruction in with bowel, and decreased straining, abdominal pain and the presence of reflux. EcologicRelief contains B. bifidum W23, B. lactis W52, B. longum W108, L. casei W79, L. plantarum W62 and L. rhamnosus W71 and is made by the Dutch company Winclove.

Other studies about probiotics for constipation and their outcomes are listed below:

B. infantis helped to reduce abdominal pain/discomfort, bloating/distention, bowel movement difficulty, incomplete evacuation of the bowels, straining and the passage of gas in adults

E. coli Nissle 1917, 25 billion CFU/day for 4 weeks’ duration in 70 constipated adults increased number of stools per week and decreased hard stools

L. casei Shirota, 6.5 billion CFU/day for 4 weeks duration in 70 constipated adults:
decrease in the degree of constipation and hard stools, increase in the frequency of bowel movements

B. lactis DN-173010 in BIOS product, 12.5 billion CFU/day in a 3.5 ounce (100 g container) for 2 weeks’ duration in 135 women with constipation:
increase in stool frequency, decrease in elimination difficulty, improvement in stool consistency

L. rhamnosus GG, 2 billion CFU/day for 12 weeks’ duration in constipated children:
no significant improvement

L. rhamnosus Lcr35, 800 million CFU/day for 4 weeks’ duration in 27 children (a small number of study subjects, so the results were said to be scientifically meaningless):
increase in stool frequency, reduction in abdominal pain frequency, decrease in the number of hard stools.

VSL3, a combination probiotics product, showed promise in an open-label study for constipation-predominant IBS and slow-transit constipation at a dose of 450 billion CFU twice per day for 12 weeks.

L. reuteri DSM 17938 was studied in a proof-of-concept, double-blind, placebo-controlled, randomized trial published in December 2014. "Proof-of-concept" means that they only wanted to see if the concept of using the probiotics in adults with constipation was valid. The study did not use statistical analysis to calculate how many participants would be necessary. At a dose of 100 million CFU, 30 minutes twice per day after eating for 4 weeks, it was found to significantly increase the frequency of bowel movements per week in 20 adults compared to 20 adults taking placebo.

L reuteri DSM 17938 was also studied in children in a double-blind, randomized, placebo-controlled study in 2008. Results showed that the 22 infants who were at least 6 months old had an increase in stool frequency at weeks 2, 4 and 8 compared to 22 infants receiving placebo. Stool consistency and inconsolable crying episodes were not affected. This study has some critics who state that there was some unclear information in the studies.

So What Are the Best Probiotics for Constipation?

One thing that's important to notice about the research on probiotics is that there wasn't just one particular probiotic species that was able to provide relief for constipation. There were many. This illustrates the concept that it takes a village of microbes to be healthy, and that what works for one person may not work for another because we are all unique individuals.

However, here's a train of thought to consider. Since Bifidobacterium live predominantly in the colon, and since constipation is predominantly a problem that occurs in the colon, Bifidobacterium species like B. bifidum, B. longum, B. animalis , B. infantis  and B. lactis (which is part of B. animalis) are a good place to start for probiotics for constipation.

Pair up the bifidos with raw foods with fiber, with cultured/probiotic foods and drinks (especially some homemade sauerkraut) and some Lactobacillus and you probably have a winning combination for many occurrences of constipation. Of course if you have any medical condition, be sure to talk this over with your doctor.

Always read ingredient labels before purchasing, but some low-dosage Bifidobacterium and/or Lactobacillus probiotic combination supplements (so you can slowly start changing the flora in your colon) that you may wish to consider as probiotics for constipation are:

Probifia Pearls (links to my review of them)

Align (links to my review of it)

Renew Life Ultimate Flora RTS Senior Care (links to my review of it)

trunature Digestive Probiotic (links to my review of it)

Colon Health by Phillips: has two Bifidobacterium and one Lactobacillus species for a total of 1.5 billion CFU

Acidophilus Pearls by Enzymatic Therapy: has one Bifidobacterium and one Lactobacillus species for a total of 1 billion CFU

Pearls IC by Enzymatic Therapy: has four Bifidobacterium and 2 Lactobacillus for a total of 1 billion CFU.

Advanced 40+ Acidophilus by Solgar: has one Bifidobacterium, two Lactobacilllus and S. thermophilus for a total of 1.2 billion CFU  

Ultimate Flora Constipation 2-Part Kit has probiotics and a magnesium relaxant

If you prefer to be more aggressive and have a kit to address your constipation problem, Ultimate Flora Constipation Relief 2-Part Kit contains two products: a probiotic supplement with 30 billion CFU of 4 Bifidobacterium strains per capsule, and a combination prebiotic fiber-mineral laxative supplement.

This product is labeled gluten free and dairy free. Follow label directions.

Remember that straining on the toilet is not healthy for your bowels. If you can't eliminate in a few minutes, get off the toilet, drink some water, do some stretches or massage, and try again later.

The Squatty Potty can help with proper positioning on the toilet to make elimination easier and potentially avoid hemorroids. It helps prevent restriction in your colon from regular sitting on the toilet.

The Squatty Potty reduces the strain of going to the bathroom

The Squatty Potty comes in 2 heights: 7" and 9", depending on how tall you are. The Squatty Potty website says, "Order the 7" if you are new to squatting. If you are advanced, limber, or have a tall comfort height toilet, get the 9". One reviewer said that if you are over 5'5" tall, get the 7".

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