can probiotics make diarrhea worse

Can Probiotics Make Diarrhea Worse? (see why)

Researchers have performed studies that suggest that probiotics can shorten the recovery duration of infectious diarrhea by about half a day or two days.

This hints that probiotics are involved in the regulation of bowel movements. So, here is an overview of its implications in diarrhea.

Key Points:

  • Probiotics with a large variety of strains and high CFU may over-populate the gut and increase the risk of diarrhea.
  • Probiotics strengthen the immune system, which helps to overcome infectious diarrhea (e.g., traveler’s diarrhea and community and hospital-acquired diarrhea).
  • Probiotics correct gut dysbiosis and support gut health to prevent loose stools.

It cannot be denied that probiotics may cause temporary diarrhea, but neither can it be said with certainty that they will worsen the existing problem. 

Nonetheless, research has proven that the probiotic Saccharomyces boulardii and many from the Lactobacillus, Bifidobacterium, and Bacillus species are the panaceas to most types of diarrheas.

So, keep reading if you want to know more about these probiotic strains and their relationship with an upset stomach.


Is It Ok To Take Probiotics When You Have Diarrhea?

Yes, you can take probiotics with diarrhea. In fact, they can help treat and prevent diseases that cause watery stools.

First of all, you should know that diarrhea is mostly caused by an overgrowth of pathogenic organisms in the intestines.

Hence, when you consume the good bacteria while having an existing infection, they will suppress the proliferation of the bad bacteria by competing with them for space in the gut. 

In this regard, multiple studies have been performed to check the impact of probiotics on different types and causes of diarrhea like acute gastroenteritis, antibiotic-associated diarrhea (AAD), necrotizing enterocolitis, traveler’s diarrhea, IBS-D, functional diarrhea (FD), hospital and community-acquired diarrhea.

Therefore, I have assembled this section to help you differentiate between probiotics that demonstrate therapeutic effectiveness against diarrheal conditions and strains that lack any benefits for them.  

So, head down without further ado.

Probiotics For Gastroenteritis

Gastroenteritis is a condition characterized by inflammation and irritation of the stomach and intestines. Its most common symptoms include diarrhea, nausea, and vomiting.

According to a review by Guarino et al., Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii are strongly recommended for speeding up the clearance of acute gastroenteritis by one day and support rehydration whereas L. reuteri was weakly recommended. 

Probiotics Strains For Community-Acquired Diarrhea

Doctors may suspect you of having community-acquired diarrhea if you have more than three unformed bowel movements in a day.

Regarding this, there is strong evidence that the L. rhamnosus GG (LGG) and Bifidobacterium lactis species, alone or in combination with Saccharomyces boulardii and L. reuteri and L. acidophilus, prevent community-acquired diarrhea.

Probiotic For Hospital Acquired Diarrhea

Hospital-acquired diarrhea can only develop within three days of hospitalization, and you can suspect it if you have a loose stool frequency of more than three times a day.

Concerning this, I found an early study that reported that the B. breve strain Yakult effectively prevents hospital-acquired diarrhea in immunocompromised children on chemotherapy.

Probiotics For Necrotizing Enterocolitis

Necrotizing enterocolitis is an infection or inflammation of the intestines characterized by diarrhea, green vomit, and other symptoms. However, It mostly affects premature babies.

For this condition, Guarino et al. referenced 12 papers published until 2016 that indicated that Lactobacilli, S. boulardii, and Bifidobacteria strains have a prophylactic effect on necrotizing enterocolitis.

Additionally, these probiotics decreased its severity which reduced mortality in preterm babies.

Probiotics For Antibiotic-Associated Diarrhea (AAD)

Taking antibiotics can offset the natural microbiome diversity, which can upset the gut and cause loose stools. This condition is referred to as antibiotic-associated diarrhea.

Correspondingly, in a recent 2021 meta-analysis, reviewers analyzed forty-two studies and concluded that the co-administration of probiotics with antibiotics reduces the risk of diarrhea by 37%.

The authors picked out the following probiotics as effective candidates for preventing AAD:

L. acidophilus, L. bulgaricus, L. casei, L. paracasei, L. rhamnosus GG, S. boulardii, Bifidobacterium animalis ssp Lactis, B. longum, B. licheniformis, Bacillus subtilis and Bacillus clausii. 

However, the strains that were not found to exhibit a significant benefit in the studies were:

L. helveticus, L. plantarum, L. reuteri, B. bifidum, S. thermophilus, and C. butyricum.

Probiotics For Chronic Diarrhea

You may have chronic diarrhea if you have had three or more watery stools daily for longer than four weeks. Such a type of diarrhea can be caused by some underlying syndromes, diseases, or chronic gut infections such as irritable bowel syndrome (IBS) or celiac disease.

In a 2021 study, researchers recruited ninety-nine individuals who were suffering from chronic diarrhea because of Irritable bowel syndrome with diarrhea (IBS-D) or functional diarrhea (FD). 

The participants of the intervention group were administered L. plantarum CCFM1143 (3.52 × 109 colony forming units (CFU) per day) for 30 days.

As a result, they underwent a reduction in their frequency of defecation, and their gut dysbiosis was alleviated.

Plus, their immune system became stronger, and they reported improvement in their quality of life and mental state.

Probiotics For Traveler’s Diarrhea

Traveler’s diarrhea is a travel-related illness that may develop within ten days of arriving at a high-risk destination.

For this ailment, a meta-analysis of 12 RCTs published in 2019 identified S. boulardii CNCM I-745 as the only probiotic strain that can significantly reduce its incidence in adults. 

In comparison, the L. rhamnosus GG may only be slightly usable for prevention, but L. acidophilus had no prophylactic effect at all.

Additionally, the reviewers reported a trend that only 3.9% to 55.3% of the probiotic-fed participants developed traveler’s diarrhea compared to 7.6%–70.7% of participants in the placebo groups.

So, Is Probiotics Bad For Diarrhea?

No, Probiotics are good for preventing and treating diarrhea. 

Considering this, in the last part of this article, I have included three of my top probiotic supplements that can help relieve your diarrheal concerns.

How Long Does Diarrhea Last When Starting Probiotics?

Depending on the individual’s gut microbiome, it may last a few days or weeks.

Speaking about probiotic-associated diarrhea, you may get it if there is overcrowding of bacteria in the gut while it is accommodating the supplemental strains.

Consequently, these bacteria may rush to digest the food you eat, which may release gases that can cause flatulence, bloating, and diarrhea.

Another reason is that certain good bacteria, such as the L. paracasei strain Shirota, can promote bowel movements that flush out toxins and bad bacteria, which may manifest in loose stools.

Coming to the point, if you do experience diarrhea, then it is most likely to resolve within one to two weeks because this is the average time in which the gut adapts to its new friends.

Still, diarrhea can be bothersome, so in the next subheading, I have discussed some remedies you can try to relieve it.

probiotics illustration

What To Do If Probiotics Cause Diarrhea?

Here are some measures that you can take to prevent the aggravation of diarrhea and speed up recovery.

1. Focus On Keeping Yourself Hydrated

The first thing you should do when you develop diarrhea for any reason is to increase your water intake.

This is because continuous loose stools may cause extreme water loss, which may compromise the efficiency of the body’s functions and cause cramping and abdominal pain.

Therefore, aside from consuming the recommended eight glasses daily, drink an additional cup of water 30 minutes after every loose bowel movement to compensate for the water loss.

Moreover, instead of plain water, it is better to opt for fluids like juices or salty broths.

Or, you can add some salt and sugar or an oral rehydration solution (ORS) in the water because glucose and sodium promote fluid re-absorption. 

2. Shift To BRAT Or Bland Diet For A Few Days

Doctors recommend eating BRAT or a Bland diet in diarrhea because they are low in fiber and spices; hence, they help to solidify the stool and are gentle on the stomach.

This strategy may also be beneficial in relieving diarrhea caused due to the pre-biotic fiber in probiotic foods or supplements because certain individuals are not used to it.

The BRAT diet stands for bananas, applesauce, rice, and toast. These foods are considered binding foods and are easy to digest.

On the other hand, some examples of a bland diet include cooked oatmeal, chicken broth, and boiled or baked potatoes.

But remember that although these two diets are easy on the stomach but are low on essential nutrients, so only pursue them for three days without consulting a doctor.

3. Try These Traditional Remedies

You can take the traditional route and try rice water and herbal teas to aid your digestive system in healing from the upset stomach caused by the probiotics.

For instance, rice water helps in rehydration and helps in firming the stools.

All you need to do is boil one cup of rice in two cups of water for 10 minutes or until it becomes cloudy and drink it.

Similarly, enjoying a cup of lemongrass tea may also help to soothe your stomach because studies show that it possesses anti-microbial, anti-inflammatory, antioxidant, and anti-diarrheal properties.

Probiotics For Diarrhea In Adults

Here are some probiotic supplements containing the scientifically acclaimed strains I have mentioned before for normalizing bowel movements and treating diarrhea.

  1. Culturelle Digestive Daily Probiotic Capsules – It contains Lactobacillus rhamnosus GG.
  2. Optibac Saccharomyces Boulardii – It contains Sacchromyces boulardii.
  3. Probulin Total Care Probiotics – It contains three Lactobacillus species (L. rhamnosus, L. acidophilus, L. reuteri), one strain of Saccharomyces boulardii, and two Bifidobacterium species (B. lactis, B. longum)


Can a strong probiotic cause diarrhea?

Yes, a strong probiotic may overpopulate the gut with bacteria and cause diarrhea at the start. These microbes now compete for space and food, due to which the gut undergoes loose bowel movements to eliminate the dead bacteria and their toxins.

Can women’s probiotics cause diarrhea?

Yes, women’s probiotics that have Lactobacillus or Bifidobacterium species that are identical to the gut commensals may cause mild diarrhea.

Should you take a probiotic if you have severe diarrhea?

Yes, probiotics are generally believed to relieve diarrhea. Still, there are multiple etiologies of severe diarrhea, and only a certain probiotic strain is better suited to treat it than the other. 

For instance, S. boulardii effectively reduces the severity of necrotizing enterocolitis, whereas L. plantarum CCFM1143 helps relieve chronic diarrhea due to IBS- D or functional diarrhea (FD).

Can probiotics cause severe diarrhea?

No, it is highly unlikely that probiotics will cause severe diarrhea. The reason is that the gut usually adjusts to the supplemental strains within a few days or a maximum of two weeks. In comparison, severe diarrhea is characterized by loose stools that remain persistent even after two weeks. 

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