The Best Probiotics for Digestive Distress

You may have heard about the digestive benefits of probiotics—living bacteria found in yogurt and other products. Probiotics are considered “good” bacteria because they support digestive function and limit the growth of “bad” bacteria (see What You Should Know).

Probiotics are available in supplement form, but it can be daunting to choose from the numerous products you’ll find at most pharmacies and health food stores. Before you guess and grab something off the shelf, you should know that certain probiotic strains are most effective for specific health concerns.

“‘Strain’ is the key word,” explains Colleen Webb, RDN, CLT, a clinical nutritionist at the Jill Roberts Center for Inflammatory Bowel Disease at Weill Cornell Medicine. “Probiotic benefits tend to be strain-specific, so research findings from one strain cannot be generalized to other strains within the same species. There is no one-size-fits-all probiotic.”

Selecting the Right Probiotics

When using probiotics to treat health problems, look for specific strains proven to be effective with particular conditions.

For antibiotic-associated diarrhea and clostridium difficile (C. diff)-associated diarrhea, Webb recommends Lactobacillus rhamnosus GG or Saccharomyces boulardii.

For ulcerative colitis and pouchitis, Webb suggests VSL#3, which is a multi-strain probiotic.

For other gastrointestinal conditions and general health, Webb advises that you look for a broad-spectrum probiotic that contains a variety of bacterial species and strains that provide more than 5 billion microorganisms per dose.

“Products containing more than one organism offer a greater chance of success compared to single-strain products,” Webb says.

In order for probiotics to be effective, they have to survive passage through the gut, which offers a variety of challenges, including stomach acid and the action of bile salts. Pills have a better chance of reaching the intestines. Powders are more likely to work on the stomach lining.

Ensuring Effectiveness

Proper storage of probiotics is critical to their ability to improve your health. Many probiotics are meant to be refrigerated until they are consumed. Others are considered “shelf stable,” which means they can be safely stored at room temperature without losing their effectiveness.

“Probiotics can be shelf stable under normal storage conditions, but you should check to make sure the product was tested and certified to contain the dosage of live bacteria stated on the label,” Webb explains. “Look for labels that say ‘alive through expiration date.’”

Where to Buy Probiotics

Webb notes that you don’t necessarily need to buy your probiotics from a health food store or online supplier. She says the name brands sold at grocery stores or drug stores, such as Align and Culturelle, can be just as effective as the specialty varieties found in health food stores. The key is to check for testing by outside health laboratories.

“Regardless of where you buy your probiotics, quality control is always an issue with over-the-counter supplements,” Webb says. “Consumers are urged to select products that have been researched and tested by third parties.”

Probiotics in Foods

“Many people assume probiotic supplements are superior to foods, but that’s not always the case,” Webb explains. “Many fermented foods that contain live, active cultures also contain prebiotics, which are a special kind of carbohydrate that help nourish probiotics. Also, fermented foods, such as yogurt, provide an optimal environment for microbes to thrive, thereby enhancing their survival.”

Other foods that may contain probiotics include kefir, sauerkraut, kimchi, and kombucha. However, not all fermented foods are good sources of live bacteria, Webb notes. “Many commercial yogurts do not contain a therapeutic dose of beneficial bacteria, and most fermented vegetables are pasteurized, which destroys the good bacteria along with the bad. In addition, fermented foods do not offer strain-specific microbes, so they can’t be trusted for specific healing effects like carefully designed probiotic supplements that have been shown to produce specific clinical outcomes.”  

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