Do Probiotics Really Work for Digestive Issues?

by Amy Hendel, P.A. Health Writer

Americans love to eat. Unfortunately, the highly processed foods we often choose don't support the healthy balance of our gut microbes. Having an “upset stomach” is a common complaint and it can often result from specific food choices.

Twenty percent of Americans with digestive complaints take some form of probiotics. You can find probiotics in a wide variety of foods, including chocolates, dairy products, nutrition bars and of course, yogurts and fermented foods. In fact, eating (unsweetened) yogurt daily is considered an excellent health habit. Yogurts can contain between 90 billion and 500 billion colony-forming units or CFUs, which are considered key to the health value of probiotics. But does a probiotic habit really translate into better gut health?

We also demand antibiotics when we’re sick, even when they may not be helpful. A course of antibiotics can influence gut microbiota, killing off both bad and good bacteria. Probiotics can help to restore balance and some people believe that probiotics can even prevent infections. Taking probiotics on a regular or intermittent basis has become a mainstream way of dealing with stomach complaints and an imbalance of gut microbes.

Taking probiotics with a course of antibiotics

It’s a good idea, say many experts. Given the fact that antibiotics do kill all kinds of microbes, they can upset the delicate balance of gut bacteria, and cause unpleasant diarrhea. Probiotics can help to prevent the diarrhea associated with a two-week course of antibiotics. Many doctors now suggest taking probiotics if you will be on an antibiotic for more than several days, and especially if you are on more than one antibiotic.

Irritable bowel syndrome and probiotics

Irritable bowel syndrome or IBS is a disorder characterized by abdominal pain, cramping, and changes in bowel habits. There are several possible triggers of IBS. It can certainly occur after an intestinal infection (post-infectious IBS). Probiotics can often help individuals suffering with IBS though it may not be a solution for everyone.

Constipation and probiotics

It’s estimated that about 25 percent of the world’s population suffer with constipation and bowel issues. Results from a recent study involving 1200 subjects between the ages of 18-70 years old with complaints of mild constipation and stomach discomfort suggest that probiotics can help these ailments. The Chr Hansen randomized, double blind, placebo-controlled study gave the participants a probiotic-rich supplement, BB-12, containing either 1 billion or 10 billion CFU, or a placebo, over a 4 week period. Those who received a supplement (either one) had improvements in frequency of bowel movements and improvements in their complaint of gut discomfort, compared to the placebo group. There was clearly an “upper limit of efficacy” with the supplements, since both formulas had a similar response.

Infants and probiotics

A just released study suggests that a special probiotic formula reverse’s cow’s milk allergies by changing the gut bacteria of infants. This can be a new game changer in helping infants with a milk allergy to reap the benefits of fortified cow’s milk.

Other conditions and probiotics

Based on current research, probiotics do not appear to have significant impact on allergies, eczema, Crohn’s disease, asthma, celiac disease, upper respiratory infections or urinary tract infections. People with a compromised immune system or a very serious illness should consult with their doctor before considering the use of probiotics.

Foods rich in active cultures or supplements – is one better?

It’s a no-brainer that you should first source these healthy organisms from foods, on a daily basis. Yogurts and fermented foods are a good place to start. You do need to examine just how many billions of colonies probiotic-fortified foods offer with special attention paid to portion size, calories, sugar and fat. Some chocolates and trail mix options have one billion colonies, and are quite caloric, with significant amounts of added sugars and fat. That level of probiotic is considered low, compared to an unsweetened yogurt option which can have several hundred billion CFU’s. Read food labels carefully to assess the probiotic content.

Some tips if you decide to try probiotic supplements

Look for names like L. acidophilus, L. casei, L. rhamnosus and S. boulardii (combinations are good) in supplements. Speak to an authority at the pharmacy or natural food market so you buy verified supplements (USP label), and know how many billions of CFU’s are appropriate for your health complaint. A supplement with about 10 billion CFU’s is recommended for diarrhea. If you are buying a yogurt product, look for unsweetened, lower fat versions that have a logo from the National Yogurt Association which verifies the amount and type of live and active cultures. Check expiration dates on foods and supplements. Read labels so you refrigerate probiotic supplements if indicated.

Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at Her personal mantra? “Fix it first with food, fitness, and lifestyle.”