Are probiotics a good idea for lingering digestive ickiness?

December 14, 2014 6:47 PM

For the past several days, I've felt really queasy, especially after eating. Also, the general poop situation has been, um, less than solid. I'm assuming it's some kind of lingering food poisoning or stomach virus. Would probiotics be a good idea at this point? I've never tried them before.

My main concern is that I might cause additional digestive problems. Are over-the-counter probiotics the type of thing where the worst that can happen is that they don't work, or can they make things worse / do other bad things?

Other possibly relevant information: I have no appetite, but I've been forcing myself to eat little bits of applesauce and toast. Drinking cold sparkling water helps a little bit. It's not so bad that I have to stay home from work or cancel plans, but I just feel queasy and icky and would like this to stop.

posted by anonymous to Health & Fitness (18 answers total)

I eat yogurt on the theory that it has probiotics when this happens to me (usually I get struck by the poop situation, not the general nausea). It helps me! I like it as a quasi-lassi -- thin it out until it's drinkable, then blend with fresh mint and salt.

Your case sounds more severe though, and if I were you, I'd make a doctor's appointment before schedules start getting wacky for the holidays. Getting stuck in urgent care would not be fun.

Are you a person who could conceivably be pregnant? If so, have you checked that you aren't?
posted by Ragini at 7:02 PM on December 14, 2014

(I am not a doctor.) As far as negative effects go, I think it's very unlikely you will have any. That said, it's also very unlikely you'll have any positive effects, either. Probably you have some sort of infection, and probiotics don't really have any ability to kill other germs.

Much as I hate to say it, this is a case where you probably want to consider antibiotics. When I was in India this spring, the travel doc sent me with Cipro and told me to take it if I had diarrhea that didn't clear up within a day. I did, and took the Cipro, and was all better within twelve hours. Just make sure you take the whole course if you do this!
posted by goingonit at 7:02 PM on December 14, 2014

Best answer: OK, now I have done the lit review that I should have done a few minutes ago. References ahoy!

• It is very unlikely that you will have any negative consequences from taking lactobacillus (the main component in most probiotics) unless you are immunocompromised. You can tell how unlikely it is because doctors tend to write up case studies when they have even one or two people who develop infections from probiotics.
• Depending on what kind of bug is causing your symptoms, you may even be able to fight it just with lactobacillus! So I was wrong above. Evidence is limited, but (as above) unless you are immunocompromised it almost certainly can't hurt.

posted by goingonit at 7:17 PM on December 14, 2014 [2 favorites]

Liquid Kaopectate is your friend.
posted by harrietthespy at 7:20 PM on December 14, 2014

I haven't looked at the resources, but goingonit beat me to a referenced answer! In short, documented reports of harm are associated with a compromised immune system or specific genetic disease. Probiotics have shown a statistically significant mild-moderate positive effect on GI health post infection in children. One of the theories is that they prevent invasion by foreign bacteria and maintain balance within your gut depending on the species in the probiotics. We'll hear a lot more about new insights into the gut microbiome and probiotics over the next few years.

Keep yourself hydrated with some kind of oral rehydration solution rather than just water since you're not able to keep food down, and go see your doc if it's been 3-4 days and hasn't improved.
posted by palionex at 7:24 PM on December 14, 2014

When I'm not feeling well I like to drink kefir. It's like yogurt and has the same lactobacillus, but it's a little blander, more like a smoothie and it comes in nice, slightly sweet fruit flavors (I like the blueberry the most.) The fruit and the texture make it taste more like a drink than real food, plus if I have no appetite I figure the simple sugars are probably gentle for my digestive system but still get me some calories.

If everything goes completely to pot (heh) and you (heaven forbid) end up throwing up, it's also basically the least unpleasant food to throw up ever. Kefir and fresh mint tea are my go-to for all digestive upset, from, uh, either end.
posted by WidgetAlley at 7:27 PM on December 14, 2014 [1 favorite]

You probably need to see a doctor. But it wouldn't hurt to also get some yogurt (any kind containing active or live cultures in the ingredients) and see if it helps. You will know pretty quick. I have found that I really like kefir, which often comes in a lactose-free variety if that's an issue.
posted by zennie at 7:27 PM on December 14, 2014

If you decide to go the probiotic route, the brand that I've seen recommended on Metafilter and which was also recommended by our family doctor is Culturelle.
posted by alms at 8:29 PM on December 14, 2014

Best answer: IANYD. Just stopping by to point out that most acute diarrhea absolutely does not require antibiotics to be treated in general - in fact, most antibiotics also cause diarrhea…. I'm pretty sure you know this hence you're asking about probiotics. Supportive care/conservative treatment with hydration is very appropriate for acute diarrhea, i.e. increasing your fluid intake to make up for losses, particularly using oral rehydration solution or similar. Many people also find over the counter agents like kaopectate and Imodium to be helpful, although they should not be used in cases of bloody diarrhea and there are some other cautions to be aware of, they are generally useful for mild diarrhea.

Some doctors are quick to jump on treating traveler's diarrhea, in particular, with antibiotics (see goingonit's anecdote above, which is not unusual for a traveler). However, many sources still recommend treatment with hydration first unless there are special circumstances like fever or blood in the diarrhea. Enterotoxigenic E coli is the most common cause of traveler's diarrhea, whereas in the United States, norovirus is the most common cause of gastroenteritis (fancy medical jargon for food poisoning/stomach bug) - this is why traveler's diarrhea is treated differently.

You can absolutely go ahead with the plan to see your doctor, of course, and I would never discourage that - just wanted to dispel the notion that the reason for doing so would be because you definitely need antibiotics. And in my anecdotal experience, probiotics have never caused me any problem - I view them as generally benign, although there are a number of different types on the market and I'm wary of making any general pronouncements that they could not cause harm.
posted by treehorn+bunny at 8:34 PM on December 14, 2014 [5 favorites]

Ruling out any other issues, as someone who has had regular digestive problems, I have found that taking lactobacillus in some form has helped quite a bit in the past (I have done it regularly in the past although I'm not currently). However, I've never seen it as a way to cure something, but more of a preventative measure.

So ... maybe figure out what this is first and then decide if you need to do this. It doesn't seem to hurt anything, though, but I am not a doctor/etc. If this is an ongoing problem for you, it's not bad to decide to be on it regularly.
posted by darksong at 8:42 PM on December 14, 2014

That's how I felt when I had gastro; digestive enzymes helped a lot too (I took probiotics as well). Of course, YMMV/IANAD.
posted by jrobin276 at 9:03 PM on December 14, 2014

I've had good success in treating chronic digestive problems by drinking kombucha every day. I tried a bunch of other fermented foods, as well as probiotic supplements (not to mention many different prescription drugs), but kombucha is the only thing that helps me. I've been drinking it daily for about five years. If I miss a few days, I notice it.
posted by akk2014 at 9:15 PM on December 14, 2014

Nthing keffir. But maybe don't start with blueberry flavor, because sadly delicious blueberries can indeed make things worse (or better -- but in my case, even in keffir, it's for the worse). First try one of the many other fine keffir flavors.

Hope you feel better soon.
posted by feral_goldfish at 9:20 PM on December 14, 2014

(Just throwing it out there, since I don't see it mentioned, but if you don't get better after a while, you might go to the doctor and get them to check, among other things, to see whether you could have giardia.)
posted by gudrun at 10:13 PM on December 14, 2014 [1 favorite]

You absolutely can have negative effects from probiotics. The most common is people who have a poor reaction (gas, cramping) to probiotics that contain inulin as a prebiotic to jump-start the bacterial cultures. This doesn't happen to most people, but it isn't uncommon, either.
posted by deludingmyself at 11:13 PM on December 14, 2014 [1 favorite]

I have experienced negative effects from taking probiotics, even ones I've taken before. The effect is generally pretty mild (somewhat increased existing symptoms) and goes away as soon as I stop taking the probiotic. So I don't think there's a significant downside to giving it a shot.

Out of the probiotics my doctors have suggested I got the best results from Activia yogurt, followed by Culturelle. Align was highly recommended but it just made me feel bloated and uncomfortable. YMMV.
posted by fox problems at 5:59 AM on December 15, 2014

In Iran, they drink a mix of yogurt, salt, pepper and carbonated water. It tastes good, and I strongly believe it saved my life once.
posted by mumimor at 12:31 PM on December 15, 2014 [1 favorite]

Use only the probiotics that are kept refrigerated - the others are worthless. I buy acidophilus capsules, refrigerated, and keep them in the fridge. It only takes a couple to straighten out my bowel problems. The ones I get cost around $12 a bottle and they're nothing fancy, just plain-old acidophilus, live culture, refrigerated.

Good luck.
posted by aryma at 10:54 PM on December 15, 2014