Probiotics

Probiotics are micro-organisms that are considered “good” for you. Probiotics are usually available as foods or dietary supplements for digestive disorders and for a number of other diseases.

To start with the basics, we carry bacteria within our digestive tract (or “gut”) as well as other openings of the body, including mouth, nose, ear, eye, urinary and genital tracts. The “good bacteria” that usually live there are medically called “normal flora”, which means they normally grow there in healthy people. Just as different people might be attracted to different types of neighborhoods, the bacteria of the gut are influenced by the food we eat. They adapt and help digest our food for us. That’s why a change in diet can catch our intestinal bacteria unprepared and lead to bloating, gas or diarrhea.

As microbiology and pathology developed a hundred or more years ago, it was noted that in disease the normal flora was replaced by other microbes, and it was discovered that the symptoms and treatment could often be inferred by identifying the “bad” or pathogenic organism involved.

As antibiotics and antimicrobial drugs were developed, it was also discovered that these drugs can destroy the normal flora, in which case disease might develop if a pathogenic organism overgrew in place of normal bacteria. Naturally (yes, there is a pun here), it makes sense to encourage the growth of normal flora to provide good digestion and regularity as well as to prevent disease.

And that’s where prebiotics and probiotics enter. Prebiotics are foods that feed the healthy gut bacteria and encourage healthy normal flora in the gut. Probiotics are food or dietary supplement sources that contain these bacteria that may help the body. Both prebiotics (our normal diets) and probiotics effect the bacterial neighborhood of the intestines.

There are two main bacteria that are commonly found in probiotics. Lactobacillus is a friendly microbe found in the digestive, urinary and genital tracts, and also a common bacteria naturally present in cultured yogurt and fermented foods. Bifidobacterium is another friendly microbe found in the digestive system, mouth and genital tract. Lactobacillus and bifidobacterium may be combined with other micro-organisms when targeting sites other than the digestive system.
Clostridium difficile is a life-threatening intestinal infection that can develop after a course of antibiotic treatment that destroys the normal flora of the gut. There is evidence supporting the use of concurrent probiotic treatment along with antibiotics as a way of preventing the development of C difficile. Preventing C difficile with probiotics is good; an alternative treatment for C difficile infection has been the “fecal transplant” in which the patient consumes a formulation of donor poop.

Two recent papers (source: https://bit.ly/2wZyDxh and https://bit.ly/2Ny2JS5) examined the ability of probiotics to alter the bacteria of the intestines. The intestines of healthy patients appeared to welcome some probiotic bacteria more than others based on factors such as age, diet, underlying medical conditions and antibiotic exposure. Probiotics are more effective in some individuals, and when used following antibiotic treatment can be effective enough to fill the intestines with “good bacteria” but slow the recovery of normal flora by several weeks.

In addition to the expected benefit for digestive issues such as abdominal pain and bloating, diarrhea or constipation, studies have shown probiotics to be effective in a variety of illnesses, including, colds and sore throats, anxiety, weight loss and cholesterol management.

A major source of confusion for probiotics is the large number of bacterial strains on the market. The major groups of Lactobacillus and Bifidobacterium are further divided into strains, and it’s not always clear what advantages an individual strain brings to a product.

If you’d like to try probiotics, your community pharmacist may be able to help you choose the best product for you. There are a large number of choices. Identify the bacteria and strain with evidence that it might help your condition. Choose a product with a large number of bacterial cells, usually over a billion per day. Remember that probiotics should make you feel better; if they don’t, stop taking them.

Pay attention to storage conditions; often products with live organisms need to be refrigerated. If you have allergies, read the probiotic label for warnings. Talk with your pharmacist. Probiotics may help you. Take good care of yourself.