Can Probiotics Cause Acid Reflux?

Written by: Kari Raman, PharmD, RPh
Published August 7, 2023

A question came up at the pharmacy (I’m a practicing pharmacist) that I hadn’t heard before – a patient asked if probiotics could cause acid reflux. That’s not something I’d really think that they could do, since probiotics are beneficial bacteria and yeasts that are meant to promote a healthy gut microbiota. These living microorganisms can aid in digestion, bolster immune health, and provide numerous other benefits for some people. However, if you have stomach and gut issues, and start taking them, I can understand if you’d want to know if they are contributing to your acid reflux. In this article, we’ll delve into the topic of “probiotics and acid reflux” and shed light on recent scientific findings.

Let’s directly answer the question first.

Can probiotics cause acid reflux?

After reviewing the medical literature, I would not expect a high-quality probiotic supplement to cause acid reflux. When you first start taking a probiotic there may be an adjustment period, as the bacteria (and possibly yeasts) begin to colonize your gut. During this period, which may be a few days, you may experience some bloating or gas. 

If you’ve started to experience acid reflux after beginning to take one of these supplements, I would probably advise you to stop taking the supplement and consult your physician. If you’ve only started taking them, I would expect the probiotics to only stay in your system for a short while, so if they were truly causing the discomfort then the issue should resolve quickly. If you were taking them for a while, it can be up to three weeks or so before they are no longer in your gut. 

But again, I haven’t seen anything in the medical literature that suggests that they may cause this problem, and I did find some research that suggests it may help some people improve their symptoms. 

What is Acid Reflux?

Acid reflux, often referred to as gastroesophageal reflux disease (GERD), is a common condition where stomach acid flows back into the esophagus, causing a burning sensation in the chest, known as heartburn. It can also result in regurgitation and dyspepsia. The Mayo clinic has a good write up on it here.

Understanding the symptoms

The main symptoms of acid reflux include heartburn, a sour or bitter taste in the mouth, regurgitation of food or sour liquid, and difficulty swallowing. Some people may also experience symptoms like chronic cough, laryngitis, or asthma-like symptoms.

What Role Do Probiotics Play in Acid Reflux?

Your gut has an entire microbiome of bacteria, yeasts and more living in it! In a healthy person, these little critters are held in balance and help digest our food, keep our gut healthy and may even help with things outside of the gut like the immune system and our general happiness levels/mood. Probiotics play a crucial role in maintaining our gut health by keeping a balance in the gut microbiota. They can potentially prevent harmful bacteria from settling in the gut and producing too much acid, which can contribute to acid reflux.

A Systematic Review on Probiotics and GERD

A recent systematic review published in the PubMed and Web of Science databases examined the efficacy of probiotics in alleviating the frequency and severity of symptoms in GERD. The review included 13 prospective studies published in 12 articles. According to the Jadad scale, the quality of these studies ranged from high to low. 

The review found that 79% of the included studies reported positive benefits of probiotics on symptoms of GERD. These benefits included improvements in reflux symptoms, reduced regurgitation, and alleviation of dyspepsia symptoms. Probiotics also led to improvements in other upper gastrointestinal symptoms, such as nausea, abdominal pain, and gas-related symptoms like belching, gurgling, and burping.

In conclusion, the systematic review suggests that probiotics can be beneficial for GERD symptoms, including regurgitation and heartburn. However, the authors of the review also emphasized the need for further placebo-controlled, randomized, and double-blinded clinical trials with a sufficient number of participants to confirm the efficacy of probiotics in alleviating these symptoms. The species that seemed to be most helpful in the studies analyzed were Lactobacillus and Bifidobacterium, two of the most common ones included in the most popular supplements. . 

Can Probiotics Cause Acid Reflux?

Based on the current scientific evidence, probiotics are not known to cause acid reflux. In fact, they might help manage its symptoms. However, like any supplement, probiotics can affect different individuals in various ways, and the possibility of unusual side effects can’t be completely ruled out.

It’s crucial to consult with a healthcare provider before starting any new supplement regimen, especially if you have existing health conditions or if you’re currently on medication. And, again, if you start taking a supplement and find that your condition gets worse or you start having new symptoms, stop and talk to your doctor.

I’ve also written about apple cider vinegar and probiotics, which some patients try to use together to help manage complicated problems like GERD. I’d strongly recommend you talk to your doctor before trying to fix the problem yourself. 

Using Probiotics for GERD

For those interested in trying probiotics to manage their GERD symptoms, it’s important to choose a probiotic that contains strains known for their gut health benefits. Consultation with a healthcare provider or a pharmacist can provide personalized advice based on your unique health situation. I’ll review some of the most popular products later, but for now suggest looking for a product that has several different bacteria such as Bifidobacterium, and Lactobacillus. 

Typically, probiotics are taken in doses ranging from 1 to 10 billion colony-forming units (CFUs) per day. However, the optimal dose can vary depending on the specific strain of probiotic and the individual’s health status. It can take several weeks for them to begin working, so don’t expect immediate results, and consistency is important. 

What are Probiotics?

Inside our bodies, specifically within our gut, resides a complex community of microorganisms, often referred to as the microbiome. This rich ecosystem contains bacteria, yeasts, and other tiny entities that play a pivotal role in our health and well-being. A significant function of the microbiome is to aid in the digestive process, breaking down foods that our bodies cannot digest on their own, which is why my patients sometimes ask me about bacterial supplements when they are worried about acid reflux.

But, that’s not all your gut’s little ecosystem can do. These microorganisms are essential defenders against harmful invaders, and they even assist in the production of essential vitamins. Moreover, the gut microbiome seems to play a critical role in regulating our immune responses – research is still emerging, but it’s pretty interesting (if you are a science nerd who works at a pharmacy, I guess). A balanced microbiome not only ensures optimal digestion but also contributes to other vital functions, such as regulating inflammation and influencing mood and behavior.

The supplements that aim to introduce or maintain beneficial microorganisms in our gut are designed to support this delicate balance, enhancing overall health and ensuring our bodies function at their best. When considering these supplements, it’s essential to recognize the value of maintaining this natural balance for overall well-being.

Wrapping Up

In conclusion, while probiotics aren’t known to cause acid reflux, they might help manage its symptoms based on some scientific studies. More robust clinical trials are needed to definitively confirm these findings. As always, consult with your healthcare provider before starting any new supplement regimen, including probiotics. The overall goal is to improve gut health, potentially alleviate GERD symptoms, and promote general well being.

Other gut health articles

Digestive issues like constipation and diarrhea can sometimes be improved with the right bacterial or yeast supplements, although this doesn’t work for all patients. Here is my article on constipation, and here is my article on diarrhea. Having either of these be a chronic problem can really, really impact the quality of your life, so if you are having these issues I strongly suggest you talk to your doctor to see if they can help. Also, explore my comparative review of two super easy to get probiotics—Florastor and Culturelle—typically advised during antibiotics administration to mitigate diarrhea risks.

From what my patients at the pharmacy tell me, that get a lot of varied guidance on consumption and how to take bacterial and yeast supplements. To set the record straight, I’ve sifted through extensive research, culminating in my pieces about the best time of day to take probiotics, and insights on how long they take to work. Queries such as how long they stay in your system, how many you can combine, are also topics I’ve written about.

Pharmacist Kari Raman

I’m Kari Raman PharmD, RPh, and I am a licensed, practicing pharmacist. I hold a Doctorate in Pharmacy from The University of the Pacific, and I’ve served patients in retail, compounding and hospital pharmacies.

Probiotics are confusing!

One of the most common questions I get asked by patients is about probiotics. And the truth is, probiotics are not as well understood by the healthcare community as they should be.

So I’ve been reading a lot of probiotic clinical trials, and sharing what I’m learning here.

I hope Pharmacist Probiotics helps you find out if there is a type of probiotic that works for you!