Doctor's Note

This is the first of my four-part video series on the current state of probiotic science. Next up is Preventing the Common Cold with Probiotics?—in which their effect on immune function is explored.

Of course, the best way to avoid antibiotic-associated diarrhea is to prevent the need for antibiotics in the first place—by avoiding infection. See, for example:

You can also avoid consuming antibiotics in your diet; see Lowering Dietary Antibiotic Intake and More Antibiotics In White Meat or Dark Meat?

Another mention of frozen “poopsicles” can be found in Relieving Yourself of Excess Estrogen.

The mislabeling of probiotic supplements will come as no surprise to those who’ve been following my work. For example, see:

I also have many other videos on probiotics; for example, see Boosting Good Bacteria in the Colon without Probiotics.

For more context, check out my associated blog posts: Probiotics & DiarrheaProbiotics During Cold Season?How Should I Take Probiotics?; and How Probiotics Affect Mental Health.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

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  • Veggivet

    I think I’ll reserve my Vitamix for fecal-free smoothies, thank you!

  • Plantstrongdoc

    Fecal enema? Donor stool through the nose? Preferred stool donors were spouses (that must be love!)

    I prefer diarrhea and the can…..

  • Thea

    OK, I’m seriously grossed out.

    After the shock and disgust has died down a bit, I have to say that the important part of this video, and the reason I am so glad I listened, is in the middle where Dr. Greger told us how often the probiotics sold in stores do not actually contain what they say. And often even contain harmful contaminants. I long suspected such might be the case, but am still saddened to hear that it’s true. Since so many people are buying those probiotics, I wish this information was widely disseminated to the public.

    • Help your body make your own probiotics by eating lots of raw fruits and veggies.

  • Thea

    I also wanted to share another concern/question I have: I’m a big, big fan of the recipes in the book, Artisan Vegan Cheeses. SO yummy!

    But those recipes start out with me essentially making my own probiotic. It is called rejuvalac, and I have been making it with quinoa (which works relatively fast). I have been making some delicious cashew-based cheeses, but I have no way of knowing if or when the little guys in the rejuvalac turn evil. I presume that the bacteria that develop in my rejuvalac come from a) anything that is on the (organic) quinoa itself and b) anything that is in my air and water.

    I haven’t keeled over yet. But I wonder, how healthy is it? Is there some way to tell when the bad organisms outweigh the good.

    On a different, but similar line of questioning: One of the key steps in the cheese making is where the rejuvalac-cashew mixture is left out to ferment. The word “ferment” is actually used in the book. I presume this includes the backeria in the rejuvalac having lots of time to breed. Is that what fermentation is? What I’m thinking of, is Dr. Greger’s previous videos on effects of drinking wine on our health. I wonder, do those effects apply to eating cheese too? Since it is fermented? Just wondering.

    • LynnCS

      Great post. I haven’t tried it yet, but learned of this method from Green Smoothie Girl. She didn’t show making the cheeses that I could see. Just drank it, which is ok too. Rejuvilac comes from the Ann Wigmore Institute. I’m looking forward to trying this. It appeals to me more in the form of a “cheese.” I do like to limit my use of nuts, so will see how it all works. Thanks for the update and the book title. Lynn

      • Thea

        LynnCS: Thanks for your nice feedback.

        re: limiting nuts
        I’m in a similar position in that I get too many calories and thus cutting down on some calorie-dense foods like nuts would be a good idea for me. For the most part, I stopped making these cheeses, because I thought they were so delicious, and I didn’t have a working “stop button.”

        But I think the cheeses are still great for special occasion treats and serving to guests.

        Good luck!

    • Did you ever find out the answers to your questions Thea?

      • Thea

        Scott: No. These aren’t super-burning questions for me. So, I didn’t even remember that post. But in thinking back on it, I don’t remember seeing answers over the intervening years. Now I’m curious again.

        Update: I still love those cheeses, but I know better than to make them too often, because I have a hard time eating those very calorie-dense foods in appropriate amounts.

  • B

    Oh my! This gives hole new meaning to…Eat Sh*t! And who wants to be the “Stool Pigeon” for this one? Thank goodness it’s Evidence Based ;)

  • charlotte

    If you have ever had c-diff, which I had, the thought of using the power of poop is just a way to get rid of something that is much worst than the thought.

  • Blanster

    What I don’t understand about these companies producing supplements and probiotics that are falsely labeled is why someone doesn’t sue them for false advertising or something along those lines. Don’t we as consumers have any protection that what the label says is what we’re actually getting? Any attorneys care to comment?

    • Thea

      Blanster. Thanks for your post. I’m not an attorney, but I fully support your sentiment!

  • Wouldn’t this give you a bladder infection? Fecal matter is not meant to go through your digestive track (tract?). That’s why we wash our hands after we poop and before we make lunch. (yeah, and keep it AWAY from the blender!)

  • Kim Glasson

    Disturbingly, we found that only 4 of 13 products (31%) were in accordance with label claims.

    Is there a way to find out which 4 products were in accordance with label claims?
    Thank you

  • HemoDynamic, M.D.

    I love the effective use of pauses that Dr. G used to emphasize how and where they derived the stool samples.
    Great detective work! Sniffin’ out the bad guys just like a Blood Hound!

  • Loren Barrett

    Poop is called waste for a reason; It should be eliminated from the body. The idea of putting it back in the body is absolutely disgusting. Surely, there must be better alternatives to populate the digestive system with probiotics.

  • Lara

    The whole probiotics thing confuses me. I thought we needed more bacteriodetes and less fermicutes – yet all the probiotic strains in products i looked up were fermicutes. Won’t that tip the balance the wrong way…?

    • Lara

      sorry, excuse my spelling – I mean Firmicutes and Bacteroidetes (knew I should have looked them up before typing the comment!)

      • I suspect the strains are chosen based on those in the general population. And yes, Bacteroidetes (favored by vegan diets) are better, as gram-negative Fermicutes may provide a dose of endotoxins with every meal containing saturated fats.

        • Veganrunner

          That first review cited above is so interesting. The role the gut microbiota might play in obesity is fascinating. And how quickly our gut bacteria can change amazing! Within 24 hours it can be a whole new population! Good read.

  • Shreela

    What happens to the NG transferred bacteria while in the stomach acid? I’ve read concerns about taking probiotic pills that weren’t enteric coated because of stomach acids.

    And to be honest, although both sound unpleasant, I’d choose enema over NG tube any day. I’ve read that slow-drip, retention style enemas supposedly don’t trigger the need to empty one’s bowels.

  • md

    Simply put, this video is a total waste of time. I utilize this website to be informed not amused. In no way are any of us more informed about making a practical decision to use or not use probiotics from having watched this video. In regard to probiotic use, is way more helpful – though they do charge a small membership fee for the year. Sorry Dr. Gregor, I am a fan but you really struck out on this one.

    • Veganrunner

      I respectfully disagree. We learned that there is still much to learn about probiotics. That actually is important. They are worth trying with patients but may not make a difference. The fecal part is Dr. Greger’s humor. Must we always be stuffy and professional?

      • fineartmarcella

        Actually, fecal transplants save lives for those with resistant CDiff, it is a medical treatment!

      • Donna Brewster

        I have read about fecal transplants for months now. Great to have more detail on what is a life-saving procedure for some people. Would I choose the enema or the nasal method? Not sure, but I absolutely know I would choose this treatment if it could save me from a c. diff. infection. I love the practicality of it and, it works. Kudos to the people who came up with this! I agree that Dr. Greger’s humor makes it entertaining, as well as educational!

    • Plantstrongdoc

      I am here for the info AND to be amused. Dr G has a great sense of humor.

    • Blanster

      Sounds like Consumer Labs has a real conflict of interest in how it conducts its business. I’m all for finding out which supplements are what they say they are, but I don’t believe I’ll trust a company that takes money from both consumers and the companies it’s rating.

      I belong to Consumers Union and they don’t let companies pay for reviews like Consumer Labs evidently does.

  • potteryjunky

    I turned it off after hearing about “picking a nice soft specimen” (turd) and about to put it in the nose … no thank you. TMI.

  • Verdad

    I find the video misleading since I seen the same procedure in another video
    and the fecal matter was injected in the colon and not through the nose.

    • Veganrunner

      Verdad go to sources cited above. There all the articles referenced are listed for you to read. It was through the nose.

    • Lucypi

      Both methods are used depending on the circumstances and what results are being hoped for.

  • Tim

    Isn’t this a method for getting vitamin B12 too?

    • Toxins

      Yes it is, but only a single dose.

      “In one of the less appetizing but more brilliant experiments in the field of vitamin b12 metabolism in the 50’s, Sheila Callender (7) in England delineated that human colon bacteria makes large amounts of vitamin B-12. Although the bacterial vitamin B-12 is not absorbed through the colon, it is active for humans. Callendar studied vegan volunteers who had B-12 deficiency disease characterized by classes megaloblastic anemia. She collected 24-h stools, made water extracts of them, and fed the extracts to the patients, thereby curing their vitamin B-12 deficiency.”

  • HereHere

    How on earth did this study pass an ethical review board? How could none of the patients object? I think you are going to get a huge dose of e.coli amongst the other probiotics. I’d rather go with isolated probiotics or none at all. Tough to say if you’ve been exposed to antibiotics, but I remember my uncle leaving cheese on the top of the fridge to get more rank, thinking this would build his intestinal flora. This was some 25 years ago!

  • Dave in CT

    Believe me, someone with a bad case of UC (or even a mild case) would be the first person in line for an enema. Transplanting a normal gut population back into a sick one sounds like a rational idea. The only issue I have with Dr. Greger is that he didn’t reveal the RESULTS of the studies he showed us! He usually caps off a topic with the Aha! moment- when he shows us the results that back his point. No such moment here. We’re left to track down those articles via PubMed or Sage or DeepDyve. C’mon Doc! No teasers!

  • Evy

    poop, there it is
    poop, there it is

    • Lloyd

      LOL, clever.

  • Lloyd

    Bravo Dr. Greger. Bravo… poop. I mean bravo plant foods that make good poop.

  • liowik

    Dr. Gregor, have you figured out from the studies which was the most
    accurate brand of probiotics to take? What’s your recommendation?

  • remuss

    Dear Dr. Greger.

    I have question not strictly related to this topic but still there is some connection to the enema. I would like to know if there is some scientific information about the enema itself. For example it is bad idea or even dangerous to do shallow enema after excretion? Respectively douching the region between anus and rectum with the help of the shower head? Does the warm water from boiler pose a threat to the health? Should be used only boiled water? And what about oxygen or other gases which could be introduced into the rectum or further? I thing it is know fact that the rectal mucous membrane is much more sensitive, with non regulated absorption and without defense mechanism in compare to the gastric membrane. What do you think?

    Thank you in advance.

    • Larry Hoberman

      Hi Lara: The important thing to remember about taking a probiotic: Be sure to take one containing multiple species of bacteria, as your gut needs to maintain the proper balance of bacteria to stay healthy and boost your immune system. Most high-quality probiotics contain the right balance.

  • Adam

    Does anyone have opinions on a probiotic like this? I’m on some anti-biotics and would like to keep my floral health good.

    I can’t find many reviews on this stuff.

    • TCB Health

      I am not familiar with that brand and there are many out there, making it difficult to figure out which to select. It looks like a suitable option, if you want to try that one. Align is a good one and is available in local pharmacies. (I suggest Align not because of any connection to the company, but because of personal experience.) This article offers some good information:

    • fineartmarcella

      What’s difficult is that they are in the process of dying as soon as they leave the factory. How long have they been on the shelf? Even in the refrig they are decaying. If you want to know if your probiotics are still good, put a little sugar water or milk in a saucer then dump the probiotic capsule into the mix. By morning the good probiotic will be gel, the dead will not.
      BTW, there are zillions upon zillions of probiotics in a healthy gut, you would be wasting your money to buy a probiotic that has only 1 or 2 billion probiotics in them, might as well lick the back of your hand and be done with it. Always get a brand that has at least 50 -100 billion per cap. The best and cheapest way is make your own Kefir water. Last time my mother was having a painful GI disturbance, the Kefir water quieted it down within minutes

  • norman123

    How about yogurt in diet? Does it enhance, decrease or makes no difference in well being?

  • fields4ever

    Has there been any research related to probiotic use by people without a large intestine, which work best, etc? Or how to treat diarrhea when there is no colon? Due to cancer, I had a total colectomy and an ileostomy in 1980 and stopping the diarrhea once it starts is very difficult. Any useful information would be appreciated.

    • fineartmarcella

      Most probiotic activity goes on pre-colon, in the small intestines, so I would think that taking high dose probiotics (at least 100 billion) or drinking a cup of Kefir Water every day would really help. The Colon’s main purpose is to absorb water out of the contents, it doesn’t have much more of a function, so the probiotics should help you since you have a small intestines :). Once you start making your own Kefir water it is very cheap and easy. I drink 1-2 cups a day it contains around 100 billion per tablespoon of 40-50 strains. You can buy the Kefir Water grains online for $5-10, if you treat the grains right they can keep producing and last your lifetime

      • fields4ever

        thanks so much for the suggestions, I will definitely check them out. There’s a lot of info on line about Kefir water.

  • fineartmarcella

    Fecal transfers have saved the lives of people with resistant C-Diff. It is a good thing. Nice to see that probiotics are finally hitting the spot light

  • ann charpentier

    Hello Dr. Gregor or staff,
    wondering when to take probiotics when taking antibiotics please?
    I don’t want to take antibiotics but I have a toe infection that I have been trying to heal by soaking twice daily in Epson salts and warm water, applying TTO 2-3 times daily and using an antibiotic cream 2 times daily. Still my big toe is red & oozing clear liquid. The doctor cut my toe with a scapel so as to drain the pus and now there is no more pain. Just redness and oozing. So I think I will have to take the antibiotics though I do not want to. I have had the toe infection for 10 days.
    Any thoughts?
    If I do start the pills in a day or two when should I take probiotics, before or after the antibiotics?
    Thank you for all your help in advance!
    Ann ~ Ontario Canada

    • Joseph Gonzales R.D.

      That’s a good quesiotn. ​Here is a great Q&A written by Dr. Greger on​ probiotics See if this helps? Check out the last link by Dr. Klaper he is the expert!

      Thanks for your question,

  • Jennie Cake

    In 2008, I was diagnosed with CDiff on my second trip to the ER for severe dehydration. I was symptomatic for 9 days it took 2 weeks of harsh antibiotics, little to no appetite, weakness, severe anemia (as you are losing blood as your colon begins to shed). I lost 12 pounds and about 2 months of wellness, still to this day I take probiotics at least 3-4 times a week and I am extremely paranoid about catching it again. I would have done this treatment in half a second if offered. I am healthy now, and I was so so lucky it only took one form of treatment to begin to heal. This treatment sounds horrible, but I can attest to the fact I would have done ANYTHING to recover. People do die from this and people who recover often call themselves survivors. I was a healthy 23 yr old, I had not been using any antibiotics, had been working out, eating “healthy” compared to the standard american diet. I most likely caught it from contaminated meat at the time. I know that videos like this seem gross, but the above treatment may have gotten me on my feet faster with less side effects. It also continues to save lives.

  • David Mickleborough

    what would you recommend for a probiotic supplement that been tested and meets the label?

  • Ruth OConnor

    I had c-diff and was in the hospital for 5 weeks and in re-hab for 7 weeks. It was dreadful, I almost died and there were times I wished to die it was so terrible. If I got c-diff again I would gladly take a poop-cocktail in any form not only because it makes sense but it has been proven to be affective. Naturally it seems repulsive but there are many medicines prescribed to us regularly that would be repulsive if we knew what they contained, mare’s urine for one. I think one day soon there will be a c-diff medicine with feces properties but given a medical name that only those in the medical field could decipher and the treatment will be welcomed by the public. Amen…. Ruth OConnor

  • Lindsay

    Hi. I was hoping I could get some information. I have recently become plant-based again at the beginning of the year. Since then, the past 2 weeks I’ve had diarrhea which I can’t seem to figure out how to stop. In the past, I’ve had similar issues which actually turned out to not be GI related at all (had every procedure known to man for GI). I was wondering if there is anything to make it stop? Any suggestions would be appreciated. Thank you.

  • Rose Noire