From the Guidelines
For managing diarrhea, I strongly recommend using Saccharomyces boulardii (250-500mg twice daily) and multi-strain formulations containing Lactobacillus rhamnosus GG, Bifidobacterium lactis, and Lactobacillus acidophilus (at least 10 billion CFU daily) as the most effective probiotic options, as supported by the highest quality study 1.
Key Points to Consider:
- Prebiotics, such as partially hydrolyzed guar gum (PHGG) at 5-10g daily or fructooligosaccharides (FOS) at 2.5-5g daily, can also be beneficial in managing diarrhea by providing food for beneficial gut bacteria and improving the intestinal barrier.
- It is essential to start with lower doses of probiotics and gradually increase to avoid temporary gas or bloating.
- Probiotics should be taken separately from antibiotics by at least 2 hours if you're on such medication.
- Staying well-hydrated and avoiding caffeine and high-sugar foods can also help in managing diarrhea.
- The regimen should be continued for at least 2-4 weeks for best results.
Mechanism of Action:
- Probiotics help by restoring healthy gut flora, competing with harmful bacteria, and strengthening the gut's immune function.
- S. boulardii specifically has strong evidence for reducing diarrhea duration, as shown in studies 1.
Important Considerations:
- While other studies, such as 1, 1, 1, and 1, provide some insights into the management of diarrhea, the most recent and highest quality study 1 supports the use of specific probiotic strains for managing diarrhea.
- It is crucial to prioritize the most recent and highest quality evidence when making recommendations for managing diarrhea.
From the Research
Probiotic Options for Managing Diarrhea
- Lactobacillus rhamnosus GG (LGG) has been shown to be effective in reducing the severity and duration of acute diarrheal episodes 2, 3, 4
- Saccharomyces boulardii has also been found to be effective in preventing and treating antibiotic-associated diarrhea and acute gastroenteritis 3, 5, 6
- Other probiotic strains such as Bifidobacterium lactis, Streptococcus thermophilus, and Lactobacillus reuteri have shown modest efficacy in preventing diarrhea 6
Prebiotic Options for Managing Diarrhea
- There is limited evidence on the use of prebiotics for managing diarrhea, and more research is needed to determine their effectiveness
Key Findings
- LGG and Saccharomyces boulardii have the strongest evidence for efficacy in managing diarrhea 3, 5, 6
- The use of probiotics can help reduce the duration of diarrhea by approximately 1 day 3, 6
- The effectiveness of probiotics is strain-dependent and dose-dependent 6