Can Probiotics Help Relieve Severe Bloating and Digestive Issues?

Can probiotics improve severe bloating?

Hello doctor, I have a severe bloating issue that makes my abdomen swell to the size of someone three months pregnant.
Aside from the bloating, I generally do not have any other noticeable discomfort, just frequent flatulence, although the gas often escapes without me feeling it.
This situation started suddenly one day, and I have not seen any improvement over the years.
My bowel movements occur about every 4 to 7 days, which I believe indicates constipation.
I have previously undergone a colonoscopy and consulted many doctors, but they only mentioned that my intestines are longer than average and advised me to avoid gas-producing foods, prescribing only stool softeners.
After researching online, I suspect that there may be an imbalance between harmful and beneficial bacteria in my intestines, so I am considering taking probiotics to see if my symptoms improve.
I would like to ask:
1.
Is it possible that the imbalance of harmful bacteria outweighing beneficial bacteria in my intestines is related to my condition? Or could there be other causes?
2.
The ingredients in "Xin Biao Fei Ming" and "Ruo Yuan Probiotic Tablets (White)" differ by only one component.
Which one would be more suitable for me? Xin Biao Fei Ming: Bifidobacterium, Enterococcus faecium, Lactobacillus acidophilus; Ruo Yuan Probiotic Tablets (White): Bifidobacterium, Lactobacillus rhamnosus, Lactobacillus acidophilus.
3.
I have seen online that some doctors recommend combining "Xin Biao Fei Ming" with "Ruo Yuan Gastrointestinal Tablets (Brown)" in a certain ratio.
Is this really advisable?
4.
I have started trying "Xin Biao Fei Ming" for a week, but taking three capsules after dinner has caused me to have diarrhea 2-3 times daily during this week.
The bloating issue has slightly improved, but the flatulence problem persists.
5.
Is it normal to experience diarrhea when taking "Xin Biao Fei Ming"? I read online that this is a Herxheimer reaction and is considered normal.
Is that true?
6.
Given my situation, should I take "Xin Biao Fei Ming," "Ruo Yuan Probiotic Tablets (White)," or "Ruo Yuan Gastrointestinal Tablets (Brown)"? How should I take them, and for how long?
Thank you.

Niming, 30~39 year old female. Ask Date: 2018/07/31

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, probiotics have not been clinically proven to be effective, but they can assist in the treatment of digestive issues such as bloating and diarrhea.
It is recommended to maintain a regimen with gastrointestinal medications and diet under the care of a gastroenterologist.
If necessary, you may add any type of probiotics, but the decision to continue their use should depend on the effects observed after use.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/07/31

More Info

Probiotics have gained significant attention for their potential benefits in alleviating digestive issues, including severe bloating. Your situation, characterized by pronounced abdominal distension, infrequent bowel movements, and excessive gas, suggests a complex interplay of gut microbiota, diet, and possibly other underlying conditions. Let’s address your questions systematically.

1. Gut Microbiota Imbalance: It is indeed possible that an imbalance between harmful bacteria (pathogens) and beneficial bacteria (probiotics) in your gut could be contributing to your symptoms. A healthy gut microbiome is crucial for proper digestion, nutrient absorption, and overall gut health. When the balance is disrupted, it can lead to issues such as bloating, gas, and constipation. Factors contributing to this imbalance may include diet, stress, antibiotic use, and other lifestyle choices.

2. Probiotic Choices: Regarding the two probiotic products you mentioned, both contain beneficial strains that can support gut health. The main difference lies in the specific strains included. "欣表飛鳴" contains Bifidobacterium, Enterococcus, and Lactobacillus, while "若元整腸錠(白色)" includes Bifidobacterium, Lactococcus, and Lactobacillus. Both formulations can be beneficial, but individual responses may vary. It might be worth trying one at a time to see which works better for your symptoms.

3. Combining Probiotics: Some practitioners suggest combining different probiotic strains to achieve a broader spectrum of benefits. However, it’s essential to approach this cautiously and ideally under the guidance of a healthcare professional. If you choose to combine them, start with lower doses to monitor your body's response.

4. Initial Reactions to Probiotics: It’s not uncommon to experience changes in bowel habits, including diarrhea, when starting probiotics. This can be part of the adjustment period as your gut microbiota begins to shift. The phenomenon you mentioned, known as the "Herxheimer reaction," can occur when the body reacts to the die-off of harmful bacteria, leading to temporary symptoms. However, if diarrhea persists or worsens, it’s advisable to consult a healthcare provider.

5. Normal Reactions: Experiencing diarrhea when starting probiotics can be normal for some individuals, especially if the dosage is higher than what your body is used to. It’s crucial to listen to your body and adjust the dosage accordingly. If diarrhea continues, it may indicate that the specific strain or dosage is not suitable for you.

6. Recommendations: Given your symptoms, starting with "欣表飛鳴" seems reasonable, especially since you’ve already begun this regimen. Monitor your response closely. If you find that your bloating improves but diarrhea persists, consider reducing the dosage or switching to "若元整腸錠(白色)" to see if it offers better tolerance. As for "若元胃腸錠(棕色)," it may be beneficial if you’re looking for a different combination of strains, but again, start slowly and observe your body's reactions.

In conclusion, probiotics can indeed play a role in managing digestive issues, including bloating. However, individual responses can vary significantly, and it may take some time to find the right product and dosage for your specific needs. It’s also essential to maintain a balanced diet, stay hydrated, and consider other lifestyle factors that may contribute to your symptoms. If your symptoms persist or worsen, seeking further evaluation from a healthcare professional is crucial to rule out any underlying conditions.

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