Do Probiotics Make You Poop? Yes and No

• How Do Probiotics Work?|
• How to Use Probiotics|
• 5 Signs Probiotics Are Working|
• What if Probiotics Are Too Slow?|

If you’ve landed here, you likely already know a thing or two about probiotic supplements. They’re the beneficial bacteria and fungi that you can buy for your gastrointestinal tract. 

Maybe you know they play a role in healthy digestion but are wondering specifically, do probiotics make you poop?

When it comes to bowel consistency and regularity, probiotics seem to help wherever they’re most needed. 

Since the answer to whether probiotics make you poop is anything but simple, let’s uncover how, depending on which you have, they can help minimize both diarrhea and constipation.

Then, I’ll share our specific protocol for clients with stubborn constipation.

How Do Probiotics Work to Impact Bowel Movements?

No one yet understands the exact mechanisms for how probiotics work to improve a range of bowel movements. But we do have the following reasonable guesses based on scientific evidence 1:

• Stress can make it hard for the gut and brain to communicate with each other, but probiotics seem to help get them talking again.
• Probiotics can help correct dysbiosis, an imbalance of gut flora that can lead to irregular bowel movements.
• Probiotics can improve a leaky gut, which is intestinal damage that may lead to body-wide inflammation and an overactive immune system.

• Probiotics may reduce visceral hypersensitivity, which is to feel pain or discomfort in the abdominal organs more intensely than others do.
• Daily probiotics can improve motility (how food moves through the digestive tract), stool texture, and how often you poop.

When it comes to the effects probiotics can have on diarrhea and constipation, we have solid evidence of their direct benefits.

Probiotics Put the Brakes on Diarrhea

A randomized controlled trial (gold-standard type of human study) found that after 3 months, probiotics with both live bacteria or dead (heat-killed) ones had similar benefits for people with diarrhea. Improvements in diarrhea grew strongest toward the end of the 3-month study, suggesting that 3 months of probiotics is a good target for treating chronic diarrhea 2.

Probiotics Push Through Constipation

What’s more, a meta-analysis (high-quality study of studies) discovered that probiotics could relieve constipation if people took any dose between 100 million and 30 billion CFU per day for one to 16 weeks. That suggests probiotics have a wide range of potential for improving bowel movements. Synbiotics (probiotics plus bacterial food called prebiotics) were even more effective than probiotics alone 3.

Understanding the precise mechanisms that lead to these results is still a project for medical science to unpack. Meanwhile, evidence from studies and my clinical experience show many benefits of probiotics for digestive health.

How to Use Probiotics for Best Results

In my practice, the best probiotic regimen for chronic constipation or diarrhea is a triple therapy approach, which is to combine three categories of well-studied microbes that make up the gut microbiome. 

The categories are:

• Blended Lactobacillus and Bifidobacterium species 
• A beneficial yeast called Saccharomyces boulardii
• Soil-based Bacillus species

A probiotic supplement that includes multiple species seems to help maximize the effects of probiotics 4 5.

In the clinic, we ask our clients to stay on probiotics for at least two months to see meaningful benefits 6, even if they begin feeling better after a month or so. Usually, by three months, we expect to see full improvements 2. 

After that, they can slowly go down to a lower “maintenance” dose. Some find that they can discontinue the use of probiotics altogether.

5 Signs That Probiotics Are Working

There are five main things to look for to know if probiotic supplements are working. 

These include:

1. Improved digestion (look for less constipation 3, diarrhea 2, belly pain 7, gas 8, bloating 5, or acid reflux or heartburn 9)
2. Improved mood 10 and cognitive function 11
3. Lower stress 12 and better sleep quality 13
4. Less immune reactivity (including autoimmune flare-ups 14 15, allergies 16, and food sensitivities 17)
5. Skin improvements 18 19

I’m often amazed by how comprehensive probiotic supplements can be for improving gut health and overall health. 

But for those of you who are struggling with stubborn constipation and probiotics haven’t helped (yet), the next section is for you.

What if Probiotics Are Too Slow for Constipation?

The one drawback with probiotics is that you often have to take them for a while to really feel the improvements. That can be a challenge when you’re dealing with daily constipation and need a break sooner. 

Quick-Relief Constipation Solutions

For fast but short-term constipation relief, gentle laxatives can be a great option. Magnesium and senna are highly effective natural laxatives 20 and the two I recommend most often at the clinic. We also see results with aloe vera juice, the gentlest of the three choices. 

I often ask my clients to start with lower doses of the first two, in order to avoid side effects like cramping or diarrhea. This table shows our dosing strategy for quick constipation relief at the clinic.

Long-Term Solutions for Regularity

For unexplainable chronic constipation, also called functional constipation, there’s an underlying cause to address. 

Constipation that seems to never go away usually arises from the following:

• Too little water, fiber, and daily movement
• Too much chronic stress disrupting the gut-brain axis
• A stubborn bacterial overgrowth 
• A structural problem affecting the way contents move through the intestines 

The following table shows these common underlying causes of constipation and how we treat them for long-term bowel regularity.

Probiotics are especially helpful for clearing a bacterial overgrowth, and they can also help with the other underlying causes. Probiotics are strongest (and work faster) when paired with gut-supportive lifestyle habits and certain other treatments. 

Depending on the individual client, we often pair probiotics with the following therapies or lifestyle changes to speed up constipation relief and ensure that it lasts.

Hydration

It may seem too simple to mention, but drinking enough water is a crucial piece of digestive system health. 

One meta-analysis found that drinking regular water improved constipation in 32% of volunteers, and drinking mineral water improved it in 46% of them 21. 

In the clinic, I recommend that people drink 8–10 cups of regular or mineral water or half their body weight in ounces each day. For example, a 136-lb person would aim to drink 8–10 cups or around 68 oz of water per day.

Fiber 

Fiber comes from whole grains, beans, fruits, and vegetables, all of which can make poop more regular and easy to pass 22. This table shows examples of foods that are high in fiber.

But you can also boost your fiber with psyllium. This dietary supplement is a gentle fiber that, when mixed with beverages or added to baked goods, can increase daily fiber levels. 

In fact, psyllium can increase bowel movements by up to three per week, especially after taking it for 10 days 23.

We ask our clients who deal with constipation to aim for 25 to 30 grams of dietary fiber per day, whether that’s in the form of food or supplements. To avoid digestive issues, we recommend that they start with 10 grams and work up to the most effective dose.

Exercise and Daily Movement

The physical act of moving the body can help move things through the digestive tract as well. Any holistic healthcare provider will likely recommend exercise as a remedy for the constellation of symptoms connected to gut health. That’s because the overall health benefits of daily exercise—even walking for 20 minutes—are countless.

A meta-analysis found that at least 2 hours per week of aerobic exercise, including walking, can reduce constipation to a meaningful extent 24.

Stress, Anxiety, and the Gut-Brain Connection

The gut-brain axis plays a key role in gut health. For example, psychological stress can alter the way food moves through the gut (motility) and how fast (gut transit time) 25 26 27. Anxiety can even set off diarrhea or constipation. 

Communication between the gut and the brain travels in both directions. That means stress and trauma can impact gut function, but symptoms like abdominal pain and chronic constipation, as well as the presence of harmful bacteria, can be emotionally distressing as well.

To help our clients relieve stress and support gut health, we recommend they spend at least two hours a week in nature, especially in the sun, if possible. We also coach people to take up meditation or cognitive behavioral therapy if those stress management techniques are appealing and available.

Bacterial Overgrowth

A healthy gut microbiota means having enough “good bacteria” to keep “bad bacteria” in check. It also means having a reasonable amount of gut microbes in each major section of the intestine. 

SIBO (small intestinal bacterial overgrowth) is the presence of too many bacteria or fungi in the small intestine. More than about 10,000 microbes in the small intestine can lead to a host of IBS symptoms, including constipation, bloating, and abdominal pain.

A low FODMAP diet can starve out SIBO, but constipation from this type of infection often needs at least one more of the following interventions:

• Herbal antimicrobials, which are as effective as the antibiotic rifaximin for resolving SIBO 28. 
• MSM (Methylsulfonylmethane), a sulfur found in many foods. Based on other clinicians’ reports, we like to start with a half-teaspoon of MSM and slowly increase to 2 tablespoons per day for no more than two months at a time.
• Temporary elemental diet, which can resolve SIBO with more success than antibiotics 29

Some people with truly stubborn constipation may need to ask a doctor for prescription prokinetics, such as prucalopride (Resolor) 30.

Structural Problem

Structural problems affecting the intestines are usually either hereditary or a result of scar tissue after surgery or another kind of trauma. Such a physical blockage can cause gut contents to get stuck and create the conditions for chronic constipation. In people with structural problems, a physical solution like abdominal massage can be very good for relieving constipation 31.

When our clients need this type of intervention, we recommend the following at-home abdominal massage:

• With gentle pressure from the fingertips, start a circular motion at the lower right side of the abdomen. 
• Continue this motion while moving straight up to the bottom of the ribcage and then directly left to the other side. 
• Next, move down and then stop at the lower left side. 
• Start over at the lower right side and repeat for 5–10 minutes one to three times per day.

For some people, biofeedback therapy may be a better option for treating constipation. As an overview of biofeedback studies described, the rectum (part of the colon just before the anus or butthole) is like a tube of toothpaste 32. 

To get toothpaste out, you need to take the cap off and squeeze the tube at the same time. It’s the same with the rectum. In order to have a complete bowel movement, the rectal muscles have to push while the anus relaxes. 

Some people’s bodies don’t coordinate these movements at the same time, which can lead to constipation. But studies have shown that biofeedback therapy may help train you to contract your abdominal muscles and relax your anal sphincter at the same time 32. 

When biofeedback seems like the best approach for my clients, I recommend that they see a healthcare professional who specializes in pelvic floor issues to learn this technique.

Do Probiotics Make You Poop?

After reading about the effects of probiotic bacteria and fungi on gut health, I hope you have a better understanding of their role in improving a range of gut health conditions. 

Probiotics can benefit constipation or diarrhea. They can also assist with emotional and mental health, which can have a positive impact on bowel movements.

When probiotics alone aren’t acting quickly enough to relieve constipation, we can boost their effects with short-term therapies, long-term healthy habits, and other gut supports.

At any point along your journey toward digestive health, we would love to help. Reach out to the Ruscio Institute for Functional Health to set up a time to connect. You may also be interested in exploring gut health at your own pace with my book, Healthy Gut, Healthy You.

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