How good are probiotics for constipation? Can probiotics cause constipation as well? Here is a detailed discussion the link between beneficial bacteria and hard stool especially at first in both babies and adults, best brands and reviews
Constipation is characterised by painful passage of stool less than twice a week. It could also be less than once every three days (H. Saneian and N. Mostofizadeh, 2012)[1]
Probiotics have been known to have a hand in the treatment of constipation. However, probiotics are naturally occurring organisms that are meant to be in the right population in your gut. The reason why the FDA has not approved the use of probiotics for the indications imposed on it is that it only replenishes the natural microflora and therefore does not work as a drug.
Only drugs can cure or treat the condition. Initially, about a decade ago, the use of probiotics was considered still under investigation. It still needed further study to make it more promising and large trials have therefore been done.
A recent study done though not to the standards of a large scale, placebo controlled, double blind study in October 2012, showed that in deed constipation can be managed with probiotics. This was done on its subjects comprising of pregnant women.
Until today, there has been much emphasis on the pertinence of probiotics in the management of constipation. Much less has been discussed concerning how and why some probiotics have caused constipation in some individuals.
At times constipation may occur as a side effect of probiotics. This depends on how you take it, the ingredients of the probiotic and the dosage among other functional defects. It has been found that most of the cases of constipation that people have complained about after taking probiotics is due to functional defects.
Fortunately, some studies, as discussed below have explained the relationship between functional constipation and an imbalance in the microflora of the gut.
Coupled with idiosyncratic reasons, choice, adulteration and wrongful use, the link between probiotics and constipation is a hard nut to crack but this article does so due to its extensive literature review.
Probiotics can cause constipation themselves. This has mostly occurred in individuals who have started taking them for the first time. This is a phenomenon of detoxification and cleansing believed to be the reason as to why you experience a constellation of gastrointestinal symptoms before your gut gets used to the new environment.
Constipation may occur with other signs and symptoms including diarrhea itself. This is described as paradoxical constipation. Fortunately, this constipation is self-limiting and with time and regular consumption. However, if you discover that your constipation is lasting longer than usual, then you will need to consult a medical professional for further tests.
Probiotics can cause constipation in both adults and babies. The following could be the reasons behind this:
Failure to figure out that your baby has an allergy perhaps to dairy products may lead to constipation when you feed him/her with probiotics. These include kefir and Young Coconut Kefir. While it is considered as one of the best probiotics to feed your baby with, it may act as an allergen leading to inflammation of the intestinal wall and therefore difficulty in passing stool.
Starting your baby on fermented vegetable pa se is good but if this is done in a non-tapering manner, your baby is likely to get constipated. Introduce the fermented vegetable as a juice and dip your finger in it then let your baby suck on it for a start.
As you know, colostrum contains the right mix of fats and proteins as nature provides. This may be hard to capture when it comes to probiotics. Enquire about how to blend probiotics with any other food or colostrum so as to prevent constipation from occurring. Some probiotics have fiber content that outbalances the potential to cause diarrhea.
At times, there might have occurred a diarrhea episode which may have led to dehydration. What follows is constipation and the stool hardens thereby conferring difficulty in the expulsion of stool.
take care to introduce your baby to fermented foods and drinks gradually. Feed them in small amounts. You could use the Russians’ technique whereby they introduce their babies to their native kefir as young as 4 months old. Acquire extensive information on the best time to introduce your baby to probiotics.
Probiotics can as well cause constipation in adults. This is addressed by the mechanisms similar to the aforementioned in the earlier sections.
Adults experience constipation rarely and when it happens then it is due to the wrong choice of probiotic chosen for the condition in question, an allergy to some of the ingredients in the probiotic, failure to take enough water with some probiotics that recommended so or an overdose. Adults are less a specialized case as compared to babies.
Probiotics can help manage constipation in a variety of ways. This is inclusive of:
Probiotics have been studies in elderly subjects. This study has been published in the Journal of Nutrition, Health, and Aging 15(3):215-20. It showed that laxatives were reduced in these subjects when they took probiotics and relieved constipation. This is attributed to the increased transit time and faster expulsion of colonic contents.
The gut sensorimotor system has been implicated by Barbara G, Stanghellini V, Brandi G, et al., 2005 as having a link to the commensals in the gut.
As further described by Quigley EM., 2011, mediators released by the gut immune response in the presence of these bacteria results in increased motility and therefore relief of constipation. This has also been shown to decrease straining associated with constipation.
Some strains of bacteria have been found in constipated patients meaning that these strains if included in the probiotic products, will be effective in the management of constipation.
The biggest culprits include the lactate-producing bacteria (Bifidobacteria and lactobacilli) and lactate-utilizing bacteria too. Delving in detail about the strains most implicated, some studies have found that a reduction in the H2-consuming populations, methanogens (Attaluri A, Jackson M, Valestin J, Rao SS., 2010)[2] and reductive acetogens is too a cause of constipation.
The presence of certain bacteria species allows the probiotic brands to elicit their effects against constipation. Some of these include: B. bifidum W23, B. lactis W52, B. longum W108, L. casei W79, L. plantarum W62 and L. rhamnosus W71.
All these strains are apparently the probiotics in the Winclove’s probiotic that was used in the study aforementioned in this material. There are others which are present in other brands and these are the Bifidobacterium spp and the E. coli.
It is rather convincing that Kim et al[3] published a study in the Journal of Neurogastroenterology and Motility indicating that upon use of real-time polymerase chain reaction (rt-PCR), Bifidobacterium and Bacteroides species were found to be in non-appreciable numbers. This means that they were reduced in population in patients with constipation.
The type of constipation described herewith is the functional constipation which is caused by the ‘ways’ listed earlier in this material. Strains that showed not changes and therefore indicative of little to no involvement included the Lactobacillus, Escherichia coli and Clostridium species as evidenced by the same study.
Taking probiotics for any condition depends on the colony forming units in the each dose. When you scoop one teaspoon or capsule, how many billions of bacteria does it provide and is it enough. Is it too little or an overdose?
Such information is provided for you on the label, the manufacturer’s official website and most importantly, your doctor or nutritionist. There are recommendations from other sources too apart from the aforementioned including one by The University of Maryland Medical Center.
This institution recommends 5 – 10 billion bacteria with a blend of L. acidophilus and Bifidobacterium. This is taken daily and is efficient in relieving constipation, gas and abdominal pain. Maintenance further requires 1 – 15 billion bacteria daily in the form of L acidophilus.
Note that it is important that you start with a lower dose then add up to see if you can still benefit from the probiotic and constipation relieved. This will help you prevent the constellation of side effects and further reduce their severity.
The frequency of consumption is most preferable in between meals but you could also take them when necessary. This means taking them after each episode of constipation until it is relieved and you can comfortably defecate.
Understanding how constipation can be alleviated is not enough. You should be able to choose wisely between arrays of brands of bacteria. Keen note has to be taken so as not to land on brands that are an adulteration.
Flora source is also known as Flora Probiotic Plus. It has microorganisms that replenish the imbalance of gut microflora and hence treat a variety of gastrointestinal conditions such as constipation.
It serves the digestive tract with 16 probiotics and 16 billion colony forming units. Its bacteria are actively dividing and hence highly viable.
Among the 16 probiotic strains is the Lactobacilli which apart from improving digestion has been shown to improve constipation. Bifidobacterium spp in this product improve bowel movement and aid in the expulsion of toxins from the colon.
It has 5 Bifidobacterium strains, the Bifidobacterium lactis HN019. Once used in a double-blind, placebo-controlled, 100 Person Poop-A-Thon, this product was fed to half of the 100 subjects and capsules with radio-markers swallowed. This product showed a 20 hours faster bowel movement than in those who took the placebo.
Here are the cons however:
Other online review platforms vote Flora Source as the best probiotic for constipation including Amazon with a 4 star rating and Trustedhealth.org among other platforms
Other strains that can be indicated for constipation include:
Sources & References
[1] H. Saneian and N. Mostofizadeh, “Comparing the efficacy of polyethylene glycol (PEG), magnesium hydroxide and lactulose in treatment of functional constipation in children,” Journal of Research in Medical Sciences, vol. 17, no. 1, pp. S145–S149, 2012.
[2] Attaluri A, Jackson M, Valestin J, Rao SS. Methanogenic flora is associated with altered colonic transit but not stool characteristics in constipation without IBS. Am J Gastroenterol. 2010;105:1407–1411. doi: 10.1038/ajg.2009.655.
[3] Kim SE, Choi SC, Park KS, et al. Change of fecal flora and effectiveness of the short-term VSL#3 probiotic treatment in patients with functional constipation. J Neurogastroenterol Motil. 2015;21:111–120. doi: 10.5056/jnm14048.
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