Just how effective are probiotics for relieving constipation?

February 28, 2020 9:02 AM

I started taking a Kroger Brand probiotic which has significantly improved my lifetime struggle with constipation, but at the cost of, uh, adding bulk. The probiotic has 27 billion lactobacilli and 3 billion bifidobacteria. My question is whether I should stick with the probiotic I'm using or try a different one? Also, Would a daily vitamin help? My diet isn't exactly fiber or nutrition friendly. Thanks.
posted by Beholder to Health & Fitness (18 answers total)

Usually adding fiber is most helpful, if accompanied by adding more water (just adding fiber supplements without water can stop you up). There's no evidence that I know of vitamins that help with constipation.

So the standard is advice is: Increase vegetables, fruits, whole grains and other fiber in your diet. Increase your water drinking. Ensure regular physical activity. There are also many fiber-added food products like cereal and bars you can eat that have additional fiber. If you get in the habit of having a fiber cereal with breakfast most days, drinking your water, and eating a fruit of vegetable with each meal, along with exercising, even just walking most days, maybe that will help?
posted by latkes at 9:10 AM on February 28, 2020

Seconding latkes, but also for times when all of that doesn't work, Miralax. It doesn't taste bad like fiber supplements, and works a lot better, in my experience.
posted by hijol at 9:13 AM on February 28, 2020 [1 favorite]

Response by poster: Well, I should have added that the problem only became unbearable after a subscription of antibiotics (for dental surgery) really did a number on my regularity. First too soft and now too dry. The probiotics help, but they also add bulk. I keep an eye on my carbs, so fiber bars would be a last resort.
posted by Beholder at 9:20 AM on February 28, 2020

The science behind "probiotics" as they are currently deployed in drug-store supplements is squishy, at best.

If you're watching carbs just in general and not with respect to diabetes or another diagnosed medical condition, you should at the very least be excluding insoluble fiber, which should allow you to consume, you know, many fruits and vegetables.
posted by praemunire at 9:31 AM on February 28, 2020 [6 favorites]

the bulk aspect might be temporary. Especially if you were constipated before.

I'd say stick with it, but I'm biased because probiotics help me a lot. The more variety of strains, the better. I like to rotate different brands. Unfortunately with probiotics, you tend to get what you paid for :(
posted by Neekee at 9:35 AM on February 28, 2020 [2 favorites]

Probiotics are fine and all, but IME you usually just need to eat more fruit and vegetables and go easy on animal protein. Lentils, chick peas, and avocados are all relatively high in dietary fiber, but still fairly low-carb. Raspberries have a decent amount of fiber. Whole grains are also less carby - real German pumpernickel for example, the kind that doesn't have any molasses or sweeteners. Oats are a miracle food.
posted by aspersioncast at 9:36 AM on February 28, 2020 [1 favorite]

Fresh sauerkraut and kimchi have lots of natural probiotics; I love them. If you're new to sauerkraut, simmer it with sliced kielbasa for 20 minutes. A friend adds white wine for palatability; I like it fine without. Kimchi is really good with rice, even a small amount is effective.

I have the same problem and I keep apricots around, eat fruit, and for breakfast I have oatmeal or muffins with bran, apricots and walnuts(I need the magnesium and like the protein). This is very effective.
posted by theora55 at 9:40 AM on February 28, 2020

You could try Magnesium Glycinate. My doctor recommended it to me for my migraines. I haven't had a migraine in over 4 months! Additionally, it has made my itchy winter skin, not itchy, and has also made me regular. Every morning regular. Initially, it can be a bit loose, but then became completely normal after about a week. I take 400 mcg per day. @00 in the morning and 200 in the evening.
posted by poppunkcat at 10:15 AM on February 28, 2020 [2 favorites]

Maybe ear a bit of veggies, low carb. Once you get a lot of good bacteria in your diet, you may not need the supplement anymore. You could try cutting it back while adding a couple servings of veggies and hitting the water hard. Maybe you can get off the probiotic.
posted by Kalmya at 10:32 AM on February 28, 2020

Live update from the field--be careful with the magnesium. Start slow. I took two tablets for a calming effect at night, but then had a bad experience at WORK the next morning.
posted by 8603 at 11:19 AM on February 28, 2020 [1 favorite]

If you're new to sauerkraut, simmer it with sliced kielbasa for 20 minutes.

Wouldn't this defeat the purpose of eating a fermented food for its probiotic qualities?
posted by fiercecupcake at 11:51 AM on February 28, 2020 [6 favorites]

If you can tolerate it, take a spoonful of inulin-based (soluble) dietary fiber. It should be available next to the Metamucil.

The idea with inulin is that you're feeding and promoting the growth of the "good" bacteria already in your gut instead of eating more "good" bacteria to populate your gut.
posted by porpoise at 12:46 PM on February 28, 2020 [1 favorite]

I definitely had an overabundance of probiotics in my gut which led to the exact problem you did. What you also need are prebiotics (i.e. fiber the body can't digest), which give the probiotics something to eat. I started eating oatmeal in the morning, which basically solved the problem immediately for me. There are a ton of options if you google "prebiotics". Another extremely easy option is reheated potatoes.
posted by thebots at 12:48 PM on February 28, 2020 [1 favorite]

It's possible to get fiber without carbs; dark leafy greens, cucumbers, cabbage all help, or straight psyllium husk.
posted by Pastor of Muppets at 10:48 PM on February 28, 2020

The best thing I ever did to keep regular was drinking warm water and lemon juice first thing every morning. If I miss a few days, the irregularity starts again.

Just juice one lemon (or half if they're really big), add juice (and pulp for extra fibre) to an 8oz glass, and top up with a little boiling water so it's just warm.

Make sure you swish your mouth out with a sip of plain water afterwards to rinse the acid off your teeth, to protect your enamel.

This 3 mins every morning changed my life and others I know swear by it too.
posted by Zaire at 1:50 AM on February 29, 2020

Miralax did this to me, so it's not necessarily benign long-term.

What finally fixed my gut after years of increasing trouble: 4 back-to-back rounds of this probiotic plus 2/day of this probiotic, limited carbs, and plenty of veg; then maintenance with 1/day of the Ther-biotic and plenty of veg and fruit. Pooping is underrated and magical, I tell you. Helped some with my anxiety, too.

My doc recommends rotating probiotics, FWIW. Inulin will probably help, too. Lots of veg, fruit, various fibers and low-dose probiotics alone didn't cut it for me.
posted by moira at 11:12 AM on February 29, 2020

For a probiotic/fiber combo, you could take psyllium (flea seed) husk (for a fibre shot) with plain/greek yoghurt, if you like yoghurt, or kefir, which is even better. You can get plain kefir at the supermarket, as well as a range of flavored/sweetened varieties.
posted by carter at 5:35 PM on February 29, 2020

My love has an ostomy, coupled with chemo, his digestion gets slow and constipation can be a painful result. We have found that moving his large meal to noon and only having a light breakfast and dinner help immensely. We also limit dense proteins like steak and pork to once a day at lunch. He rarely eats chicken (dislikes)
He has some issues with veggies but a salad with spinach is a common dinner. So is white fish with a rice and veg. But a smaller lunch size portion. He does snack and sometimes does that instead of eating dinner if lunch was large or late.
And drink lots of water and if needed, Miralax.
posted by ReiFlinx at 11:18 AM on March 1, 2020