Why do probiotics make my stomach hurt
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Why Do Probiotics Make My Stomach Hurt?
Introduction to Probiotics and Gastrointestinal Discomfort
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 treat various gastrointestinal (GI) conditions. However, some individuals experience stomach discomfort, such as pain, bloating, and gas, when taking probiotics. This article explores the potential reasons behind this phenomenon.
Gastrointestinal Events in Healthy Adults
A study assessing the impact of probiotics on healthy adults found that even before the intervention, participants reported various GI events, including stomach pains, indigestion, and bloating1. This suggests that some level of GI discomfort is common in the general population, which might be exacerbated by the introduction of probiotics.
Functional Abdominal Pain and Probiotics
Research on children with functional abdominal pain disorders (FAPD) indicates that while probiotics can be effective in reducing pain severity and frequency, the evidence is inconsistent and of low certainty2. This inconsistency might contribute to the varying responses individuals have to probiotics, including the experience of stomach pain.
Small Intestinal Bacterial Overgrowth (SIBO) and Probiotics
Probiotics have been studied for their role in treating small intestinal bacterial overgrowth (SIBO). While they can effectively decontaminate SIBO and reduce hydrogen concentration, they do not significantly prevent SIBO3. The alteration in gut microbiota due to probiotics might lead to temporary discomfort as the body adjusts to the new bacterial environment.
Irritable Bowel Syndrome (IBS) and Probiotics
Probiotics are often used to manage irritable bowel syndrome (IBS). Studies show that probiotics can significantly relieve IBS symptoms, including abdominal pain4 8. However, the response to probiotics can vary based on the specific strains used and individual differences in gut microbiota, potentially leading to discomfort in some users.
Mechanisms of Action and Gut Motility
The mechanisms through which probiotics affect gut motility and constipation are complex and not fully understood. Probiotics may influence immune and nervous system function, bile acid metabolism, and mucus secretion, all of which are vital to normal gut motility9. An imbalance in these components might cause symptoms like bloating and stomach pain as the gut adjusts to the probiotics.
Conclusion
While probiotics offer numerous benefits for gut health, they can also cause stomach discomfort in some individuals. This discomfort may result from the body's adjustment to changes in gut microbiota, the specific strains of probiotics used, and individual differences in gut health. Further research is needed to better understand these effects and to optimize probiotic formulations for individual needs. If you experience persistent stomach pain while taking probiotics, it is advisable to consult a healthcare professional.
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Most relevant research papers on this topic
The gastrointestinal status of healthy adults: a post hoc assessment of the impact of three distinct probiotics.
Probiotic supplementation can reduce gastrointestinal discomfort in healthy adults, with potential anti-constipation effects.
RCTProbiotics for management of functional abdominal pain disorders in children.
Probiotics may achieve more treatment success than placebo in children with functional abdominal pain disorders, but their effectiveness for complete pain resolution remains unclear due to high inconsistency and risk of bias.
Meta-AnalysisProbiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence
Probiotics effectively decontaminate small intestinal bacterial overgrowth, decrease H2 concentration, and relieve abdominal pain, but are ineffective in preventing SIBO.
Meta-Analysis
Highly CitedEfficacy of probiotics, prebiotics and synbiotics in irritable bowel syndrome: a systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials.
Probiotics have a therapeutic role in irritable bowel syndrome, with the minimal effective dose being 109 c.f.u./day and therapeutic effect occurring at 4 weeks.
Meta-AnalysisProbiotics mitigate Helicobacter pylori‐induced gastric inflammation and premalignant lesions in INS‐GAS mice with the modulation of gastrointestinal microbiota
Probiotics can reduce H. pylori-induced gastric inflammation and premalignant lesions in mice, potentially playing a role in cancer prevention.
Non-RCT
Animal StudyProbiotics and gastrointestinal conditions: An overview of evidence from the Cochrane Collaboration.
Probiotics may help treat gastrointestinal conditions by modifying gut microbiota composition and activity, but more research is needed to fill research gaps.
Systematic ReviewHighly CitedEffectiveness of Probiotics in Children With Functional Abdominal Pain Disorders and Functional Constipation: A Systematic Review
Probiotics show insufficient evidence for treating functional abdominal pain disorders and functional constipation in children, with only Lactobacillus rhamnosus GG showing potential in reducing abdominal pain in children with irritable bowel syndrome.
Systematic ReviewThe efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review
Probiotics show potential in improving irritable bowel syndrome symptoms, but the magnitude of benefit and the most effective species and strain remain uncertain.
Systematic ReviewHighly CitedMechanisms of Action of Probiotics and the Gastrointestinal Microbiota on Gut Motility and Constipation.
Probiotics may improve gut motility and constipation by affecting gut secretion and function, but further human studies are needed to determine specific strains' effectiveness.
Literature Review
Very Rigorous JournalHighly CitedProbiotics in Autoimmune and Inflammatory Disorders
Probiotics may improve gastrointestinal symptoms and multiorgan inflammation in autoimmune disorders like rheumatoid arthritis, ulcerative colitis, and multiple sclerosis.
Very Rigorous JournalHighly Cited