Do probiotics make you poop?

Probiotics are known for their ability to help support a healthy gut microbiome, regulate digestion, improve stool patterns, and decrease gas and bloating. But if you’ve ever taken probiotic supplements, you’re likely aware of the potentially uncomfortable, to put it delicately, side effects of starting a new probiotic.

With so many strains and varieties available for purchase, it’s hard to know which probiotics are right for you—and what’s normal to experience in the bathroom as your body adjusts to the new, beneficial gut bacteria.

Do probiotics make you poop more?

When you start taking probiotics, you may experience increased frequency and volume of bowel movements as your digestive system gets used to the changes to the gut microbiome that are occurring due to the introduction of new healthy bacteria, says Maureen Anderson, MD, medical director, integrative health at Corewell Health. This typically occurs within the first few days and can last up to a few weeks.

Probiotics, along with a healthy diet and regular activity, may help alleviate digestive problems such as diarrhea, bloating, and sometimes constipation. These issues can be caused by poor gut health from your diet, medications, infections, or medical conditions. At a high level, probiotics are live microorganisms that work by introducing good bacteria to your intestinal tract, which is associated with a host of health benefits.

However, it’s worth noting that everyone may have a slightly different experience with bowel movements, even when taking the same probiotic strains. That’s for good reason, says Rishi Naik, MD, MSCI, gastroenterologist and assistant professor of medicine at Vanderbilt University Medical Center. What’s considered “normal” bowel movements and the definition of constipation and diarrhea differs from patient to patient, so the definition of alleviating those concerns varies as well.

Who should take probiotics for digestion?

You should consider probiotics if you have digestive issues such as constipation, diarrhea, irregular bowel patterns, bloating, or gas—and if you’re prescribed antibiotics. The potential benefits of probiotics to digestive health include improving stool consistency, frequency, and gut transit time, says Caroline Passerrello, MS, RDN, LDN, a registered dietitian nutritionist at the University of Pittsburgh School of Health and Rehabilitation Sciences. In fact, when it comes to digestive issues, randomized controlled trials indicated earlier improvement in modulating bowel function than placebo.

While probiotics are generally well tolerated by most people, those who have digestive disorders, or are hospitalized, immunosuppressed, or on immunotherapy should consult with their healthcare provider before considering a probiotic regimen, says Lori Walsh, MD, medical director at the Center for Health and Integrative Medicine at Advocate Good Shepherd Hospital in Illinois.

If you don’t see gradual improvement in gastrointestinal tract symptoms (diarrhea, bloat, etc.) after six to 12 weeks, it is recommended to discontinue use or try a different strain of probiotic. You could also consider eating probiotic-rich foods, such as kefir, kimchi, sauerkraut, and kombucha.

RELATED: Who should not take probiotics? 

Choosing the right probiotics for your bowel health

There is no single probiotic that is more effective than others. Due to the differences in each individual’s gut microbiome, selecting the best probiotic for you may require a bit of trial and error. An integrative health or functional medical professional can help evaluate your symptoms and make personalized recommendations, suggests Dr. Anderson.

Pick the right type

Because everyone has a different gut microbiome, the probiotic that helps your symptoms may take some trial and error. For example, Limosilactobacillus reuteri is possibly effective at treating constipation, according to a 2014 trial. However, the exact mechanism as to how probiotics work for chronic constipation is unclear—and it seemed to have no effect on stool consistency.

“We need better studies in the field on which probiotics to use, what dosage, how long, and which patients are likely to benefit most from,” says Prashant Singh, MD, a gastroenterologist at the University of Michigan Health.

Combine probiotics

Evidence indicates that combining multiple probiotic strains might be more effective at treating conditions and their symptoms than a single probiotic. While it’s promising that there are many combinations of probiotics that could help you find relief, it also means that you may have to try a few different strains to determine what will work best for you.

The best way to know whether probiotic products are working is to take a “wait and see” approach, says Andrew Shreiner, MD, Ph.D., a gastroenterologist at Corewell Health. Take it for a few weeks, and see if your symptoms improve.

Select a high-quality supplement

Passerrello recommends following a few steps to ensure you are using quality supplements:

• Because dietary supplements are not regulated by the U.S. Food and Drug Administration (FDA), you should purchase supplements that have been third-party verified, such as by NSF, to contain the ingredients listed on the label.
• Find a probiotic that contains at least 1 billion colony-forming units (CFUs) at the end of the product’s shelf life, not at the time of manufacturing.
• Pay attention to the storage directions, as many probiotics require refrigeration to keep the CFUs alive as long as possible.
• Consult fact sheets and charts from reputable sources to help you understand which strains may be of the most benefit to you.

Take probiotics with prebiotics

Finally, one of the things that can boost the effects of probiotics is prebiotics, which act as a food source for probiotics. Good sources of prebiotics include beans, legumes, rice, oats, garlic, onions, apples, peaches, raspberries, carrots, and potatoes. To avoid excess bloating, it’s recommended to add these sources to the diet slowly and pay attention to symptoms as your digestive tract adjusts to the beneficial bacteria.