Can probiotics constipate you
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Can Probiotics Cause Constipation?
Introduction to Probiotics and Constipation
Probiotics are live microorganisms that, when administered in adequate amounts, confer health benefits to the host. They are commonly used to improve gut health and alleviate gastrointestinal issues, including constipation. However, there is a question of whether probiotics can sometimes cause constipation instead of relieving it.
Probiotics and Gut Transit Time
Several studies have investigated the impact of probiotics on gut transit time, stool frequency, and stool consistency. A systematic review and meta-analysis of randomized controlled trials (RCTs) found that probiotics significantly reduced whole gut transit time by approximately 12.4 hours and increased stool frequency by 1.3 bowel movements per week1. Another meta-analysis confirmed these findings, showing a reduction in gut transit time by 13.75 hours and an increase in stool frequency by 0.98 bowel movements per week4. These results suggest that probiotics generally improve gut motility rather than causing constipation.
Probiotics in Specific Populations
Parkinson's Disease
In patients with Parkinson's disease (PD), constipation is a common issue. A study involving PD patients found that multi-strain probiotics significantly increased the average number of spontaneous bowel movements per week and improved stool consistency2 6. Another trial with PD patients showed that a multi-strain probiotic (Hexbio®) improved bowel opening frequency and reduced gut transit time7. These findings indicate that probiotics can be effective in alleviating constipation in PD patients.
Irritable Bowel Syndrome with Constipation (IBS-C)
For patients with constipation-predominant irritable bowel syndrome (IBS-C), probiotics have also shown beneficial effects. A systematic review and meta-analysis reported that probiotics increased stool frequency by 1.29 bowel movements per week and improved stool consistency5. This further supports the notion that probiotics are more likely to relieve constipation rather than cause it.
Mechanisms and Strain-Specific Effects
The effectiveness of probiotics can vary depending on the strain used. For example, Bifidobacterium lactis has been shown to significantly improve stool frequency and consistency, whereas Lactobacillus casei Shirota did not show significant effects in some studies1 3. This indicates that the choice of probiotic strain is crucial for achieving the desired outcomes.
Safety and Adverse Effects
Most studies report that probiotics are generally safe and do not cause serious adverse events. In the trials reviewed, no significant adverse effects were associated with probiotic use, and any reported side effects were mild and reversible1 2 4 5. This suggests that probiotics are unlikely to cause constipation and are safe for most individuals.
Conclusion
The current body of research indicates that probiotics are more likely to alleviate constipation rather than cause it. They have been shown to reduce gut transit time, increase stool frequency, and improve stool consistency in various populations, including those with Parkinson's disease and IBS-C. While the effectiveness can vary depending on the probiotic strain, the overall evidence supports the use of probiotics as a safe and beneficial intervention for constipation.
Sources and full results
Most relevant research papers on this topic
The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials.
Probiotics may improve gut transit time, stool frequency, and stool consistency in adults with functional constipation, but more rigorous research is needed to determine the most effective strains, doses, and duration of use.
Meta-Analysis
Very Rigorous Journal
Highly CitedProbiotics for constipation in Parkinson's disease: A randomized placebo-controlled study.
Multi-strain probiotics effectively increased the average number of spontaneous bowel movements per week in Parkinson's disease patients, improving stool consistency and quality of life.
RCT
Rigorous JournalHighly CitedProbiotics, prebiotics, and synbiotics in chronic constipation: Outstanding aspects to be considered for the current evidence
Prebiotics and probiotics can improve stool consistency and reduce colonic transit time, but more high-quality randomized control trials are needed to confirm their effectiveness in managing intestinal constipation.
Systematic ReviewMeta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults.
Probiotics, particularly multispecies probiotics, can significantly reduce gut transit time, increase stool frequency, and improve stool consistency in adults with functional constipation.
Meta-AnalysisVery Rigorous JournalHighly CitedThe efficacy and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: a systematic review and meta-analysis based on seventeen randomized controlled trials.
Probiotics may be safe and may improve gut transit time, stool frequency, and consistency in patients with constipation-predominant irritable bowel syndrome.
Meta-AnalysisProbiotics for Constipation in Parkinson Disease
Multistrain probiotics effectively increased the average number of spontaneous bowel movements per week in Parkinson's disease patients, improving stool consistency and quality of life.
RCTRigorous JournalMulti-strain probiotics (Hexbio) containing MCP BCMC strains improved constipation and gut motility in Parkinson’s disease: A randomised controlled trial
A multi-strain probiotic (Hexbio) containing MCP BCMC strains significantly improved bowel opening frequency and gut transit time in Parkinson's disease patients with constipation over 8 weeks.
RCTRigorous JournalHighly CitedEffect of multispecies probiotic on gut microbiota composition in individuals with intestinal constipation: A double-blind, placebo-controlled randomized trial.
Multispecies probiotics in capsule form may modulate gut microbiota by reducing bacteria commonly increased in individuals with constipation, contributing to the balance and well-being of the individual.
RCTEffects of dietary fibers or probiotics on functional constipation symptoms and roles of gut microbiota: a double-blinded randomized placebo trial
Dietary fibers and probiotics may relieve functional constipation symptoms, with specific gut microbiota changes influencing relief, and baseline gut microbiota may predict responsiveness.
RCTSystematic review: probiotics for functional constipation in children
Probiotics are ineffective in treating functional constipation in children, with limited evidence supporting their use for treatment success, frequency of fecal incontinence, and abdominal pain.
Systematic ReviewVery Rigorous JournalHighly Cited