I suffer from constipation. Do you think probiotics might help?

DEAR DOCTOR:
I suffer from constipation. Do you think probiotics might help?
DEAR READER:
Probiotics are living bacteria found in cultured foods, like yogurt, and in dietary supplements. They have long been touted for their ability to ease digestive woes.
The strongest evidence for probiotics is in treating diarrhea caused by a viral infection or from taking antibiotics. Our bodies are home to a mix of “good” and “bad” bacteria. Both infections and antibiotics disrupt the natural balance of bacteria in your gut. Probiotics can help restore this balance.
But the opposite problem — constipation — is more common than diarrhea. Yet many over-the-counter remedies for constipation, such as laxatives and stool softeners, aren’t all that helpful.
Researchers set out to determine whether probiotics work against constipation. They analyzed 14 studies that met their criteria for a well-done study. All were clinical trials that randomly assigned people with constipation to take either probiotics or a placebo (or other control treatments).
The researchers found that on average, probiotics speeded up “gut transit time” by 12.4 hours. They increased the number of weekly bowel movements by 1.3. And they helped soften stools, making them easier to pass.
There’s not enough evidence yet to recommend a specific probiotic for constipation. Until there is, experimenting on your own is probably a safe bet. Probiotics don’t seem to have any side effects, and they are generally considered safe.
Fermented or cultured dairy products are a good source of probiotics. These include yogurt and buttermilk. Other sources include miso, tempeh and soy beverages. The bacteria occur naturally in some of these foods. In other products, they are added during preparation. You can also consult with a registered dietitian who is familiar with probiotics.
Probiotics are also available as dietary supplements. You can find a variety of them on drugstore and supermarket shelves. Let your doctor know if you are using probiotics.
Whether or not you decide to try probiotics, eating more insoluble fiber should help your constipation. Insoluble fiber is found in the skin, peels and husks of fruits, vegetables and whole grains. It passes through your digestive tract without breaking down, creating “bulk” for your stools.
There also are various powders containing fiber available over-the-counter at any drugstore. In my experience, the type containing dextrin works better for many people than the type containing methylcellulose. Take them as directed on the package. Experiment — your gut will tell you what works for you. You may notice that you have more gas after starting these fiber powders, but that reaction usually goes away after a week or two. So stick with it.
A final piece of advice: if you have to go, go. Holding in a bowel movement, for whatever reason, may invite a bout of constipation. more