Can probiotics make you poop or cause diarrhea?

Yes, it is possible to have diarrhea when you first start to take probiotics. Probiotics alter the microbiome, so when they are first introduced, some people may experience temporary symptoms such as gas, bloating, diarrhea, and abdominal cramps. These symptoms will dissipate after a few days. There have been a few cases where diarrhea resulting from probiotic use may be a sign of more severe complications. Issues like sepsis and fungus in the blood may occur in people who are already severely ill or have compromised immune systems. For those with healthy immune systems, symptoms will be temporary. If diarrhea persists past a few days, it may be a good idea to stop the probiotic supplement.

Is yogurt a good probiotic?

Fermented foods such as yogurt, pickles, and kombucha use probiotics in the process of manufacturing. While many of these probiotics will survive from manufacturing to ingestion, many may not make it to the intestines alive. Probiotics are more likely to survive until they reach the intestines when a combination of probiotics and prebiotics—a food source for probiotics—are included in yogurt products. While food may contain probiotics, it will not contain as many probiotics as supplements. For those with antibiotic-associated diarrhea and pouchitis, yogurt won’t provide adequate probiotics. For all other healthy individuals, it will not harm you to have yogurt made with probiotics, but it may not help either.

How long does it take for a probiotic to work?

How long it takes for a probiotic to work depends on the strain, the potency, and what you are taking them for. For antibiotic-associated diarrhea, it’s recommended that you take probiotics within the first 48 hours of your first dose of antibiotics. If you are taking the recommended single strain of Saccharomyces boulardii found in Renew Life Ultimate Flora Probiotic for Adults , you should not experience diarrhea at all; that’s your sign that they are working! For pouchitis, we don’t know when probiotics start to work. However, the appropriate probiotics can not only prevent pouchitis but can also lead to quick healing of acute pouchitis compared to those who do not use probiotic supplementation.

Can you take too many probiotics?

Our gut microbiome has 109 microorganisms , so it would be quite difficult to ingest enough probiotic supplements to overpower these. However, it is possible that taking too many can trigger uncomfortable symptoms such as gas, bloating, abdominal cramping, and diarrhea. There are some people who would be harmed by taking even the recommended dose, namely those with compromised immune systems and those that are severely ill. Supplementing may lead to sepsis, bacterial or fungal blood infection, and in rare cases, anaphylaxis.

When else might probiotics be helpful?

Research on the safety and efficacy of probiotic supplementation is on-going. To date, there are many knowledge gaps due to few studies proving that probiotics are impactful on our health. Research is growing with respect to using a specific combination of probiotics in preterm, low-birth-weight infants born before 37 weeks gestation for the prevention of necrotizing enterocolitis. Even with the research, probiotics are not appropriate for all preterm, low-birth-weight infants.

The 5 Best Probiotic Supplements of 2022

Probiotics are live microorganisms or microbes (small, living things) that may provide health benefits. They may help regulate the community of microorganisms living in our lower digestive tract, known as our microbiome. However, the research on the benefits of probiotics is still emerging, and there are only certain health conditions where probiotic supplements have proven benefits.

Our microbiome functions best when it has a variety of microorganisms living in harmony. However, when the variety or balance of microbes changes, it can be more difficult for these microbes to do their jobs. Probiotic supplements may help with these functions, although more research is needed to verify which probiotics are useful and in which instances.

Healthy people do not need to take probiotic supplements to have a well-populated, diverse microbiome. However, “there is evidence that a few specific commercially available probiotics can help with certain gastrointestinal conditions,” says Suzie Finkel, MS, RDN, CDN. The two GI conditions with the clearest research to support probiotic supplementation are antibiotic-associated diarrhea and pouchitis.

Reviewed & Approved

Best Overall for Antibiotic-Associated Diarrhea: Renew Life Ultimate Flora Probiotic for Adults is our top choice because the probiotic strain may reduce the occurrence and duration of antibiotic-associated diarrhea. We like that it doesn’t need refrigeration, so it can easily travel with you.
Best Overall for Pouchitis: VSL3#-DS is a versatile option that helps those with pouchitis and also contains eight different probiotic strains, which may be beneficial for healthy individuals who want to take a probiotic. We like that it’s unflavored and has no inactive ingredients that might trigger gut discomfort.

Always speak with a healthcare professional before adding a supplement to your routine to ensure that the supplement is appropriate for your individual needs and which dosage to take.

Are Probiotic Supplements Beneficial?

Much of the information you will find on probiotics is biased, as it is put out by probiotic supplement manufacturers who want you to buy their products. To provide healthcare providers with objective information for their patients, the American Gastroenterological Association (AGA) published a set of guidelines to help clarify the role of probiotics in the management of gastrointestinal disorders. These guidelines form the basis of our recommendations in this article.

"Probiotics" is a general term for many different microorganism species, including different types of bacteria and yeasts. Different strains have different effects in the body, so we can't make blanket statements about probiotics being helpful or not. It depends on the strain or strains and the health status of the person taking them. It should be noted that there is still a great deal of research to be done on the microbiome and the role of probiotic supplementation. This information may change as new strains are discovered, and new combinations of strains are found to impact our health.

Should Healthy People take probiotics?

You may have heard that all people should take a probiotic supplement. However, “research suggests that generally healthy people do not attain a benefit from probiotic supplements. A few specific supplements are clinically recommended for a few specific medical conditions, but you can otherwise obtain the most benefits from nourishing the microbes already in your gut,” says Finkel.

She uses the analogy of a garden. Imagine you have a beautiful garden with a wide variety of plants that are not getting enough water and sunlight. Rather than uprooting and replacing every plant in your garden, why not take better care of the garden you have? Finkel recommends "nourishing the garden" of your microbiome by eating fiber-rich foods that will feed your microbiome, including fruits, vegetables, whole grains, beans, legumes, nuts, and seeds.

Conditions that Benefit from Probiotic Supplementation

Based on current research, the following gastrointestinal diagnoses benefit from probiotic supplements:

Antibiotic-associated diarrhea

Antibiotics can sometimes create an imbalance, or dysbiosis, of microbes within the microbiome and trigger frequent loose stools, aka diarrhea. The goal of probiotic supplementation is to re-establish balance within the microbiome. To create this balance, research has shown that the use of Saccharomyces boulardii, a yeast-based probiotic, taken within 48 hours of the first dose of antibiotics can reduce the risk of antibiotic-induced diarrhea.

The AGA recommends that if a person is concerned with the cost of probiotics, and is not at risk for Clostridium difficile, a bacterial infection in the gut that impacts those who are immunocompromised, then they can go without supplementation as antibiotic-induced diarrhea is a temporary condition.

Pouchitis

Some people with Inflammatory Bowel Diseases (IBD) such as Crohn’s and Ulcerative Colitis may eventually need to have their entire colon and rectum removed. This is done via a procedure called Ileoanal anastomosis or J-pouch surgery. Once the J-pouch is in place, there is a risk of an infection known as Pouchitis.

To help prevent pouchitis, the AGA recommends the use of a specific 8-strain probiotic supplement over all others. In an analysis of seven studies, this 8-strain combination was seen to prevent pouchitis in 90% of study participants. Although this is an impressive number, the number of people included in the studies was low, and therefore, this information cannot be applied to everyone with IBD. As with many of their recommendations, and because research is still evolving, the AGA notes that if there is a financial burden, then a probiotic is not necessary.

Who May Not Benefit From Probiotic Supplements

There is a lot we don’t know about how probiotic supplementation affects those with gastrointestinal disorders. For many conditions, it is unclear if probiotics might be harmful or exacerbate symptoms. Based on current research, probiotic supplementation may not be beneficial as a treatment for Irritable Bowel Syndrome in all ages or for acute gastroenteritis in children.

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder impacting 20% of children and adults in North America with symptoms that include abdominal pain or discomfort, changes in bowel habits, and changes in stool appearance and form. Although the cause of IBS is still unknown, the gut microbiome plays a role in the physiological symptoms. Current research shows that probiotic supplementation likely does not provide significant relief for those with IBS.

As time goes on, more research will be done to determine the connection between the microbiome and IBS in hopes of finding a cure and/or relief from symptoms, and that may include the use of probiotics.

Acute gastroenteritis in children

Acute gastroenteritis (also known as a stomach virus, stomach flu, or stomach bug) is a common short-term illness. Although there are many studies testing probiotic use for acute gastroenteritis in children, the results are conflicting. One group of researchers from China recommends using the probiotic strains Lactobacillus acidophilus and Lactobacillus rhamnosus either in combination or alone in otherwise healthy children to help with symptoms.

However, the AGA states that because many of the studies look at children in Asia and Europe, the data can’t be generalized to North America because of the difference in pathogens that cause gastroenteritis. Whether or not probiotic use is effective may depend on what caused the infection. The bottom line: Using Lactobacillus acidophilus and Lactobacillus rhamnosus either in combination or alone in otherwise healthy children will not harm them, but it may not help.

Can Probiotic Supplements Be Harmful?

Though many companies and influencers encourage everyone to use probiotics, they are, in fact, not beneficial for everyone, and different strains have different effects on different people.

More research is needed, but preliminary research has shown that probiotics may be harmful to people with certain underlying conditions or diagnoses, such as those with critical illness, AIDS, organ transplantation, necrotizing enterocolitis, cancer, and allergies. In such cases, probiotic supplementation may lead to life-threatening illnesses, including pneumonia, endocarditis (an infection of the inner lining of the heart), and sepsis.

In This Article

Are Probiotic Supplements Beneficial?
Who Will Not Benefit
Can Probiotic Supplements Be Harmful?
Our Picks
How We Select Supplements
What to Look For
FAQ

Renew Life

Pros

No inactive ingredients
Vegetarian and allergy-friendly
Smaller, more affordable pack

Cons

Not third-party tested

Renew Life Ultimate Flora Probiotic contains 6 billion colony forming units (CFU) of Saccharomyces boulardii, which is proven to rebalance the gut microbiome after antibiotic-associated diarrhea. The capsule is coated to ensure that the microbes make their way safely to your intestines, and you only need to take one capsule a day to get in the appropriate dosage.

The size of the capsule is shown on the side of the packaging, so you can see that it’s not a big pill to swallow. The typical recommendation for probiotic use with antibiotics is 10-14 days; this package contains 20 pills, which is enough for two 10-day courses. To top it off, this is also a more affordable option compared to some other brands.

In many cases, Saccharomyces boulardii needs to be refrigerated, but the Renew Life Ultimate Flora Probiotic is shelf-stable, meaning that you don’t need to keep it chilled, making it easy to take with you when you travel. Those with food allergies need not worry about using Renew Life Ultimate Flora Probiotic because it is free of gluten, dairy, and soy. The capsule itself is also made from vegetarian ingredients.

Price at time of publication: $14 for 20 count ($0.70 per serving)

VSL#3

Pros

Powder form makes taking it easy
No inactive ingredients
Easy packaging for travel

Cons

By prescription only

This probiotic supplement requires a prescription, so if you have had J-pouch surgery and think it might be a good fit for you, ask a healthcare provider about a prescription.

VSL#3-DS contains 900 CFU of the eight specific probiotic strains recommended for preventing pouchitis in those with Inflammatory Bowel Disease (IBD) who have had J-pouch surgery. Simply mix two unflavored packets with cold fluids or foods, like applesauce or pudding. This probiotic is available through prescription only, and you can request it from a healthcare provider. Although VSL#3-DS needs to be refrigerated, the packets can be at room temperature for up to two weeks, so they are easy to use when traveling.

It is possible for people with IBD to have other GI conditions such as Irritable Bowel Syndrome (IBS). VSL#3-DS is likely suitable for people with these conditions, as it does not contain any fermentable ingredients like lactose that could cause or exacerbate IBS symptoms. The company that makes VSL#3-DS also makes a non-prescription version that they market to those with IBS. That version is not appropriate for those with pouchitis.

VSL#3-DS can be purchased at your healthcare provider’s office or through your pharmacy. The manufacturer offers a savings card for a discount on your purchase.

Vitacost

Pros

Allergy-friendly
No inactive or extra ingredients
Widely available

Cons

Needs refrigeration
Expensive

We like this probiotic because it’s wheat, dairy, egg, soy, tree nut, and peanut-free, and safe for the majority of people with food allergies. Every two capsule serving contains 10 billion CFU of the single-strain probiotic option recommended to treat antibiotic-associated diarrhea. As with most Saccharomyces boulardii probiotic supplements, this one needs to be refrigerated and may be delivered to you with a cold pack. However, it can last up to five days without refrigeration.

Pure Encapsulations Saccharomyces boulardii supplement is also GMO-free, gluten-free, soy-free, and vegan. Pure Encapsulations as a company is known for producing high-quality supplements. Their ingredients are carefully sourced and tested for identity and contaminants, their probiotics are verified with DNA testing, and their facilities are inspected twice per year by NSF. This bottle contains 30 servings—enough for at least two rounds of antibiotics.

Price at time of publication: $58 for 60 count ($0.97 per serving)

Pharmaca

Pros

Multistrain formula backed by science
Enteric-coated capsules to ensure it reaches the intestines
Vegan and gluten-free

Cons

Not easily found in stores

We like Bio-K Plus Daily Care 50 Billion Probiotic because it contains the research-backed combination of three probiotic strains to reduce the risk of antibiotic-associated diarrhea. The capsule is coated to ensure that the probiotics reach the intestines without being damaged by stomach acid. With 50 billion CFU, you only need one small capsule to prevent imbalance in your microbiome from antibiotic use. As with many of our other picks, this one is also gluten-free and vegan.

Bio-K Plus Daily Care 50 Billion Probiotic has 60 capsules in each bottle—enough for four rounds of antibiotics or four family members—and is shelf-stable for six months. For optimal potency, store it in your refrigerator. If you are traveling, they can be out of the fridge for up to 60 days.

Price at time of publication: $45 for 60 count ($0.75 per serving)

Visbiome

Pros

High-dose of probiotics in one serving
Certified low-FODMAP
Easy to take for those who have trouble with pills

Cons

Available by prescription only
Must be refrigerated

This probiotic supplement requires a prescription, so if you have had J-pouch surgery and think it might be a good fit for you, ask a healthcare provider about a prescription.

We like Visbiome Extra Strength High Potency because it contains all eight of the most beneficial probiotic strains for preventing pouchitis in those who have had J-pouch surgery. It contains all 900 CFU in one pouch of unflavored powder that can be mixed into cold fluid or food. Visbiome Extra Strength High Potency for UC needs refrigeration but is good for up to a week at room temperature. As an added bonus, the package has an indicator that lets you know if the product has been exposed to heat and is no longer viable.

It is possible for people with IBD to have other GI conditions such as Irritable Bowel Syndrome. Visbiome products have been certified low-FODMAP by Monash University, so this probiotic supplement is safe for those with IBS.

Visbiome Extra Strength High Potency does need a prescription. However, you can order it on their website, and they will contact the healthcare provider you are working with for authorization for you, or you can speak to a healthcare provider directly.

Final Verdict

The best probiotic for you is going to be based on your diagnosis. We like Renew Life Ultimate Flora Probiotic for Adults to treat Antibiotic-Associated Diarrhea because it’s inexpensive and easy to take when traveling. For pouchitis, we really like that VSL#3-DS has all eight of the needed strains for the prevention of this painful ailment.

How We Select Supplements

Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here.

We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products. We prioritize products that are third-party tested and certified by one of three independent, third party certifiers: USP, NSF, or ConsumerLab.

It's important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.

What to Look for in a Probiotic Supplement

Third-Party Testing

Supplements that are third-party tested are sent to a lab where they are tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it’s important to note:

Third-party testing does not test to see if a product is effective or safe for everyone, and it does not ensure the supplement will not interact with other supplements or medications.
Not all third-party testing is created equal. It is not uncommon for supplement companies to pay labs for certificates after conducting minimal to no testing.
The third-party certifications we can trust are ConsumerLab, NSF, and USP. However, these certifications are difficult to obtain and/or expensive for manufacturers, so many companies choose not to get their products tested by one of these three organizations.
Sometimes products tested by these three companies are more expensive to try to offset the cost they pay for certification.
Just because a supplement is not tested by one of these three companies does not mean it’s a bad product. We recommend doing some research on the reputability of the manufacturer and calling up the manufacturer and their testing lab to determine their protocols and decide if you feel comfortable consuming the supplement.

Form

Only live microorganisms offer health benefits. Since probiotic manufacturers are required to list the total amount of microbes on the label, which includes both alive and dead microorganisms, it is impossible to know how many are alive and therefore are beneficial.

As probiotic supplements sit on the shelf or in your cupboard, they can lose potency. Look for probiotic supplements that list their quantity at the end of their shelf life instead of their quantity at the time they were packaged. Quantity is typically listed in Colony Forming Units or CFU, and the amount varies by the type of probiotic and its use.

Probiotics are classified by their strain, which includes the genus, species, subspecies (in some cases), and a series of letters and numbers similar to a zip code to further specify them. Some strains even have nicknames. The most common microbes used in probiotic supplements are Lactobacillus (L), Bifidobacterium (B), Saccharomyces (S), Streptococcus, Enterococcus, Escherichia, and Bacillus. Some recommendations will specify the strain or the strain nickname.

Frequently Asked Questions

Can probiotics make you poop or cause diarrhea?

Yes, it is possible to have diarrhea when you first start to take probiotics. Probiotics alter the microbiome, so when they are first introduced, some people may experience temporary symptoms such as gas, bloating, diarrhea, and abdominal cramps. These symptoms will dissipate after a few days.
There have been a few cases where diarrhea resulting from probiotic use may be a sign of more severe complications. Issues like sepsis and fungus in the blood may occur in people who are already severely ill or have compromised immune systems. For those with healthy immune systems, symptoms will be temporary. If diarrhea persists past a few days, it may be a good idea to stop the probiotic supplement.
Is yogurt a good probiotic?

Fermented foods such as yogurt, pickles, and kombucha use probiotics in the process of manufacturing. While many of these probiotics will survive from manufacturing to ingestion, many may not make it to the intestines alive. Probiotics are more likely to survive until they reach the intestines when a combination of probiotics and prebiotics—a food source for probiotics—are included in yogurt products.
While food may contain probiotics, it will not contain as many probiotics as supplements. For those with antibiotic-associated diarrhea and pouchitis, yogurt won’t provide adequate probiotics. For all other healthy individuals, it will not harm you to have yogurt made with probiotics, but it may not help either.
How long does it take for a probiotic to work?

How long it takes for a probiotic to work depends on the strain, the potency, and what you are taking them for.
For antibiotic-associated diarrhea, it’s recommended that you take probiotics within the first 48 hours of your first dose of antibiotics. If you are taking the recommended single strain of Saccharomyces boulardii found in Renew Life Ultimate Flora Probiotic for Adults, you should not experience diarrhea at all; that’s your sign that they are working!
For pouchitis, we don’t know when probiotics start to work. However, the appropriate probiotics can not only prevent pouchitis but can also lead to quick healing of acute pouchitis compared to those who do not use probiotic supplementation.
Can you take too many probiotics?

Our gut microbiome has 109 microorganisms, so it would be quite difficult to ingest enough probiotic supplements to overpower these. However, it is possible that taking too many can trigger uncomfortable symptoms such as gas, bloating, abdominal cramping, and diarrhea.
There are some people who would be harmed by taking even the recommended dose, namely those with compromised immune systems and those that are severely ill. Supplementing may lead to sepsis, bacterial or fungal blood infection, and in rare cases, anaphylaxis.
When else might probiotics be helpful?

Research on the safety and efficacy of probiotic supplementation is on-going. To date, there are many knowledge gaps due to few studies proving that probiotics are impactful on our health.
Research is growing with respect to using a specific combination of probiotics in preterm, low-birth-weight infants born before 37 weeks gestation for the prevention of necrotizing enterocolitis. Even with the research, probiotics are not appropriate for all preterm, low-birth-weight infants.

Best Overall for Antibiotic-Associated Diarrhea

Renew Life Ultimate Flora Probiotic Saccharomyces boulardii

Best Overall for Pouchitis

VSL#3 Double Strength Probiotic Medical Food

Best Allergy-Friendly Probiotic for Antibiotic-Associated Diarrhea

Pure Encapsulations Saccharomyces boulardii

Best Multistrain Probiotic for Antibiotic-Associated Diarrhea

Bio-K Plus Daily Care 50 Billion Probiotic

Best High-Dose Probiotic for Pouchitis

Visbiome Extra Strength High Potency Probiotic