3 probiotics to take in the event of diarrhoea

What is diarrhoea, and what causes it?

A relatively common gastrointestinal disorder, diarrhoea is defined as the emission of stools that are more liquid and more frequent than usual (more than 3 per day), accompanied by an urgent need to have a bowel movement.

A distinction is made between:

• acute diarrhoea, which lasts less than two weeks. It is usually caused by bacteria (Salmonella, Escherichia coli), viruses (rotavirus, norovirus) or certain medicines such as antibiotics
• chronic diarrhoea, which persists for more than four weeks. It may be linked to chronic inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), food intolerances (lactose, gluten) or severe stress

Generally speaking, diarrhoea can be triggered by:

• infection by a pathogenic agent (virus, bacteria or parasite)
• antibiotics that upset the balance of the intestinal microbiota
• stress and anxiety, which modify the nervous and hormonal activity linked to the digestive tract, leading to faster transit
• food intolerances responsible for local inflammatory reactions
• chronic intestinal diseases such as IBD (chronic inflammatory bowel disease, including Crohn's disease and haemorrhagic rectocolitis), or IBS (irritable bowel syndrome), which is considered to be more of a functional disorder

In some cases, an imbalance in the intestinal microbiota is involved.

Its alteration, known as dysbiosis, can encourage the proliferation of pathogens, alter intestinal permeability or lead to inflammation of the mucosa, creating a breeding ground for digestive disorders.

It's important to remember that an episode of diarrhoea, however short or mild, can lead to complications such as dehydration, deficiencies and a weakened digestive system.

If symptoms persist for more than three days, it is advisable to consult a doctor.

What probiotics should I choose if I have diarrhoea?

As live microorganisms, probiotics help to maintain the balance of the intestinal microbiota. They could therefore be of real benefit in cases of diarrhoea.

The potential benefits of probiotics in cases of diarrhoea

Probiotics essentially refer to the ‘good bacteria’ that populate our microbiota (bifidobacteria, lactobacilli, lactococci, streptococci), as well as certain yeasts (saccharomycetes).

They are naturally present in some fermented foods such as yoghurt, kefir and sauerkraut, or are available in the form of food supplements.

Their effects on digestive health are now widely documented, and several strains are showing particularly promising results.

By acting on the balance of the intestinal microbiota, certain probiotics could be of real benefit in cases of diarrhoea.

Lactobacillus rhamnosus

There are numerous scientific publications on the benefits of Lactobacillus rhamnosus for different types of diarrhoea.

In particular, this strain is said to have the ability to survive in an acidic gastric environment and to implant itself on the intestinal mucosa, offering potential long-term benefits (1).

Some studies suggest that Lactobacillus rhamnosus could help reduce the duration of antibiotic-associated diarrhoea episodes (2), and even help prevent them (3).

Other research is also looking at its potential effects in cases of traveller's diarrhoea and acute diarrhoea associated with gastroenteritis (4).

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Saccharomyces boulardii

Saccharomyces boulardii is one of the most studied yeast strains in the world. Scientists are particularly interested in this probiotic for its potential effects on diarrhoea.

One study revealed that Saccharomyces boulardii could reduce the duration of the episode, the frequency of stools and the risk of recurrence within the following two months in children suffering from acute watery diarrhoea (5).

According to another meta-analysis, Saccharomyces boulardii is also of interest in the management of diarrhoea in adults, particularly in the prevention of antibiotic-associated diarrhoea and traveller's diarrhoea (6).

A randomised double-blind trial also showed that taking Saccharomyces boulardii in adults with acute viral diarrhoea could be associated with more frequent and faster improvement in clinical signs (7).

Find out more about Saccharomyces Boulardii, a highly dosed probiotic and a strain resistant to gastric acidity, proteolysis and antibiotics.

Lactobacillus reuteri

The researchers also looked at the potential effects of the Lactobacillus reuteri strain on diarrhoeal episodes of various origins.

It should be noted in passing that Lactobacillus reuteri has become rarer in the human microbiota since the 1960s, reflecting the negative impact of changes in our modern diet.

In hospitalised adults taking antibiotics, administration of Lactobacillus reuteri for 4 weeks significantly reduced antibiotic-associated diarrhoea (8).

Another study emphasises that Lactobacillus reuteri acts on intestinal homeostasis via various mechanisms: modulation of the microbiota, maintenance of the intestinal barrier, production of metabolites and immune regulation (9), etc.

Some strains are being studied in the treatment of infant colic (10), and could also be used as an adjuvant strategy in diarrhoea, constipation and H. pylori infection (11). Other potential applications in chronic digestive diseases remain to be confirmed.

Clinical data also suggest potential interest in antibiotic-associated diarrhoea, irritable bowel syndrome and chronic inflammatory bowel disease (12).

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Advice and precautions for using probiotics in cases of diarrhoea

Taking probiotics should be part of an overall approach to supporting the intestinal microbiota.

Their use is generally well tolerated. But in the event of persistent digestive problems, it is always advisable to seek the advice of a healthcare professional.

It is also possible to turn to multi-strain probiotic formulas to benefit from the complementary nature of different microorganisms studied for their interactions with the microbiota.

Discover Colon Friendly, a combination of 4 exceptional probiotics for a complete multi-strain formula: Saccharomyces cerevisiae (closely related to Saccharomyces boulardii), Bifidobacterium longum infantis, Bifidobacterium longum longum and Lactobacillus acidophilus.