Can Probiotics Cause Diarrhea or Chronic Diarrhea?

Key takeaways:

• Some people experience mild digestive upset, including diarrhea, when first starting probiotics.
• Knowing how to tell the difference between probiotic-related diarrhea and other causes can help to address symptoms.
• Understanding how to find relief can help you manage any discomfort such as diarrhea, gas, and bloating while taking probiotics.

Probiotics are live microorganisms that are introduced to the gut usually in capsule form. Species that are commonly used are Lactobacillus sp., Bifidobacterium sp., Streptococcus thermophilus, and Saccharomyces boulardii, among others.

Probiotics are widely used to support gut health and balance digestive bacteria, but some people may experience side effects, including diarrhea. If you’re having diarrhea while you are taking probiotics, it’s natural to wonder if the two are connected.

Let’s look at why probiotics can sometimes cause diarrhea, how to tell probiotic-related diarrhea from other causes and explore effective ways to find relief.

Is it normal to have diarrhea while taking probiotics?

Yes, it can be normal to experience mild diarrhea when beginning probiotics, especially if you are introducing a new strain or adjusting to a higher dose. Probiotics work by introducing live beneficial bacteria into your gut, which can change the existing balance of microorganisms that are already there. This change can result in a temporary adjustment period, leading to symptoms such as gas, bloating, and sometimes diarrhea.

Most cases of probiotic-related diarrhea are mild and go away within a few days to a week as your digestive system adjusts. However, if diarrhea continues or gets worse, it may be worth exploring with your healthcare provider whether it’s the dosage, the specific strain of probiotic, or it’s your individual response that is contributing to the issue.

How probiotics can cause diarrhea

Probiotics generally promote digestive health, but they can lead to diarrhea for several reasons:

• Gut flora adjustment: Introducing new bacteria to your gut can disrupt the existing balance, especially if you haven’t taken probiotics before. This adjustment period can sometimes cause temporary diarrhea.
• Overgrowth of certain bacteria: Some strains of probiotics may cause specific types of bacteria to become more active, which can lead to digestive problems in some people.
• High doses: Taking a large dose of probiotics can sometimes overwhelm your digestive system and can lead to an imbalance rather than promoting healthy intestinal flora.
• Individual sensitivity: People react differently to probiotics, and if you are sensitive to certain strains or types of probiotics, this may result in diarrhea as your body adjusts.

Most of the time these reactions are temporary, but understanding the causes can help you figure out whether adjustments to your probiotic plan may be needed.

How to tell the difference between diarrhea from probiotics and other causes of diarrhea

Telling the difference between probiotic-related diarrhea and diarrhea caused by something else is important in managing your symptoms. Here are some things to notice that can give you clues:

• Timing of symptoms: If the diarrhea begins within a few days of starting probiotics, it may be related. On the other hand, if you’ve been taking probiotics for a while and up until now you have not had a problem, the sudden appearance of diarrhea may be from another cause.
• Duration: Diarrhea from probiotics often goes away within a week or less as your body adjusts. Severe diarrhea or diarrhea that lasts longer than a week is more likely due to another cause, such as an infection or a food sensitivity.
• Associated symptoms: Diarrhea due to probiotics can come with mild bloating or gas. If you are having other symptoms like fever, vomiting, or abdominal pain, these could mean there is a different issue that requires medical attention.

If you’re uncertain, consider temporarily stopping your probiotics to see if your symptoms go away. Then gradually reintroduce them to gauge your body’s response.

Other common causes of diarrhea

While probiotics can be the reason for temporary diarrhea, there are many other potential causes to consider:

• Dietary changes: High-fat, spicy, or sugary foods can irritate your digestive system and lead to diarrhea.
• Viral and bacterial infections: Common stomach flu infections like the norovirus, or bacterial food poisoning can lead to diarrhea that lasts for several days.
• Medications: Antibiotics, certain pain relievers, and other medications can upset your stomach and result in diarrhea.
• Food intolerances: Intolerances to dairy, gluten, and other foods can cause you to have diarrhea when these foods are eaten.

Read our guides on different types of diarrhea and common causes of diarrhea for more.

When to see a doctor about diarrhea from probiotics

If you’re having diarrhea that you believe may be related to probiotics, keep in mind that it’s often temporary. There are certain times when you should get medical attention.

You should see a doctor if:

• The diarrhea continues for more than a week without improvement.
• You are having signs of dehydration such as extreme thirst and dry mouth.
• You are having other symptoms such as nausea, vomiting, or abdominal pain.

You should go to the emergency room if:

• You have signs of severe dehydration, such as dizziness, confusion, or your urine becomes scant and looks dark.
• Your diarrhea contains blood or appears black.
• You are having severe abdominal pain or abdominal pain with a fever.

Questions to ask your doctor about diarrhea from probiotics

If you’re experiencing ongoing diarrhea, consider the following questions to ask your doctor:

• Could the strain or dosage of my probiotic be causing these symptoms?
• Are there specific types of probiotics that may be less likely to cause diarrhea?
• Should I take probiotics with food to reduce side effects?
• Would it be helpful to temporarily stop the probiotics to see if my symptoms improve?

These questions can help you and your physician understand how you can use probiotics safely and comfortably.

How to treat or get relief from diarrhea from probiotics

Here are some steps you can take to find relief from probiotic-related diarrhea:

• Adjust the dosage: Reducing your dose of probiotics or taking them every other day can help your body to gradually adjust.
• Take with food: Taking your probiotics with meals can be gentler on your digestive system and help to reduce the risk of diarrhea.
• Hydration: Staying hydrated by drinking water or electrolyte solutions such as sports drinks or Pedialyte™ can help to prevent dehydration from diarrhea.

These adjustments can make your probiotic use more manageable and allow your body time to adapt.

Read our full guide on treating diarrhea for more.

Frequently asked questions: diarrhea and probiotics

When taking probiotics, you may have questions about their potential side effects. Here are answers to some of the most commonly asked questions:

Is diarrhea a sign of taking too many probiotics?

Yes, high doses of probiotics can sometimes overwhelm your digestive system, leading to diarrhea. Starting with a lower dose and gradually increasing it may help to reduce this risk.

How long does diarrhea from probiotics typically last?

Diarrhea related to probiotics usually goes away within a few days to a week as your body adapts to the new bacteria.

Can probiotics make diarrhea worse?

In some cases, probiotics may make diarrhea worse, especially if your body isn't used to that particular strain or if you have an underlying digestive issue. Lowering the dose or switching to a different strain of probiotic might be helpful.

Managing your symptoms

Probiotics are generally safe and beneficial for most people, but in some cases, they can cause mild side effects like diarrhea, especially when you first start taking them. Monitoring your body’s response, adjusting the dosage, and consulting your healthcare provider if your symptoms continue can help you find the right approach to using probiotics safely and effectively.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

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Kligler, Benjamin, and Andreas Cohrssen. “Probiotics.” American Family Physician, vol. 78, no. 9, 2008, pp. 1073–1078. https://www.aafp.org/pubs/afp/issues/2008/1101/p1073.html. Accessed 4 Nov. 2024.

National Center for Complementary and Integrative Health. "Probiotics: Usefulness and Safety." National Institutes of Health, https://www.nccih.nih.gov/health/probiotics-usefulness-and-safety. Accessed 4 Nov. 2024.

"Norovirus." Centers for Disease Control and Prevention, https://www.cdc.gov/norovirus/index.html. Accessed 4 Nov. 2024.

Office of Dietary Supplements. "Probiotics: What You Need to Know." National Institutes of Health, https://ods.od.nih.gov/factsheets/Probiotics-Consumer/. Accessed 4 Nov. 2024.