Fullscript Protocols

Digestive Wellness – Hard Stools

Woman ordering supplements on her laptop
Protocols Fullscript Protocols
Digestive Wellness – Hard Stools

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence. These are categorized as follows:

Class Qualifying studies Minimum requirements
A Systematic review or meta-analysis of human trials
B Human RDBPC ≥ 2 studies and/or 1 study with ≥ 50
C Human RDBPC or RCT 1 study < 50 subjects
D Human trials or In-vivo animal trials

RDBPC = Randomized Double-Blind Placebo Controlled
RCT = Randomized Controlled Trials

Please refer to the complete Rating Scale for further information.


The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

Upload this template

Digestive Wellness- Hard Stools


4-15g, total per day, minimum 3 weeks

  • Transit time, stool frequency, stool consistency and hardness of stool were improved by inulin1,2
  • Total Clostridium species was decreased2
  • 4 g of inulin-type fructans per day improved stool consistency in constipated children aged 2 to 5 years old3,4
Inulin in the Fullscript catalog.


1-10 billion CFU, total per day, minimum 28 days7,9

  • Abdominal pain, abdominal discomfort, relief, stool consistency and frequency were all improved when Bacillus subtilis and streptococcus faecium8
  • Bifidobacterium lactis was shown to increase up to two bowel movements per week7
  • Lactobacillus reuteri significantly improved pain, bloating, abdominal discomfort, gas and overall defecation benefits6
  • Bifidobacterium longum improved constipation symptoms in elderly patients5,6
Probiotics in the Fullscript catalog,

Psyllium Husk

10-20g, total per day, minimum 8 weeks11,12

  • Psyllium was shown to increase stool frequency10,11,12,13
  • Improvement in stool consistency and pain on defecation was observed12
Psyllium Husk in the Fullscript catalog.


Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials