Probiotics for treatment of diarrhea
Pro Research Analysisby 
Searched over 200M research papers
Probiotics for Diarrhea Treatment: Effectiveness and Key Strains
Probiotics and Acute Infectious Diarrhea: General Findings
Multiple studies have shown that probiotics can help reduce the duration and severity of acute infectious diarrhea, especially in children. Several large reviews and meta-analyses found that probiotics, when used alongside standard rehydration therapy, can shorten the duration of diarrhea by about one day and may increase the likelihood of clinical cure, though the effect size is generally small and the certainty of evidence is low to moderate due to high variability between studies 1356. However, some recent high-quality analyses suggest that probiotics may make little or no difference in the number of people with diarrhea lasting more than 48 hours, and the evidence for reducing overall duration is uncertain 45.
Most Effective Probiotic Strains for Diarrhea
Among the many probiotic strains studied, certain types have shown more consistent benefits:
- Saccharomyces boulardii and Lactobacillus rhamnosus GG are the most frequently cited as effective for reducing the duration and severity of acute diarrhea in children, including cases caused by rotavirus 236.
- Lactobacillus reuteri and Bifidobacterium lactis have also demonstrated significant reductions in diarrhea duration compared to placebo .
- Multi-strain combinations, such as Lactobacillus spp. plus Bifidobacterium spp. plus Saccharomyces spp., have shown some benefit, but single strains like S. boulardii may be the most effective .
Probiotics for Antibiotic-Associated Diarrhea (AAD)
Probiotics are particularly effective in preventing and treating antibiotic-associated diarrhea. Meta-analyses and systematic reviews indicate that probiotics, especially Lactobacillus rhamnosus GG and Saccharomyces boulardii, can nearly halve the risk of AAD in both children and adults, with no significant increase in adverse events 8910. Lactobacillus casei is noted as especially effective for cases associated with Clostridium difficile infection .
Mechanisms and Additional Benefits
Probiotics may help by restoring the balance of gut microbiota, boosting immune responses, reducing inflammation, and increasing beneficial bacteria like Bifidobacteria and Lactobacillus in the gut. These effects can lead to improved symptoms, reduced intestinal inflammation, and better overall gut health during episodes of diarrhea 678.
Safety and Recommendations
Probiotics are generally considered safe for most people, including children, with very few serious adverse events reported in clinical trials 49. However, the effectiveness can depend on the specific strain, dose, and patient population. There is still a need for more large-scale, high-quality studies to determine the best strains and dosages for different types of diarrhea and patient groups 45.
Conclusion
Probiotics, especially Saccharomyces boulardii and Lactobacillus rhamnosus GG, are useful adjuncts to standard therapy for acute infectious and antibiotic-associated diarrhea, particularly in children. They can modestly reduce the duration and severity of symptoms, though the overall certainty of evidence is low to moderate due to variability in study designs and probiotic regimens. Probiotics are safe for most people, but more research is needed to identify the most effective strains and optimal use in specific populations.
Sources and full results
Most relevant research papers on this topic