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Preventing & Treating Diarrhea With Probiotics

Probiotics have slowly moved from the field of alternative medicine into the mainstream, particularly for the prevention of antibiotic-associated diarrhea and the treatment of gastroenteritis.

After taking antibiotics, up to 40 percent of people experience diarrhea. Administering probiotics along with the antibiotics, though, may cut this risk in half. Which kinds and how much? Lactobacillus rhamnosis and saccharomyces boulardii appeared to be the most effective strains, and studies using more than 5 billion live organisms appeared to achieve better results than those using smaller doses. For example, taking 100 billion organisms seemed to work nearly twice as well as 50 billion in preventing antibiotic-associated diarrhea.

Of course the best way to avoid antibiotic-associated diarrhea is to avoid getting an infection in the first place. See, for example:

You can also avoid consuming antibiotics in your diet: Lowering Dietary Antibiotic Intake and More Antibiotics In White Meat or Dark Meat?

The second well-established indication for the use of probiotics is in the treatment of acute infectious diarrhea, shortening the duration of symptoms by about a day. We still don’t know the best probiotic doses and strains. Studies have used between 20 million organisms a day to 3 trillion, and there are thousands of different strains to choose from. Then even if you wanted a particular strain, odds are the label is lying to us anyway. Less than a third of commercial probiotic products tested actually contained what the label claimed. About half had fewer viable organisms than stated, and half contained contaminant organisms–including potentially pathogenic ones–as well as mold.

The mislabeling of probiotic supplements will come as no surprise to those who’ve been following my work. For example:

Ideally, we’d repopulate our gut with the whole range of natural gut flora, not just one or two hand-picked strains. This has been attempted for serious infections, starting back in 1958. Patients were given a fecal enema. Gut bacteria was taken from a healthy colon and inserted into the unhealthy colon. Or you can go the other route and administer the donor stool through the nose. Evidently, this route of administration saves time, it’s cheaper, and it’s less inconvenient for the patient.

Preferred stool donors (in order of preference) were spouses or significant others, family members, and then anyone else they could find (including medical staff). Doctors pick a nice soft specimen, whip it up in a household blender until smooth, put it through a coffee filter and then just squirt it up the patient’s nose through a tube and into their stomach. Don’t try this at home!

How receptive were the patients to this rather unusual smoothie recipe? None of the patients in this series raised objections to the proposed stool transplantation procedure on the basis that it “lacked aesthetic appeal.” †However, since production of fresh material on demand is not always practical, researchers up in Minnesota recently introduced frozen donor material as another treatment option. †All described in great detail in the latest review on the subject out of Yale entitled, “The Power of Poop.”

Another mention of frozen “poopsicles” can be found in my video Relieving Yourself of Excess Estrogen.

The above video is the first of a four-part series on the current state of probiotic science. See also:

In health,
Michael Greger, M.D.

PS: If you havenít yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: St. Murse via Flickr and†Eric Erbe via Wikimedia Commons

Bristol Stool Scale
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Boosting Gut Flora Without Probiotics

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Dr. Michael Greger

A founding member of the American College of Lifestyle Medicine, Michael Greger, M.D., is a physician, author, and internationally recognized speaker on nutrition, food safety, and public health issues. Currently Dr. Greger serves as the Director of Public Health and Animal Agriculture at The Humane Society of the United States. Hundreds of his nutrition videos are freely available at


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1:19AM PST on Nov 14, 2014

Thank you!

7:28AM PDT on Aug 28, 2013

Within the past year I added a probiotic to my daily vitamin regimen. Depending on the number and combination of organisms, I have noted positive results in both digestion and mental outlook.This was a great article and I viewed several of the videos as well. Thanks for not pushing a specific product with the article!

5:15PM PDT on Aug 11, 2013


2:20AM PDT on Aug 10, 2013


5:15AM PDT on Aug 3, 2013

Thank you Dr. Michael Greger, for Sharing this!

11:47AM PDT on Aug 2, 2013


8:13AM PDT on Aug 2, 2013

thank you

4:48AM PDT on Aug 2, 2013


3:48AM PDT on Aug 2, 2013

Not all viruses are bad

9:55PM PDT on Aug 1, 2013


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