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Which Probiotic Is Best For Antibiotic Diarrhea

Can Probiotics Cause Diarrhea Possible Side Effects

Probiotics Cut Antibiotic-Associated Diarrhea

Every body is different. So even though all signs point to probiotics benefits in normalizing bowel function, there are some people who might experience diarrhea because of them. Most dont experience a worsening of their diarrhea, however.

When first starting a probiotic, the gut flora rebalances and purges the undesirable organisms in a common process called die off. This can temporarily exacerbate GI symptoms including diarrhea before beginning to improve them.

If your digestive symptoms persist after more than a few days, check with a healthcare provider who has experience recommending probioticsAdjusting your dose, product, or routine could help reduce gastrointestinal distress.

As a reminder, if youre very ill or want to give a probiotic to a sick child, always check with a doctor first.

Probiotics To Prevent Antibiotic


Am Fam Physician. 2020 Mar 1 101:online.


1 in 9 did not develop antibiotic-associated diarrhea



1 in 6 did not develop antibiotic-associated diarrhea when receiving high-dose probiotics


1 in 9 did not develop antibiotic-associated diarrhea



1 in 6 did not develop antibiotic-associated diarrhea when receiving high-dose probiotics

Probiotics For Travelers Diarrhea

In one meta-study, researchers looked at 63 studies involving the use of probiotics for infectious forms of diarrhea. Comprising over 8,000 participants, the results of these studies showed that probiotics shortened the illness by about one day on average. The studies showed that about 55 percent of participants were diarrhea-free after three days of treatment with probiotics, while just 34 percent of those who did not take probiotics showed no symptoms after three days.4

A meta-study evaluated the effectiveness of probiotics in cases of travelers diarrhea. The results from 12 different studies showed that probiotics significantly reduced travelers diarrhea. This applied to several strains of probiotics, but primarily Saccharomyces boulardii and combinations of Lactobacillus acidophilus and Bifidobacterium bifidum.6

Another meta-study looked at the relationship between childhood diarrhea and Lactobacillus probiotic strains. Identifying nine studies, researchers noted reductions in diarrhea duration by 0.7 days in children who had received a Lactobacillus probiotic supplement. Results also showed a reduction in diarrhea frequency by 1.6 stools on the second day of treatment. This suggests that Lactobacillus is a safe and effective treatment for children with acute diarrhea.7

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Best Probiotic For Ibs Diarrhea

Image: Attribution 2.0 Generic by H o l l y, via Flickr

Lactobacillus rhamnosus GG is an isolated strain of Lactobacillus rhamnosus that was removed from the intestinal tract of a healthy person and replicated. This probiotic strain is the most studied probiotic in existence. Research has verified that it successfully treats diarrhea. This powerful strain of probiotic is sometimes prescribed to treat IBS with diarrhea. In addition, other conditions that it treats are Crohns Disease, lactose intolerance, Rotavirus in babies and children, antibiotic-induced diarrhea, travelers diarrhea. Interestingly, it also adis diarrhea as a side effect of chemotherapy.

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Summary Of The Evidence For Probiotic Prevention Of Antibiotic

Several systematic reviews on adult and paediatric AAD suggest that probiotic bacteria offer a solution. Data indicate that Lactobacillus strains in particular seem to be effective, however the largest body of evidence is for the yeast S. boulardii . The latest meta-analysis of 10 randomized control trials testing the efficacy of S. boulardii in preventing AAD shows an overall, pooled relative risk of 0.47 . McFarlands previous meta-analysis examined other bacteria as well and found the relative risk of getting AAD is 0.31 while taking L. rhamnosus GG . Data from seven other trials using various mixtures of bacteria were combined and showed a relative risk of 0.51 . Finally, six further trials of various single bacterial strains were combined to give a relative risk of AAD of 0.46 . Caution is required in interpreting meta-analyses of more than one strain because each strain has specific actions. Previously the small number of trials testing each individual strain led to meta-analyses combining results from various stains, but now, as the numbers of trials increase, it is encouraging to see that new single-strain meta-analyses are being published. It can be concluded from these results that several bacterial strains and one yeast have the potential to prevent AAD. The strongest evidence is for S. boulardii and L. rhamnosus GG because these have been used in most studies.

The Safety Implications Of Probiotic Use In Patients At Risk Of Antibiotic

Probiotic bacterial strains used in food products are generally regarded as safe in healthy populations, demonstrated by their extensive use over centuries, with few reported adverse consequences. However, by definition, healthy populations are not at risk of developing AAD, and so it is important to consider the risks of probiotic administration in the at risk group. Risk factors for AAD and CDAD include duration and type of antibiotic course, increasing age, severity of underlying illnesses, duration of hospital stay, presence of a nasogastric tube, and use of proton pump inhibitors . In short, the population at greatest risk is old, hospitalized patients treated with antibiotics.

Probiotic bacteria can cause infective episodes if they translocate from the gastrointestinal tract to extraintestinal sites, such as regional lymph nodes, spleen, liver, bloodstream, heart valves, or other tissues. Bacterial translocation is caused by a defective intestinal barrier, immunosuppression, or gut prematurity, and may result in bacteraemia, sepsis, and multiple organ failure . However, cases of probiotic administration leading to bacteraemia or fungaemia are rare. In 2003 an expert panel concluded that Current evidence suggests that the risk of infection with probiotic Lactobacilli or Bifidobacteria is similar to that of infection with commensal strains, and that consumption of such products presents a negligible risk to consumers, including immunocompromised hosts .

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How Long Does It Take For Probiotics To Work In Dogs With Diarrhea

The time the probiotic needs to start working in dogs with diarrhea depends on several factors, including the diarrhea trigger and the probiotic quality.

For example, if the diarrhea is caused by stress or a sudden diet change, the effects of the probiotic are likely to kick in after one or two uses. On the other hand, if the diarrhea bout stems from inflammatory bowel disease, it will need more time before it is managed.

The probiotic type and features matter too. Namely, Purina FortiFlora is efficient from the first sprinkle, while other products may require few uses before yielding visible improvements in the stool quality.

Bottom line, probiotics are not miracle cures, and it would be irrational to expect immediate results give them between one and three uses, and if your dogs diarrhea does not seem to respond, call the vet and ask for another probiotic product or treatment plan.

Search Strategy And Study Selection

Diarrhea Treatment – Probiotics

The flow of the meta-analysis, from search to study selection, is depicted in Fig. . The literature search identified 128 relevant studies. An overview of these studies, including the reasons for their exclusion, is presented in Additional file . A total of 32 trials satisfied our inclusion criteria and were included in the meta-analysis: 26 were obtained from previous reviews and six from direct database searches . The specific characteristics of all included studies are summarized in Additional file .

Fig. 1

Prescriptions of antibiotics in The Netherlands including those for high risk of AAD. The data have been extracted from the Genees- en hulpmiddelen Informatie Project from the Zorginstituut Nederland, that collects trends on use of medication in the Netherlands as reported by health insurance companies. Grey bars indicate the antibiotics that are associated with a higher risk of AAD

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Search Strategy And Inclusion Criteria

Included in this review are studies that assessed the efficacy of probiotics in reducing the incidence of antibiotic-associated diarrhea in patients treated with antibiotics, regardless of their age, of the intervention setting and of the indication for which they were prescribed. In order to identify these studies we first screened the references listed by previously published systematic reviews and meta-analyses, and then we directly searched clinical trials in public databases. Database searches were conducted on the 16th of January 2017.

We searched reviews and meta-analyses on the following databases for the period 19602016: the Database of Abstracts of Reviews of Effects , the Cochrane Database of Systematic Reviews and PubMed. For the DARE and the CDSR databases we searched combinations of the following terms: probiotic, antibiotic, diarrhea and antibiotic-associated diarrhea. The search yielded 25 results from the DARE and 50 from the CDSR. In PubMed, we searched for meta-analyses using the following search texts: AND ), which yielded 28 results and AND AND ), which yielded 34 results. After screening of titles and abstracts and exclusion of duplicates and reviews not relevant to our purpose, we identified 28 relevant reviews and meta-analyses , containing a total of 102 relevant studies.

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Lactobacillus Rhamnosus Gg Y Saccharomyces Boulardii

The WGO World Gastroenterology Organization, and in line with ESPGHAN, in its latest report in 2017 states that the probiotics that have most clearly demonstrated their efficacy in this pathology are Lactobacillus rhamnosus GG and Saccharomyces boulardii. It also mentions Lactobacillus reuteri DSM 17938, although to a lesser extent than the two previous ones.

Likewise, studies carried out with the administration of Lactobacillus rhamnosus GG showed a reduction in the number of diarrheal episodes compared to the control group given a placebo 2.

Lactobacillus rhamnosus GG and the yeast Saccharomyces boulardii

There are numerous studies that support these data. In 2016, a study of 200 kids, of whom 100 were given Saccharomyces boulardii and 100 placebo, concluded that there was a significant reduction in the duration and number of bowel movements in kids with diarrhea 1

Agreements And Disagreements With Other Studies

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This study is concordant with findings from the aforementioned Cochrane systematic review. Goldenberg found that probiotics led to a significant reduction in incidence of AAD from 18% to 12% of participants . The present review included 18 additional studies . This increase in total population increases the power of our review to detect smaller clinically relevant differences between groups in incidence of AAD.

Our subgroup analyses found similarly to one previous meta-analysis that the Lactobacillus and Saccharomyces genera reduced incidence of AAD. A more recent meta-analysis found, also concordantly, that many Lactobacillus and Bifidobacteria species and S. boulardii were effective. Previous meta-analyses have not reported on doseâresponse.

Our subgroup analyses were also in agreement with The American Gastroenterological Association Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders which suggest the use of S. boulardii or the two-strain combination of L. acidophilus CL1285 and L. casei LBC80R among other probiotic species for prevention of AAD.

Contrary to the findings of our review, one meta-analysis reported that probiotics may not be effective in reducing the incidence of AAD. However, only 13 studies were analysed, including adults over 65 only. This suggests a need for looking separately at the effectiveness of probiotics in populations of younger and older adults.

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Which Probiotic Strains Are Best For Diarrhea

Supplementation with different probiotics ensures youre replenishing microbial diversity to your gut. A few strains stand out in clinical trials among the rest for preventing and reducing the duration of diarrhea, particularly strains of lactic acid bacteria. Beneficial strains include:

  • Bifidobacterium lactis
  • Lactobacillus rhamnosus
  • Saccharomyces boulardii

When choosing a probiotic supplement, its important to consider which strains are used, but sometimes the right types of bacteria are not enough. You should also consider the research, ingredients and especially the effectiveness of the delivery mechanism to maximize your benefits.

How Fast Do Probiotics Work For Diarrhea

The speed at which probiotics take effect can vary based on the probiotic strains, the CFU dosage, and your own metabolism, meaning it may not always be an instant fix. You can generally expect probiotics to reduce your diarrhea duration by about half a day to two days on average.11

Probiotics may play an essential role in reducing the frequency, duration, and severity of diarrhea. If you think you could benefit from probiotics for diarrhea, consider incorporating a dietary supplement, like DrFormulas® Nexabiotic® which contains 17.25 billion CFUs of 23 probiotic strains including Saccharomyces boulardii and Lactobacillus acidophilus.

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Physicians Choice Probiotics 60 Billion Cfu

Diarrhea can be caused by a number of issues the most common one being an imbalance of bacteria in your gut which evidently is known to result from certain issues like your diet, medications like antibiotics, so it is always best to have a worthy probiotic close to you.

The Physicians Choice Probiotics might just be the one. It has 60 billion colony forming units to help in banishing your diarrhea from the hell hole it came from! It also has 10 probiotic strains accompanied by a prebiotic blend that have been chosen based on their successive streaks.

It comes with a patented shelf stable bottle that helps to preserve the purity of the probiotic by preventing the loss of CFUs because of heat conditions. It is made with NON-GMO and allergen free ingredients that dont contain soy, milk, wheat, nuts or shellfish to maintain your health.

Benefits Of Probiotics For Cat Diarrhea

Antibiotics, Probiotics, and Diarrhea

A study investigating the Effect of the Probiotic Enterococcus faecium SF68 on Presence of Diarrhea in Cats and Dogs Housed in an Animal Shelter found out that this probiotic strain has a positive impact on diarrhea. In fact, cats supplemented with Enterococcus faecium had fewer episodes of diarrhea.

Another study reviewing the Effects of Concurrent Ronidazole and Probiotic Therapy in Cats with Tritrichomonas Foetus-Associated Diarrhoea established that the addition of probiotics decreased the risk of a relapse following the end of treatment.

These are specific bacteria strains focusing on specific diarrhea types. In general, continuous use of probiotics results in improved stool quality and decreased risk of GI tract conditions that trigger diarrhea. In cases of already developed diarrhea, probiotics help restore microbial balance in the cats gut leading to shorter diarrhea episodes and smoother recoveries.

When choosing the right probiotic product for your cats diarrhea, it is recommended to consult with your vet as different beneficial bacteria target different types of diarrhea stress-triggered, medication-related, and infectious.

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Do Probiotics Help With Diarrhea In Cats

Yes, probiotics can help with diarrhea in cats. In fact, probiotics are often described as the new treatment for acute diarrhea in cats and dogs.

Cats with diarrhea have altered fecal microbiome, emphasizing the importance of introducing new beneficial bacteria into the cats gut.

It should be noted that before yielding positive results, the probiotics can make the situation look worse. However, this short-lasting effect occurs because the intestinal microbiome needs some adjustment time before returning to baseline.

How To Choose The Best Probiotic For Dog Diarrhea

Choosing the best probiotic for dog diarrhea can be tricky the labels are often inaccurate, and the claims are exaggerated. Therefore, you can quickly end up with a substandard probiotic supplement that can do more harm than good.

To avoid a bad scenario and make the probiotic shopping experience pleasant and successful, we have compiled a checklist with the things you need to consider when choosing the best probiotic for dog diarrhea.

Different Bacteria Strains. Single-strain probiotics can be helpful to target specific conditions. Still, when it comes to diarrhea management, you need a probiotic with various strains of good bacteria, including Bifidobacterium animalis, Enterococcus faecium, Bacillus coagulans, and Lactobacillus acidophilus. This is because different bacteria help with different types of diarrhea.

Colony Forming Units . Measures the number of good bacteria found in the probiotic and is expressed in millions or billions of live cultures per gram. The general rule of the thumb is that need between 1 and 4 billion CFUs per day. However, dogs with specific forms of diarrhea may benefit from a probiotic with more than 4 billion CFUs.

Additional Health-Boosting Ingredients. The more synergistic ingredients added to the probiotic formula, the better. For example, to thrive and support the dogs gut, probiotics need prebiotics. Therefore, many probiotic products include prebiotics. Some even add vitamins, minerals, digestive enzymes, and antioxidants.

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