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This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

How to Use Probiotics for Bloating and Constipation Relief

Written by Michael Ruscio on October 3, 2020

Hilary Watts

Written by Michael Ruscio on October 3, 2020 — Reviewed by Hilary Watts Hilary Watts

The Best Probiotic Strategy for Bloating

Feeling bloated and gassy are two of the most common digestive symptoms people experience. Fortunately, good scientific evidence shows using probiotics for bloating can relieve your symptoms.

Probiotics for bloating: Woman grimacing and holding stomach

What Causes Bloating?

Bloating happens when there is excess gas or pressure in your intestines. It frequently affects people with Irritable Bowel Syndrome (IBS). Let’s take a look at what causes bloating.

Dysbiosis

Dysbiosis is an imbalance in your trillions of gut microbiota, which includes bacteria, yeasts, and protozoa. Bloating is a common symptom in IBS. Research suggests IBS is often caused by an imbalance of the good bacteria and bad bacteria in your digestive system or by specific bacterial infections [1, 2].

Bad bacteria or other pathogens can cause inflammation of the gut lining, which is believed to be a trigger of bloating and gas production [3]. Increased gas levels from bacterial overgrowth may also cause bloating [4, 5].

Diet or Food Allergies

Eating a poor diet high in carbs or fermentable fiber can be a huge contributor to gas and bloating.

For example, high FODMAP foods, such as dairy products and sauerkraut, naturally contain fermentable carbohydrates that feed bacteria. A low FODMAP diet has been shown to reduce bloating symptoms in 50-80% of IBS patients [6, 7, 8].

Food allergies or sensitivities can also contribute to bloating. For example, if you are unable to properly digest lactose, you may feel bloated when you eat dairy products.

SIBO

Small intestinal bacterial overgrowth (SIBO) is a type of bacterial dysbiosis. SIBO is usually caused by an overgrowth of normal gut bacteria in the small intestine, which normally has very few bacteria [9].

SIBO is not a specific condition. Rather, it’s often diagnosed when a lab finding correlates with the symptoms of IBS, including bloating [10].

Constipation

Probiotics for bloating: Hands making a heart shape on the stomach

Constipation is low stool frequency. It happens when food moves too slowly through your digestive system. When food takes too long to travel through your gut, it’s more likely to ferment and fuel bacterial overgrowth [11]. The longer food lingers, the more likely it may back up in the intestines and lead to distention and discomfort [12].

Improving constipation relieves bloating symptoms for many IBS patients [13, 14].

Probiotics Help Relieve Bloating

Probiotics are live microorganisms that live in your digestive tract that confer health benefits primarily in the large intestine. Fortunately, probiotic supplements have been shown to relieve bloating as well as many of the common causes of bloating [15, 16, 17, 18, 19, 20]. In fact, bloating is one of the digestive issues probiotics have been most shown to relieve.

How Probiotics Work for Bloating

Bulleted list of how probiotics work

Probiotics work to improve your gut environment and gut microbiome by interacting with your immune system and your existing good bacteria. According to the Journal of Clinical Gastroenterology [21] and the journal Trends in Microbiology [22], probiotics:

  • Increase the bacterial diversity of your bacterial community [23]
  • Fight bad bacteria and their toxins [24, 25, 26]
  • Promote a faster recovery from imbalances in your gut microbiota [27]
  • Promote a healthy gut immune system response [28, 29, 30]
  • Reduce gut inflammation [31]
  • Encourage the growth of good bacteria in your gut [32]
  • Reduce leaky gut [33, 34, 35]

Even better, most probiotics provide these gut health benefits without side effects [36].

Probiotics for Bloating, Gas, and Distention

When it comes to bloating, probiotics can help improve the balance of bacteria in your gut [37], which often corrects the underlying cause of the bloating. 

Research supports this hypothesis. According to a meta-analysis published in the World Journal of Gastroenterology, “Probiotics were… associated with less abdominal pain compared to placebo [38].” A randomized, controlled trial in the study showed probiotics significantly reduced abdominal pain and distention in IBS patients [39]. Several other studies reached similar conclusions [40, 41, 42, 43].

Probiotics for Constipation

Bloating often happens with constipation [44]. Two recent meta-analyses and systematic reviews (the highest quality of scientific evidence) recently combed through the available research regarding probiotics for constipation. Both reached the conclusion that probiotics reduced gut transit time and increased stool frequency [45, 46]. One of the analyses in the journal Clinical Nutrition concluded probiotics were an effective solution to constipation in adults. The study found probiotics “may substantially reduce the Gut Transit Time, increase the stool frequency, and improve the stool consistency [47].”

Probiotics for SIBO-Related Bloating

Bloating is one of the most common SIBO symptoms. Despite fervent debate, high-quality studies clearly show that probiotics improve the outcomes of SIBO treatment and can, therefore, reduce bloating in SIBO [48]. One meta-analysis of probiotics for the treatment of SIBO concluded, “probiotics supplementation could effectively decontaminate SIBO, decrease H2 concentration, and relieve abdominal pain [49].”

How to Use Probiotics for Bloating

Along with an anti-inflammatory diet, such as the low FODMAP diet, a combination of three probiotics is a good approach for IBS symptoms like bloating.

Some probiotics protocols make this unnecessarily complicated. However, there’s no best probiotic for bloating. 

Instead, probiotics generally improve your digestive health by improving your gut environment.

As I discuss more fully in my book, Healthy Gut, Healthy You, the most important probiotic strategy for bloating (or any digestive problem) is to include a diversity of high-quality probiotics.

Most probiotics fall into one of these three categories:

I recommend using one high-quality product from each category. When used together, the three probiotics work synergistically to improve your gut health. Probiotic strains from all three categories have been shown to help bloating [50, 51, 52, 53, 54].

The three types of probiotics work together like the legs of a three-legged stool. If the stool only has one or two legs, it’s likely to be unstable. With three legs, the stool can stay upright.

3 PROBIOTICS FOR GUT BALANCE 16x9 3

When mixtures of several probiotics were compared with single strains of probiotics in the treatment of IBS, two systematic reviews and meta-analyses indicated the multi-strain probiotics were more effective than single-strain probiotics [55].

Though more data are needed, the current research indicates the more diverse the array of probiotics, the better.

Choosing Probiotics for Bloating

Probiotic manufacturing is not highly regulated by the U.S. Food and Drug Administration (FDA), which means you should be careful when buying them. One study of 26 commercial probiotics concluded none fully supported their label claims, and some of them contained unacceptable microorganisms [56].

You don’t need to purchase the most expensive probiotic supplements, but you should be wary of quality. Here are some tips for choosing high-quality probiotic supplements.

Choose Probiotic Supplements With:

  • A clearly stated list of species
  • A clearly stated number of colony-forming units (CFUs) in the billions
  • A manufacture date and expiration date
  • Labeled free of common allergens and other substances you may wish to avoid (e.g., gluten-free, non-GMO, vegan)
  • Good Manufacturing Practices (GMP) certification
  • Lab-verified for probiotic species and potency by third-party analysis (independent lab testing)

Other Tips for Bloating

Probiotics aren’t the only option for improving your bloating. Here are some other options that may help you reduce bloating, especially when used alongside probiotics.

Low FODMAP Diet and Prebiotics

The low FODMAP diet is low in fermentable fibers bacteria enjoy feasting on. Eating less food for bad bacteria likely means you’ll experience less bloating and gas. Research clearly shows eating a low FODMAP diet reduces IBS symptoms such as bloating, constipation, and abdominal pain [57, 58, 59, 60].

Prebiotics are food for your good bacteria. While prebiotics or prebiotic fiber may be generally good for your digestion, these are often high FODMAP foods. It’s common for prebiotics to flare IBS symptoms like bloating. I recommend waiting to introduce prebiotics until you are well through your gut healing process.

Prebiotics are commonly used as additives in probiotic supplements. Make sure to read your probiotic supplement labels to avoid inadvertently using prebiotics.

If you’re not sure how to eat a low FODMAP diet, it may be helpful to meet with a health coach or nutritionist for support.

Exercise

According to a meta-analysis, regular gentle exercise such as walking, aerobic exercise, or Qigong had a significant impact on constipation [61] and may, therefore, help relieve bloating.

Digestive Enzymes

One promising study showed digestive enzymes reduced bloating, abdominal pain, and flatulence for IBS and IBD patients [62]. Including digestive enzymes may improve digestion of FODMAPs or other difficult-to-digest foods and reduce bloating.

Hydration

Drinking enough water each day can likely help prevent constipation and associated bloating [63]. A review of studies in the journal Nutrients stated there hasn’t been much research into whether adequate hydration affects constipation and bloating [64]. However, they summarized a few studies that suggested drinking enough water improved bowel function [65, 66].

The Bottom Line

Multiple studies show various types of probiotics reduce bloating, abdominal pain, and the constipation that often accompanies these symptoms. Including one high-quality probiotic from each of the three categories alongside an anti-inflammatory diet — like the low FODMAP diet — is likely to relieve your bloating.

Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

➕ References

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  2. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-1562. doi:10.1038/ajg.2014.202
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