Probiotics for Diarrhea: Types, Benefits, Side Effects

Diarrhea is characterized by the frequent passing of loose, watery stools, commonly associated with infection, food poisoning, gastrointestinal conditions, food allergies or intolerances, side effects of medication, or travel. Probiotics are live microorganisms often used to help with diarrhea through the restoration of gut microbiota.

This article will consider different strains of probiotics, review their mechanisms and benefits, and consider the latest data and scientific news regarding their use in the treatment of diarrhea.

What are probiotics for diarrhea?

Probiotics are live microorganisms, or even yeast, with beneficial properties, more commonly referred to as ‘good bacteria.’ Probiotics can be found in several food sources, such as yogurt, cottage cheese, and various fermented foods, but they can also be introduced into the body using supplements.

Typically used to improve digestion and restore normal flora, probiotics have numerous alternative uses. There is some evidence for its benefits in allergy sensitivity and eczema, boosting the immune system, and even aiding in the management of some mental health conditions. Probiotics are also used as an adjuvant in high blood pressure, high cholesterol, cancer, and gastrointestinal diseases.

Throughout this article, we will focus on their application in the treatment and prevention of diarrhea.

How do they work?

Probiotics have some antibacterial effects against pathogenic (harmful) bacteria within the gut while also maintaining the balance of intestinal flora. The bacteria, or sometimes yeast, found in probiotic supplements is thought to reach the bowel, where they suppress the germs that are causing the diarrhea and help the body fight them. More specific mechanisms include the restoration of gut microflora (typically disrupted during diarrhea), enhancing the body's immune response, strengthening the gut barrier, and inhibiting the growth of harmful bacteria or pathogens.

Types of probiotics for diarrhea

An effective way to differentiate between probiotics is to determine the specific strain of bacteria or yeast. There are a range of different probiotics available to you, and each one has a slightly different mechanism of action. The choice of probiotic should be based on the particular cause or circumstances of the diarrhea being treated.

Lactobacillus spp.

Lactobacillus species of probiotic make up some of the most commonly supplemented strains, including Lactobacillus rhamnosus, Lactobacillus bulgaricus, and Lactobacillus casei.

Lactobacillus rhamnosus and Lactobacillus bulgaricus can increase the amount of beneficial bacteria within the intestines, inhibiting the growth of harmful bacteria and helping restore the imbalance of intestinal flora.

One systematic review and meta-analysis identified a clear reduction in the frequency of episodes of diarrhea with Lactobacillus acidophilus supplementation. This review was conducted in children, and further studies are needed to truly understand the effects of doses and different species of Lactobacillus.

Bifidobacterium spp.

Often found in fermented dairy products, such as yogurts, cheeses, acidified milk, and kefir, this strain helps to maintain a healthy gut flora, reducing the risk of diarrhea.

Specific probiotics in this group include Bifidobacterium lactis, Bifidobacterium longum, and Bifidobacterium bifidum.

One literature review concluded that Bifidobacterium infantis was one of the most beneficial probiotics in irritable bowel syndrome, helping to relieve symptoms like diarrhea and improving stool frequency.

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Saccharomyces boulardii

Saccharomyces boulardii has anti-inflammatory properties and works by inhibiting pathogenic bacteria and toxins.

This strain of probiotics is characteristically unique, being a non-bacterial strain of yeast.

According to one meta-analysis, Saccharomyces boulardii may be the most effective probiotic for treating acute diarrhea in children.

Streptococcus thermophilus

Animal studies have shown that Streptococcus thermophilus can help reduce the duration and severity of diarrhea, particularly effective in reducing the incidence of antibiotic-associated diarrhea by maintaining a balanced gut microbiome.

Another animal study suggested that Streptococcus thermophilus produces lactase, an enzyme that breaks down lactose, making dairy products more digestible and reducing associated symptoms, such as diarrhea. Again, further research is needed to establish the benefits in humans.

Enterococcus faecium

Enterococcus faecium is well utilized in the treatment and prevention of diarrhea in some countries. It competes with pathogenic bacteria while also enhancing the immune response.

Analysis of four randomized, placebo-controlled, double-blind trials found that in the treatment of acute diarrhea with Enterococcus faecium, the time to resolution of symptoms was significantly reduced and that Enterococcus faecium is effective for antibiotic-associated diarrhea.

Numerous strains of probiotics may have a beneficial effect on diarrhea, each with a unique mechanism of action. For best results, discuss the appropriate type of probiotic to utilize based on the circumstances and history of your particular case of diarrhea with your healthcare provider.

Reviewing the benefits of probiotics for diarrhea

The benefits of using probiotics for diarrhea are multi-faceted, helping alleviate the symptoms while providing additional important health benefits throughout the gut and beyond.

Potential benefits of probiotics for diarrhea include:

• Reduced the severity and duration of symptoms
• Improved digestion
• Improved immune function
• Restored balance of gut flora
• Reduced pathogenic bacteria
• Reduced inflammation
• Supported gut barrier integrity
• Relief from certain types of diarrhea
• Alleviated symptoms of food allergy or intolerance

Side effects of probiotics for diarrhea

Probiotics are generally considered effective, well-tolerated, safe, and low-cost. Across scientific literature, side effects are often considered to be mild and can include constipation, gas, or abdominal discomfort.

One meta-analysis found a low risk of adverse events through ingestion of probiotics.

However, there is a chance that the bacteria or yeast in probiotics may sometimes lead to opportunistic infection in people who have a weak immune system due to chronic illness, use of immunosuppressant drugs, or premature infants.

It is always advised to discuss the implementation of any new supplement regimen with your healthcare provider. Any persistent and severe episodes of diarrhea should be assessed by a medical professional.

The effectiveness of probiotics for diarrhea: do they work?

There is a wide body of research available that provides considerable and promising evidence for the use of probiotics in the management of diarrhea. Studies indicate that the use of probiotics is particularly effective in conjunction with infectious diarrhea, antibiotic-associated diarrhea, and travelers' diarrhea, helping to reduce both duration and severity.

It is important to note that diarrhea is a symptom, and steps should always be taken to assess and treat the underlying cause of diarrhea. Probiotics should not replace any medication that is prescribed by your doctor.

Alternatives of probiotics for diarrhea

There are several alternatives to probiotics that can be used in the management of diarrhea.

Dehydration is a common complication of diarrhea and is one of the most important things to address during treatment. Oral rehydration sachets provide a simple but effective rehydration treatment, replacing essential electrolytes lost during episodes of diarrhea.

Herbal teas may be used to soothe the digestive system. Camomile tea is particularly promising, containing compounds that have anti-inflammatory and anti-diarrheal effects.

Activated charcoal is an additional substance that has been used in the treatment of diarrhea due to its ability to adsorb toxins from the digestive tract. However, evidence for its use is often inconsistent and may not apply to all causes of diarrhea, so it is highly advised to discuss its use with a healthcare provider.

How to choose the best probiotics for diarrhea?

There are several factors that should be considered when choosing a probiotic.

1. Bacteria strains. a good probiotic supplement should contain various gut-friendly bacteria, however, there are some strains that may be more beneficial for diarrhea, according to research. Brands may offer different types of probiotic formulations, making it very important to double check if the bacteria in the supplement may actually be beneficial in diarrhea management.
2. CFU count. colony forming units (CFUs) refer to the amount of viable bacteria in the supplement. When choosing between products it is better to pick the one with the higher CFU.
3. Other ingredients. Some probiotics may include beneficial or unnecessary filler or flavor ingredients that you should look out for. This is especially important for people with allergies.
4. Brand reputation. Third-party testing for label accuracy, ingredients analysis, and good customer feedback about the products and the brand are some factors that can help you choose between similar products offered by different brands.
5. Dosage and price. Products vary in price and serving sizes, so you should consider your budget and personal preferences when choosing a product.

Healthnews editor’s top picks

We have researched and reviewed the best probiotics for diarrhea in a dedicated article. Here is a summarized list of our top picks.

Ritual — overall best probiotics against diarrhea

• Combined prebiotics, probiotics, and postbiotics
• Lactobacillus rhamnosus and Bifidobacterium animalis strains
• 11 billion CFUs
• Vegan

Try Ritual now

We liked that Ritual provides a 3-in-1 product for supporting your gut microbiome. The combination of pre-, pro-, and postbiotics may be more beneficial than probiotics alone. We also appreciated the third-party testing for label accuracy and ensuring that the product is non-GMO and allergen-free. We also loved how affordable the product was, however we wish it included more bacteria strains or had more CFUs.

YourBiology — best probiotic for chronic diarrhea

• Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium breve, Lactobacillus paracasei, Lactobacillus fermentum, Saccharomyces boulardii, Lactobacillus casei, Bifidobacterium longum and Lactobacillus plantarum strains
• 20 billion CFU
• Vegan
• Added Vitamin D3
• Added digestive enzymes
• Added prebiotic fiber

Try YourBiology now

We appreciated the wide range of bacterial strains and the inclusion of prebiotics, which may help feed the gut-friendly bacteria. We also appreciated the addition of vitamin D3 and digestive enzymes, which may offer additional digestion-improving benefits. However, the product is quite pricey and may not be for everyone’s budget.

Routine — best probiotics against GI discomfort for women

• Bifidobacterium and Lactobacillus strains
• May be beneficial for people with Irritable Bowel Syndrome
• Includes ashwagandha, which may have adaptogenic properties
• 24 billion CFUs
• Vegan

Try Routine now

We liked that Routine probiotics included strains that may be more beneficial for addressing IBS symptoms, according to research. We also appreciated the inclusion of ashwagandha, a medicinal herb with stress-relieving properties as it may indirectly reduce the number of episodes of stress-induced diarrhea. Unfortunately, there is no information about third-party testing to ensure label accuracy.

Oweli — best probiotic for traveler’s diarrhea

• Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, and Lactobacillus plantarum strains
• Contains prebiotic fibers from marine polysaccharide complexes
• 40 billion CFUs
• MAKtrek® Bipass Technology enables the live-cultured strains to survive stomach acid
• One of the cheapest options on the market

Try Oweli now

We loved Oweli's affordable, high-quality probiotic option. We also appreciated the inclusion of fiber, which helps feed the gut-healthy bacteria. Although the product is one of the cheapest on the list, it also means it is often sold out or unavailable.

Seed — best subscription-based probiotic for gut balance

• Lactobacillus and Bifidobacterium strains
• Seller states it may also support skin health
• Contains prebiotics
• 53.6 billion AFUs, which shows the count of viable bacteria, but is measured using a different method than CFU
• Third-party testes
• ViaCap Delivery Technology safeguards the live bacteria through digestion
• Vegan

Try Seed now

We liked Seed DS-01 Daily Synbiotic for its full-body approach to boosting gut health and barrier health as well as strains that may potentially promote skin health. We also appreciate third-party testing for label accuracy. Although the product is affordable and one of the cheaper options on the list, it is only available on a subscription basis, which may not be favored by everyone.

Diving into the latest research on probiotics for diarrhea

One Cochrane review of 63 randomized controlled trials, published in the Cochrane Database of Systematic Reviews, found evidence based on a total of 8,014 participants that probiotics significantly shortened the duration of acute infectious diarrhea by around 25 hours in children and infants.

The Cochrane Inflammatory Bowel Disease Group evaluated the prevention of antibiotic-associated diarrhea with probiotic use in children, finding that for every nine children, probiotics will prevent one case of diarrhea.

One systematic review and meta-analysis point toward a protective effect of the use of probiotics as adjunct therapy to prevent antibiotic-associated diarrhea in all ages.

There is some solid evidence of the efficacy of probiotics as an active treatment of gastroenteritis in addition to rehydration, though not all guidelines follow the same recommendation.

Diarrhea has many different causes; whether or not a particular probiotic will help with your diarrhea depends on your individual cause and history. Discussion with your healthcare provider can assist you in identifying the most appropriate probiotic strain and dosage.

Article history

Our experts strive to provide up to date information and update articles when new information becomes available

June 20, 2024

Co-written by Urtė Gumuliauskaitė, MSc

June 18, 2024

Fact checked by Alifia Fernandes Jokubauskienė, MPharm

June 18, 2024

Written by Bethany Cooper, BSc, MSc, RN, PhD Candidate