Get Your Gut Moving: Probiotics for Constipation

Find Relief from Constipation

Probiotics for constipation: Man using his phone in the toilet

Americans spent $1.43 million on over-the-counter laxatives in 2019 [1]. When you consider that chronic constipation negatively impacts social functioning and quality of life [2 Trusted SourcePubMedGo to source], it’s clear that a lot of people suffer in silence with this condition.

Chronic constipation is a common digestive disorder, affecting up to 27% of the population [3]. And while constipation can affect anyone, it is more common among women and adults over 65 years of age [4].

Constipation is officially defined as having fewer than 3 bowel movements per week and/or having hard stool that is difficult to pass. However, in functional medicine, having 1-3 healthy bowel movements per day is one of the benchmarks of good digestive health.

Laxatives are fine for occasional constipation. However, for chronic conditions, it’s best to address the root causes. Probiotics help to correct the bacterial imbalances that underlie many cases of constipation.

Constipation and Gut Dysbiosis

Probiotics for Constipation: Doctor pointing on search box with the word Dysbiosis

For some people, overcoming constipation is simply a matter of making better food choices. If your diet is high in processed foods, adding fiber-rich whole foods and drinking enough water may be all that’s needed.

But fiber can be a double-edged sword if your constipation is caused by gut dysbiosis, an imbalance of the microorganisms in the digestive tract. Fiber feeds your gut bugs. If you have an overgrowth of harmful bacteria, eating more fiber maymake constipation, bloating, and abdominal pain worse [5 Trusted SourcePubMedGo to source, 6 Trusted SourcePubMedGo to source].

Chronic constipation and gut dysbiosis can be a self-perpetuating cycle. As fecal matter sits immobile in your digestive system, it encourages more growth of harmful bacteria and yeast, creating more constipation. Digestive system overgrowths can also cause inflammation and leaky gut, which can lead to other symptoms like fatigue, brain fog, food sensitivities, itchy skin, and more.

Probiotics can be very helpful in breaking the cycle of chronic constipation.

How Can Probiotics for Constipation Help?

Probiotics, or “good bacteria,” are bacteria species that we consume for their health benefits. Probiotics are capable of improving the health of your gut microbiome and can fight harmful microorganisms [7 Trusted SourcePubMedGo to source, 8 Trusted SourcePubMedGo to source, 9 Trusted SourcePubMedGo to source, 10 Trusted SourcePubMedGo to source].

Research shows that the beneficial bacteria in probiotic supplements can help with chronic constipation. Several systematic reviews and meta-analyses (the highest quality of research) have shown that probiotics:

While research clearly shows that probiotics can significantly improve constipation in adults and elderly people [20 Trusted SourcePubMedGo to source], the effect of probiotics are less conclusive for children [21 Trusted SourcePubMedGo to source, 22 Trusted SourcePubMedGo to source, 23 Trusted SourcePubMedGo to source]. Since the prevalence of bacterial overgrowths like SIBO increases with age [24], this may be a factor in the differences between adults and children when it comes to the success of using probiotics for constipation.

As a result of balancing gut microorganisms, probiotics also reduce inflammation [25 Trusted SourcePubMedGo to source], promote a healthy immune system function [26 Trusted SourcePubMedGo to source, 27 Trusted SourcePubMedGo to source, 28 Trusted SourcePubMedGo to source], and reduce damage to your gut lining (leaky gut) [29 Trusted SourcePubMedGo to source, 30 Trusted SourcePubMedGo to source31 Trusted SourcePubMedGo to source].

Lacto-Bifido Probiotic Blend

Best Probiotics for Constipation

One meta-analysis of 15 clinical trials showed that multi-strain probiotics were more effective than single-strain probiotics for increasing stool frequency, improving stool consistency, and reducing bloating [32 Trusted SourcePubMedGo to source]. Similar results have been found when comparing multi-strain and single-strain probiotics for treating irritable bowel syndrome (IBS) [33 Trusted SourcePubMedGo to source, 34 Trusted SourcePubMedGo to source].

I’ve seen similar results using probiotics for constipation in my clinic. Many people don’t seem to achieve balance in their gut microbiome with just one strain of probiotic. For many patients who have tried probiotic supplements without much success in the past, a multi-strain approach makes all the difference. For this reason, I recommend a comprehensive approach that includes all three categories of probiotics.

3-for-Balance Probiotic Protocol

You don’t need to try every different probiotic strain on the market, hoping to find the right one. The 3-for Balance Probiotic Protocol is comprehensive and eliminates the guesswork of choosing probiotic products.

Nearly every probiotic product can be classified into one of three categories [35]. When following the 3-for-Balance Probiotic Protocol, you’ll pick one quality supplement from each category.

CATEGORY 1CATEGORY 2CATEGORY 3
Lactobacillus & bifidobacterium species predominated blendsSaccharomyces Boulardii (a healthy fungus)Soil-Based Probiotics using various Bacillus species
These are the most well-researched, with well over 500 trials assessing their validity. These live microorganisms are also known as lactic-acid producing probiotic bacteria. They include a large number of well-known probiotic species, such as:
⚫️ Lactobacillus acidophilus,
⚫️ Lactobacillus Plantarum,
⚫️ Lactobacillus casei,
⚫️ Lactobacillus reuteri,
⚫️ Bifidobacterium lactis,
⚫️ Bifidobacterium longum,
⚫️ Bifidobacterium infantis
The second most researched probiotic, with more than 100 studies. Saccharomyces boulardii (S. Boulardi for short) is not a normal part of human gut microbiota, meaning it does not colonize us but does improve the health of the host.The third most researched category of probiotics is soil-based probiotics. This category is also known as spore-forming bacteria. This category of probiotic can colonize the host. [36 Trusted SourcePubMedGo to source]

What You Need to Do – Easy As 1, 2, 3

  1. Try a quality formula probiotic from each category 1, category 2, and category 3 – take all three together.
  2. Monitor your symptoms for 3-4 weeks. If you’re improving, stay on the 3-for-Balance protocol until your improvements have plateaued.
  3. Once you’ve seen your maximum improvement (you’ve plateaued), stay on the protocol for about a month to allow your system to calibrate to these new improvements. Then, reduce your dose and find the minimal effective dose. Stay on the minimal effective dose.
  • If you haven’t noticed any change in your symptoms after 3-4 weeks, you can stop taking probiotics and feel confident that you have fully explored probiotic therapy. There’s no need to shop for other strains of probiotics.
Probiotic EASY Protocol Infographic

Read more about how to pick a high-quality probiotic supplement in my Probiotic Starter Guide.

Probiotics for Constipation: How Long Does It Take To Work?

If you are taking high-quality probiotic supplements with a CFU count in the billions, you can expect to start seeing results in 1-4 weeks [37 Trusted SourcePubMedGo to source, 38 Trusted SourcePubMedGo to source, 39 Trusted SourcePubMedGo to source, 40 Trusted SourcePubMedGo to source].

For Rachel, it only took 48 hours to see improvements on the 3-for-Balance Probiotic Protocol.

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Rachel came to see me after reading my book, Healthy Gut, Healthy You. She had IBS-C and only went to the bathroom once every 5-6 days. Her struggle with constipation was lifelong, and she had tried many different natural treatments with little success.

With my support, Rachel started using the 3-for-Balance Probiotic Protocol. Within 48 hours, her lifelong constipation normalized. She also noticed that her mood was better. Rachel continued to take probiotics and was able to reduce her dose over time.

Not everyone enjoys the benefits of probiotics as quickly as Rachel. Allow at least three weeks to see if the 3-for-Balance Probiotic Protocol works for you. Even small improvements in your symptoms should be taken as a good sign that probiotics are working to restore your gut health.

Additional Treatments for Constipation

For some patients, probiotics offer a partial solution, improving but not eliminating symptoms. If this is your experience, you may benefit from these additional treatment options:

Prokinetic Agents

Prokinetic agents are drugs or natural supplements that help increase the strength and coordination of your migrating motor complex (MMC). The MMC is a complex system of nerves, muscles, and neurotransmitters that moves waste through the gastrointestinal tract. Prokinetic agents aren’t harsh like most laxatives and are better suited for long-term use.

It’s very important to keep waste moving through your gut. When fecal matter becomes trapped in your digestive tract, harmful bacteria thrive. Poor gut motility contributes to SIBO and other conditions of bacterial overgrowth.

A recent meta-analysis compared 36 clinical interventions for chronic constipation [41 Trusted SourcePubMedGo to source]. Probiotics combined with a prokinetic agent was found to be the most effective treatment.

MotilPro is an effective natural prokinetic agent. There are also a number of prescription options for prokinetic agents. A recent meta-analysis reviewed 33 clinical trials involving 17,214 patients to determine which drug was most effective for constipation [42 Trusted SourcePubMedGo to source]. While prucalopride was not the most effective initially, it ranked as the most effective after 12 weeks of therapy.

Low Fiber Diet

Fiber consumption works well for some, however it can be very counterproductive for others with functional constipation [43 Trusted SourcePubMedGo to source]. That’s because fiber may feed the gut bugs that cause constipation.

If you’ve tried high-fiber diets without success, it may be time for a different approach. One clinical trial found that a low- or no-fiber diet significantly improved constipation and bloating [44]. In the study, 41 patients who completely stopped fiber intake increased bowel movement frequency from once every 3.75 days to once per day.

The low FODMAPs diet was designed to remove all fermentable fibers that feed gut bugs. It can be helpful for treating gut dysbiosis, IBS, and leaky gut [45 Trusted SourcePubMedGo to source, 46 Trusted SourcePubMedGo to source, 47 Trusted SourcePubMedGo to source, 48 Trusted SourcePubMedGo to source, 49 Trusted SourcePubMedGo to source, 50 Trusted SourcePubMedGo to source].

Antimicrobial Treatment

Antibiotic therapy may be needed to reduce harmful gut bacteria if other treatments aren’t successful. Research shows that antibiotic treatment with Rifaxamin eliminates SIBO for 67% of patients [51 Trusted SourcePubMedGo to source].

Herbal antimicrobials are more commonly used in functional medicine and work the same way as antibiotics. There’s not as much research for herbal antimicrobials, but they have been shown effective for IBS and SIBO [52 Trusted SourcePubMedGo to source, 53 Trusted SourcePubMedGo to source].

Herbal antimicrobials have beneficial side effects and fewer risk factors when compared to antibiotic treatment. They are anti-inflammatory and possibly antidepressant [54, 55]. They can be effective for eliminating bacteria, fungi, and protozoa while antibiotics mostly work against bacteria [56 Trusted SourcePubMedGo to source].

Some SIBO patients relapse after antimicrobial and antibiotic therapy. For many patients, ongoing management of digestive function with probiotics, prokinetic agents, and/or a low fiber diet can help to prevent relapse.

Set Yourself Free from Constipation

Probiotics for Constipation: woman facing sunset light in the field

Constipation is uncomfortable, frustrating, and can be a lifelong struggle without the right advice. Many patients haven’t found much support in the conventional medical system, beyond the faulty advice to consume more fiber.

Your health depends on good elimination. Treatment of long-term, chronic constipation is possible. Start with the beneficial effects of probiotics and consider additional treatment recommendations if needed.

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