Do probiotics really work and which products are the most beneficial?
Probiotics are bacteria that live in the body and help it function, in appropriate amounts. They help defend the body from invading bacteria and germs that cause infection. Probiotics increase the population of anaerobic bacteria, which are known as friendly bacteria. Probiotics are bacteria that are found normally in the body, however, many can take pills to increase the probiotic residents. They can also be found in foods such as yogurt and kefir, a fermented dairy beverage.
Probiotic health benefits include decreasing inflammation, increasing immune response, and increasing the intestinal barrier. There are many immunologic benefits of probiotics. One is they activate macrophages, increase antigen presentation, and increase secretory immunoglobin A. Probiotics induce the protective cytokines of the body, which helps treat ulcerative colitis and Crohn’s disease. They also modulate cytokine profiles and increase the body's tolerance to food antigens. Other benefits are helping increased digestion, adjust bodily pH, produce bacteriocins, and increase intestinal barrier function.
Probiotics are usually defined by their genus, species, subspecies, and strain designation. The most commonly used probiotics include species of lactic acid bacilli such as Lactobacillus and Bifidobacterium. Other strains include a nonpathogenic strain of Escherichia coli (eg, E. coli Nissle 1917), Clostridium butyricum, Streptococcus salivarius, and Saccharomyces boulardii. The range of doses available vary from 1–10 billion CFU/dose. However, the dose needed varies based on species.
One of the most common uses and benefits of probitotics include the treatment and severity of diarrhea. Treatment of acute diarrhea in adults includes Lactobacillus paracasei B 21060 or L. rhamnosus GG or Saccharomyces boulardii CNCM I-745, strain of S. cerevisiae. There is also evidence of probiotic's prevention of acute diarrhea in both adults and children. Probiotics can also prevent antibiotic-associated diarrhea, radiation-induced diarrhea, and C. dificil diarrhea. Treatment of postoperative sepsis in elective gastrointestinal surgery patients includes Lactobacillus acidophilus, L. plantarum, and Bifidobacterium longum 88. Lactobacillus casei strain Shirota has been shown effective in treating small-bowel injury from NSAIDs. Probiotics have also been shown to decrease the side effects of H. pylori treatment. There is no evidence that probiotics alone can treat the infection, but there are benefits of adding them to antibiotic therapy. They can also prevent or treat allergies. Some probiotics contain lactase, therefore ingesting these probiotics can help patients with lactose intolerance. The lactase helps digest the lactose that the patient cannot break down on its own.
The issue with probiotics is that they are unregulated. Companies don’t need to disclose all the information on the packaging. Patients can buy probiotics without consulting their doctor. Patients with a weakened immune system are more susceptible to infections that can occur with probiotics. Other side effects include allergic reactions, such as hives, swelling, itching, diarrhea, bloating, and stomach upset. These are temporary common side effects, however, slowly introducing the probiotic can decrease the effects.
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By definition, probiotics are “live microorganisms that have demonstrated beneficial effects on human health.” These microorganisms include different types of bacteria and yeast. Probiotics have gained much attention due to its ability to support intestinal health in humans, which is extremely beneficial in cases of drug therapy with antibiotics that result in diarrhea, along with other disease states. Probiotics can be used to “improve the homeostasis of internal microbiota to maintain the human intestinal health.” This works because the unwanted bacteria that aren’t beneficial to the host cannot survive the acidic conditions in the intestines, whereas the beneficial bacteria will proliferate in these acidic conditions. This results in a balance in the intestinal microbiota, which is what’s needed. There are many types of probiotic bacteria that have been used in studies for multiple disease states. A few examples include: L. acidophilus, S. thermophilus, L. delbrueckii subsp. Bulgaricus, L. paracasei, L. plantarum and E. faecalis.” Each of these bacteria has been studied with certain disease states to see which ones display the most benefit to each disease state.
The disease states consist of the following: antibiotic associated diarrhea (AAD), inflammatory bowel disorder (IBD), Crohn’s disease (CD) and colorectal cancer (CRC). AAD is a common side effect when a patient has been prescribed antibiotics, and should be counseled to expect this. However upon further research, it has been discovered that “probiotic intervention may reduce the risk of AAD by 51% with no apparent increase in the risk of side effects.” Because of this breakthrough, patients being prescribed antibiotics should be informed of the benefits of taking them concomitantly with the probiotics of their choice. IBD is a “chronic inflammatory bowel disease of the gastrointestinal tract.” The term IBD also includes ulcerative colitis (UC), Crohn’s disease (CD) and indeterminate colitis (IC). While an unbalanced diet, stress and other life factors affect IBD patients, intestinal microbiota is suspected to have something to do with causing IBD. According to studies, it has been indicated that “probiotic supplementation in patients with inflammatory bowel disease is a promising adjuvant treatment in UC but not in CD.” Crohn’s disease is still undergoing research with the benefits of probiotics, as mentioned before. According to the studies that have already been done, “due to inconsistencies in the results of clinical trials involving probiotic supplementation in the treatment of CD, further research is needed to identify the roles of probiotics.” This does not mean that probiotics serve no benefit at all in CD cases, but possibly just the ones that have been used are providing no benefits. Colorectal cancer, or bowel/colon cancer, “ is a cancer in any part of the large intestine including the colon or rectum.” With the probiotics studies dealing with CRC, it was found that synbiotics have proven to be beneficial. According to the studies, “The study of clinical trials showed that the intake of synbiotics resulted in a significant change in intestinal microbiota in colorectal cancer patients, with an increase in Lactobacillus.” Due to the synbiotic presence, the patient’s body is able to increase production of the probiotic “good bacteria” on it’s own, without the need of an additional probiotic.
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Cleveland Clinic Medical Professional. “Probiotics: What Is It, Benefits, Side Effects, Food & Types.” Cleveland Clinic, my.clevelandclinic.org/health/articles/14598-probiotics. Accessed 23 Aug. 2023.
Probiotics are live microorganisms that can be beneficial to one's health and play a vital role in maintaining a balanced gut microbiome, which is closely linked to various aspects of our overall well-being. They are primarily found in fermented foods, such as yogurt, kefir, and sauerkraut, and can also be taken as dietary supplements. The gut microbiota is a complex community of trillions of microorganisms residing in our gastrointestinal tract, which plays a fundamental role in human health. A balanced and diverse gut microbiota is associated with improved digestion, nutrient absorption, and a well-functioning immune system. However, factors like an unbalanced diet, stress, antibiotics, and certain medications can disrupt this delicate balance, leading to an overgrowth of harmful bacteria.
Probiotics work by replenishing and restoring the beneficial bacteria in the gut, thus helping us maintain a healthy balance of microorganisms. Lactic acid-producing bacteria, such as Lactobacillus and Bifidobacterium, are among the most commonly used probiotics. They have been proven to show antagonistic activity toward viruses such as herpes simplex and human influenza. One of the substantial benefits of probiotics is in supporting digestive health. It has been shown to aid in the breakdown of complex carbohydrates and proteins, which can be beneficial for individuals with digestive issues. A study published in the Journal of Clinical Gastroenterology investigated the effects of a multi-strain probiotic supplement on patients with irritable bowel syndrome (IBS). The results showed a significant improvement in overall IBS symptoms, including bloating, abdominal pain, and stool consistency, suggesting a potential therapeutic role for probiotics in managing this condition. Probiotics have also shown effects on immune system support. The gut plays a critical role in the body’s immune response as it is one of the primary areas that interact with foreign substances. There has been recent evidence suggesting that certain probiotic strains can enhance the activity of immune cells, such as T cells and natural killer cells.
In conclusion, probiotics' ability to improve gut and immune health can have a substantial effect on an individual’s overall health. However, it is essential to note that the effects of probiotics can vary depending on the specific strains, dosages, and individual health status.
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The word probiotics is defined as “for life” and stems from Greek origin. Probiotics are living microorganisms in the form of bacteria or yeasts, containing the genus Lactobacillus, Bifidobacterium, Bacillus or Saccharomyces boulardii, that can be found in dairy, fermented foods, and dietary supplements, which include yogurt, sauerkraut, kefir, sour milk, yakult, natto, tempeh, and kimchi. Popular probiotic oral supplements on the market include Culturelle Digestive Daily, Nature’s Bounty Probiotics, and Align Probiotics. According to the Food and Agriculture Organization of the United Nations World Health Organization, probiotics is described as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” In lay terms, probiotics are the “good bacteria” that support immune health and provide improved digestive health. These microbes play a critical function in converting carbohydrates from foods to its digestible and nutritious form via small acids, acetate butyrate, lactate, CO2, H2, and ethanol. In addition, it aids in food digestion, maintains pH of the digestive system, and plays key roles in infection control and disease management in individuals who suffer from irritable bowel syndrome, inflammatory bowel disease, infectious diarrhea or those who are taking antibiotics.
The human body’s gut microbiota consists of 10^14 microbes and of those, there exists between 500 to 1000 different species. There exists a state of homeostasis between commensal intestinal microbiota and pathogenic bacteria in a healthy human being. Gut barrier function is dependent on colonic microbiota since these agents are responsible for the fermentation of nutrients, endogenous host-derived substrates (such as mucus and pancreatic enzymes), and dietary constituents that escape digestion in the upper gastrointestinal tract. Majority of anaerobic bacteria are located in the GI tract to prevent the colonization of pathogenic bacteria; this concept is referred to as “colonization resistance.” Gut barrier function is compromised when pathogenic bacteria accumulates or when the host is exposed to exogenous stimuli (i.e. antibiotics), thereby disrupting the balance of the “good” bacteria; as a result, this may lead to systemic inflammatory response syndrome and can be as severe as multiple organ dysfunction syndrome in the critically ill. Thus, probiotic supplementation containing a balance of lactobacilli, streptococci, clostridia, coliform, and bacteroides may restore the good bacteria in those with the aforementioned conditions; it helps maintain gut health due its ability to proliferate and differentiate epithelial cells, neutralize pathogenic microbes, and ensure immune system homeostasis. Understanding probiotics’ mechanism of action provides a stronger appreciation for its ability to help maintain digestive balance and support immune health; however, it is important to note that probiotics are acid-labile and cannot tolerate the stomach’s environment; therefore, acid-protective dosage forms are required to ensure efficacy.
There are numerous factors that may disrupt gastrointestinal health, such as an individual’s prolonged exposure to stress, alcohol overconsumption, high fat-content diets, genetic disorders, and chronic antibiotic use. Research has been conducted to determine the therapeutic efficacy of probiotic use in those with gastrointestinal conditions, antibiotic associated diarrhea, C. difficile infection, inflammatory bowel disease, and many others. For instance, a 2017 review of 17 studies (total of 3,631 participants) revealed that non-hospitalized patients on antibiotics who were given probiotics concomitantly for the prevention of antibiotic-associated diarrhea were 50% less likely to develop diarrhea. This conclusion is deemed tentative since these studies were of moderate quality. Another review of 23 studies (3,938 participants) conducted in children indicated that probiotics had a protective effect against antibiotic-associated diarrhea with moderate quality of evidence. In regards to C. difficile infection, a 2017 analysis of 31 studies (8,672 patients) revealed that probiotics can reduce the risk of C.difficile infection in adults and children taking antibiotics with moderate certainty. For inflammatory bowel disease, a 2014 review of 21 studies in patients with ulcerative colitis (1,700 participants) showed that adding concomitant probiotic treatment may be helpful in maintaining remission of the disease.
Currently, probiotics are categorized as functional foods or dietary supplements and are FDA regulated as foods. Probiotics are available over the counter, however, they do not undergo the testing and approval process that is required of drugs. It is the responsibility of manufacturers to ensure the products’ safety before marketing and that the stated claims presented on the labels are true. Further, the FDA has not approved or verified any of the health claims present on probiotic products. Due to a lack of regulatory oversight, consumers must be mindful of the contents that they are actually ingesting since studies have found discrepancies existing between the labeled ingredients and what is actually contained in the product. There are studies that do merit the use of probiotics to maintain gut health; however, more clinical trials must be conducted to determine a definitive answer in its role in supporting overall gastrointestinal health.
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Shurtleff, David, and Yisong Wang. “Probiotics: What You Need to Know.” National Center for Complementary and Integrative Health, July 2019, www.nccih.nih.gov/health/probiotics-what-you-need-to-know#:~:text=Probiotics%20might%3A,Influence%20your%20body’s%20immune%20response.
Thank you Dr. Khong for your stellar research efforts. Would you like to create an Instagram for your article? If you like that suggestion, would you consider discussing refrigerated priobiotics vs the off-th-shlf bottled ones. This could be a Public Health Pharmacist or SocioEsthetician Pharmacist project. Either way, your article is excellent as it stands now.
Probiotics are live microorganisms that are taken for health benefits. Many of the microorganisms are the same as the ones that are naturally in our bodies. These microbes are different for everyone and is made up by a combination of bacteria, fungi, viruses and protozoa. The microbes in our gut make up the intestinal microbiome, but they may be altered by diet, lifestyle, exposure to toxin and antibiotic use. Probiotics can help maintain the immunologic equilibrium in the gastrointestinal tract through direct interaction with immune cells. For probiotics to be successful, the microorganisms must be able to withstand passage through the gastrointestinal tract, colonize and reproduce in the gut, attach and adhere to the intestinal epithelium, and stabilize the balance of the gut flora. Then, the microorganisms can help digest food, destroy disease-causing cells and produce vitamins.
These microorganisms are usually bacteria such as Lactobacillus and Bifidobacterium, but they can also be yeasts such as Saccharomyces boulardii. Different probiotics may have different effects, so if a specific kind of Lactobacillus helps prevent an illness, it doesn’t mean others would do the same. Probiotic effectiveness can be species-, dose-, and disease-specific. Also, the duration of use depends on the clinical indication. Therefore, it is essential to pick the right type of probiotic. However, there is still little knowledge on which probiotics are helpful and which are not. So, taking broad-spectrum probiotics or multi-probiotics may be the way to go.
Probiotics are supposed to help colonize the gut with good microorganisms. Probiotics are found to be effective for acute infectious diarrhea, antibiotic-associated diarrhea, Clostridium difficile-associated diarrhea, hepatic encephalopathy, ulcerative colitis, irritable bowel syndrome, functional gastrointestinal disorders and necrotizing enterocolitis. Other illnesses associated with the urogenital system such as bacterial vaginosis, candida vaginitis, urinary tract infections may also respond to probiotics. Some studies also suggested a beneficial effect on atopic eczema, lactose intolerance, gum disease, weight loss, inflammation, depression and anxiety, blood cholesterol, blood pressure, upper respiratory infections, antiaging and sepsis.
Probiotics are the third most commonly used dietary supplement among adults, and about one in five Americans take probiotics for digestive problems. However, probiotics that are sold as dietary supplements don’t require FDA approval. Therefore, the labels may make claims about how the product affects the structure or function of the body.
Besides dietary supplements, probiotics are also in foods prepared by bacterial fermentation, such as yogurt, buttermilk, sourdough bread, cottage cheese, kefir, sauerkraut, tempeh, kombucha, pickles, miso and kimchi. Probiotics are also supplemented in some foods such as ice cream, snacks and nutrition bars, breakfast cereals and infant formulas.
Probiotics are generally safe to use for healthy infants, children, adults and older patients. In the first few days of use, there may be some side effects related to digestion such as gas and mild abdominal discomfort. However, these should go away soon after. However, in people with severe illnesses or compromised immune systems, there are harmful effects such as infections, production of harmful substances, and transfer of antibiotic resistance genes from probiotic microorganisms to other microorganisms in the digestive tract.
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Probiotics have become incredibly popular over the past decade as a solution to all gastrointestinal issues. But how true is this proclamation, let’s find out. The gut microbiota is presumed to partake in the development of diseases such as IBD, diabetes, etc. However, with the administration of probiotics, the prognosis of such diseases have improved. A probiotic can be defined as live microorganisms like bacteria and yeast. The theory behind its success is that it maintains the balance of our intestinal microbiota, harmful bacteria get destroyed in our acidic gut while good bacteria that can tolerate an acidic environment flourish. Advantages of probiotics include the strengthening of our immune system, prevention of constipation and many more. Since our intestinal microbiota is affected by a variety of factors such as lifestyle, diet and antibiotic usage, consistent use of probiotics may be beneficial in improving overall health. The usefulness of probiotics has been proven in many studies in the recovery of intestinal diseases. In a study conducted for 8 weeks, 176 IBD patients (86 probiotic yogurt group and 90 placebo group with general yogurt) and 84 healthy people as a control group with probiotic yogurt were volunteered. Results depicted beneficial bacterial strains were increased in both probiotic yogurt groups and mRNA levels of inflammatory cytokines were significantly reduced.
Probiotics can also be found in certain foods such as yogurt, sourdough bread, cottage cheese, kombucha and kimchi. Although, probiotics have a myriad of benefits, there are some adverse reactions to be aware of such as mild stomach upset, diarrhea, or flatulence and bloating. Probiotics should also be used with caution in people with an increased risk of infection like chemotherapy or HIV/AIDs patients.
There is also concern over the safety and efficacy of probiotics because they are sold as dietary supplements or food, which don’t require FDA approval before they are marketed. A probiotic may work differently from brand to brand and even from batch to batch within the same brand due to vague regulations. As of now, no probiotic products have been approved by the FDA to treat specific diseases. But companies are able to make claims about how the product affects the structure or function of the body. For such reasons, it is important to research about the probiotic product you are purchasing and be sure to seek well-established companies.
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Diseases.” JMB, Korean Society for Microbiology and Biotechnology, 8 Aug.
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and Human Services, Aug. 2019.
Probiotics can either be a single group or a combination of live bacteria and/or yeasts. Bacteria is bacterial in nature while yeast is fungal in nature. It is important to note that bacteria can either be bad or good and probiotics are the good type of bacteria that keeps our bodies healthy as it can help to fight off the bad bacteria when our bodies have too much of it. Our body’s microbes (tiny living things that not only can make us sick but can also be very important to our health) include bacteria, fungi (including yeasts), viruses, and protozoa. The good bacteria primarily resides in our body’s gut, mouth, urinary tract, vagina, lungs, and skin. They have many different roles including to help us break down and digest food (the gut) and to keep bad bacteria from getting out of control in order to preclude us from getting sick (the urinary tract). The two most common types of bacteria probiotics that are found in our body are lactobacillus and bifidobacterium. These strains make it too acidic for harmful microorganisms to survive in our body. A common type of yeast probiotics is saccharomyces boulardii.
The exact mechanism of action of probiotic activity has not yet been fully deduced. The mechanism of action is hypothesized to range from bacteriocin which are peptidic toxins produced by bacteria to inhibit the growth of closely related or similar bacterial strains and short chain fatty acid production. This would then lower the pH of the body’s gut which would then lower the competition for nutrients and the stimulation of mucosal bacterial function.
Increasing the amount of probiotics in our diet can help in a wide variety of conditions including urogenital infections and diarrhea. Examples of urogenital infections include bacterial vaginosis, yeast infections, and urinary tract infections, many females eat yogurt or even insert it into their vagina for treating recurring yeast infections. For treating diarrhea, controlled trials have effectively demonstrated that Lactobacillus GG can abridge the course of infectious diarrhea in both infants and children (albeit not in adults). The most common dietary sources of healthy probiotics include yogurt, sourdough bread, tempeh, cottage cheese, and kimchi. Probiotics can help aid in digestion for our gut health and maintenance of our vaginal health.
Both in vitro and in vivo studies have been done to study the beneficial effects of probiotics. In relation to inflammatory bowel diseases (IBD’s) and our body’s immune system, ulcerative colitis (UC) and Crohn’s Disease (CD). Disruption of the balance between the immunity of the intestine and microbiome is seen to be a cause of these bowel diseases. Enteric bacteria may be able to change the equilibrium of both pro-inflammatory and anti-inflammatory cytokine levels of the intestine that inherently are the predisposing factor for intestinal disorders. Pro-inflammatory cytokines are very important in maintaining the homeostasis of the immune system in the intestinal barrier. Overall, probiotics have several crucial benefits including to both prevent and alleviate symptoms/treat bowel diseases by improving the immune system in addition to disrupting bile acids by the enzyme bile salt hydrolase (BSH) and hence improving lipid profiles.
Probiotics. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/14598-probiotics
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Probiotics. Prebiotics. Antibiotics. What is the difference? When hearing the word bacteria, one might associate it with sickness. Although that is true that some bacteria might cause illness, others are needed in the body to keep you healthy. Probiotics, prebiotics, and antibiotics all work on the bacteria in our body. Probiotics and prebiotics aid in protecting the good bacteria in our body which keep our body healthy. They act as natural antibiotics in the body by naturally killing harmful bacteria but when there is an increase in harmful bacteria then prescription antibiotics are required to help protect the body against harmful effects of those bacteria. A side effect of taking antibiotics is that they can cause diarrhea therefore taking probiotics during the antibiotic course treatment can help reduce the diarrhea side effect.
A good gut health is needed for a healthy lifestyle and it can be improved with including probiotics and prebiotics in one’s diet. Just like how vitamins can be consumed not only through supplements but also through our food intake, prebiotics and probiotics can be consumed through certain foods. The difference between probiotics and prebiotics is that probiotics are living strains of the good bacteria and when it is consumed then it adds to the population that already exists in the digestive system and prebiotics are plant fibers that act as food for the good bacteria that is in the digestive tract therefore it promotes the growth of the already existing good bacteria in the digestive tract. Foods that have probiotics include but are not limited to yogurt, sourdough bread, pickled vegetables, miso soup, kombucha, and sauerkraut. Foods that have prebiotics include bananas, onions, berries, legumes, oats, apple skin, asparagus, peas, beans, and chicory root.
Probiotics are made up of bacteria and yeast strains. Most probiotics include lactobacillus and Bifidobacterium bacteria strains as well as saccharomyces boulardii yeast strain. Including probiotics in your lifestyle is beneficial because it can help against many conditions such as diarrhea, constipation, yeast infections, urinary tract infections, and other conditions.
Probiotics are available in different formulations including capsules, pills, powders, and liquids. A few of the common probiotics that people might purchase at the local pharmacy include Visbiome and Floragen. Visbiome is a probiotic that is intended to be used to aid in the management of conditions such as Irritable Bowel Syndrome (IBS), Ulcerative Colitis, Hepatic Encephalopathy, as well as other conditions. Visbiome can be consumed as a capsule. Each capsule includes 112.5 billion Colony Forming Units and one can consume 2-8 capsules daily as directed depending on the condition it is used for. Visbiome should not be used in infants in the Neonatal Intensive Care Unit. If a patient is taking an antibiotic course, then Visbiome should be taken at least 4 hours apart from the time the antibiotic was consumed. For those who are lactose intolerant, Visbiome contains milk as well as skim milk or milk protein therefore it might cause some bloating. It can be stored at room temperature for up to one week and still maintain effectiveness.
Just like Visbiome, Floragen is another probiotic that is used to help promote good bacteria in the gut. Floragen comes in different products that target different audiences, this includes Floragen Eczema, Floragen Women, Floragen Kids, and more. Look on the package for the recommended daily dose which can be one capsule daily with or without food. Floragen should be taken at least 1 to 2 hours apart if taking an antibiotic. Floragen is recommended to be stored in the refrigerator in order to maintain its full effect without losing its shelf life but it can be stored at room temperature for up to two weeks and still maintain effectiveness. Both Visbiome and Floragen include different bacteria strains such as Lactobacillus strains and Bifidobacterium.
Probiotics should be used with caution in people who are immunocompromised (have a weak immune system) such as those who are receiving chemotherapy treatment since an increase in bacteria for a weak immune system might risk the cause of an infection. Overall, probiotics have many great health benefits and in general do not cause harm. If interested, make sure to ask your local pharmacist about the ways to incorporate probiotics in your lifestyle.
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Probiotics are a combination of live beneficial bacteria and/ yeasts that naturally live in your body. These probiotics make up what is known as your microbiome. A microbiome is a diverse community of organisms including good bacteria, fungi, viruses, and protozoa. A healthy microbiome is important for a healthy gut, but are also found in the mouth, vagina, urinary tract, skin, and lungs. Everyone’s biome is unique, including twins.
Probiotics are important for maintaining a healthy balance in the body by supporting your immune system and controlling inflammation and taking part in digestion. Since this is a natural part of your body, eating a well-balanced diet rich in fiber keeps the good bacteria at its proper levels. However, some people do benefit from a probiotic supplement. The most common types of bacteria found in over-the-counter supplements include lactobacillus, and Bifidobacterium. As of right now, probiotics are all the rage in the wellness world and are being researched in people with diarrhea, constipation, Inflammatory bowel disease, irritable bowel syndrome, yeast infections, urinary tract infections, eczema, and even sepsis.
Personally, for women who are prone to yeast infections, it is recommended that they take a probiotic when being prescribed antibiotics (spacing the two out to avoid an interaction).
Moreover, taking the probiotic also prevents the instance of diarrhea in patients taking an antibiotic for an infection. According to an evaluation in a nursing home, 20% of nursing home patients taking antibiotics and a probiotic experienced diarrhea while 36% of patients experienced diarrhea that did not receive a supplemental probiotic.
Furthermore, probiotics may be taken for the elimination of drug resistance for antibiotics and protection of the skin. It is important to also realize that overuse can be harmful leading to bacteremia and endocarditis, so taking them as directed is vital.
Whether you are taking probiotics for a specific need, or just overall good health, there are many foods that contain the natural bacteria including yogurt, kombucha, yakukt, kefir, cottage cheese, kimchi, sauerkraut, and miso. Additonally companies such as KIND have been marketing probiotics in their granola products (bars, cereal, etc). Poppi a new tonic/ sparking beverage company launched a line of probiotic soda.
Probiotics: What is it, Benefits, Side Effects, Food & Types. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/14598-probiotics. Published March 9, 2020. Accessed June 9, 2021
Van Wietmarschen HA, Busch M, van Oostveen A, *** G, Jong MC. Probiotics use for antibiotic-associated diarrhea: a pragmatic participatory evaluation in nursing homes. BMC Gastroenterol. 2020;20(1):151. Published 2020 May 13. doi:10.1186/s12876-020-01297-w
Wieërs, G., Belkhir, L., Enaud, R., Leclercq, S., Philippart de Foy, J. M., Dequenne, I., de Timary, P., & Cani, P. D. (2020). How Probiotics Affect the Microbiota. Frontiers in cellular and infection microbiology, 9, 454. https://doi.org/10.3389/fcimb.2019.00454
Prebiotics, probiotics, and synbiotics are food supplements categorized as functional foods and are known to alter/restore the gut’s pre-existing microflora. Common probiotic strains are Lactobacilli, Bifidobacterium, B. coagulans, and S. bougulans. Common prebiotics include galactooligosaccharide (GOS), fructooligosaccharide (FOS), xylooligosaccharide (XOS) and Inulin. Synbiotics are intended to improve probiotic viability and are formed when fructan fibers are used with probiotics.
Probiotics are non-pathogenic microorganisms used to improve intestinal health. Popular probiotics include Lactobacillus reuteri, Lactobacillus rhamnosus, enterococci Enterococcus faeciumSF68 and yeast Saccharomyces boulardii. Contrary to popular belief probiotics are not only limited to dairy products such as greek yogurt and cottage cheese but are consumed worldwide in non-dairy foods for example kimchi, sauerkraut miso and kombucha. Probiotic products can either contain a single or multiple strains, and while single strains prove beneficial there are benefits unique only to combined strains.
Prebiotics are indigestible fibers that aim to stimulate growth and metabolism of microorganisms in the colon specifically targeting Lactobacilli and Bifidobacteria. Proper prebiotics need to be resistant to stomach acid/hydrolyzing enzymes found in the intestine, unabsorbed in the GI tract, and easily fermentable. Prebiotics are forms of complex carbohydrates found in foods such as inulins (ex: Jerusalem artichokes), psyllium, oligosaccharides, fructose/lactulose, raw oats, unrefined wheats and barley among other non digestible carbohydrates. When consumed, the gut bacteria will ferment the prebiotics forming an acid luminal environment that stops growth of harmful bacteria. Prebiotics will treat irritable bowel syndrome (IBS) by relieving inflammation and maintaining a healthy gut flora among other symptoms. Prebiotics are also used to decrease occurrence and duration of diarrhea, and protect against colon cancer.
Synbiotics are formed when prebiotics and probiotics are combined. Synbiotics will improve the survival of microbial supplements to selectively stimulate the growth of a limited quantity of health-promoting bacteria in the colon. Ideal synbiotics are formed when the prebiotic strain favors the probiotic strain. Common probiotic strains found in synbiotics include Bifidobacteria, Lactobacilli, and B. coagulans; whereas common prebiotic strains found in synbiotics include oligosaccharides such as FOS and GOS. Synbiotics will improve liver function, immunomodulating activity, increase levels of healthy microbiota, and prevent/reduce nosocomial infections in patients undergoing surgery.
Any alteration in the microbiota will result in several metabolic disorders including obesity, diabetes, and other eating disorders. Balanced microbiota is essential for maintenance of a healthy gut and homeostasis, with gut bacteria serving as a key regulator of host pathophysiology. In obesity, gut microbiota will trigger systemic inflammation leading to metabolic disturbances. Strains such as Lactobacillus and Bifidobacterium as well as Pediococcus pentosaceus has been proven to reduce weight gain, lower BMI, smaller waist circumference and reduce fat mass.
Pandey KR, Naik SR, Vakil BV. Probiotics, prebiotics and synbiotics- a review. J Food Sci Technol. 2015;52(12):7577-7587.
Travis AC. Diverticular Disease of the Colon. In: Greenberger NJ, Blumberg RS, Burakoff R. eds. CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e. McGraw-Hill; Accessed May 26, 2021. https://accessmedicine-mhmedical-com.jerome.stjohns.edu/content.aspx?bookid=1621§ionid=105184014
Cerdó T, García-Santos JA, G Bermúdez M, Campoy C. The Role of Probiotics and Prebiotics in the Prevention and Treatment of Obesity. Nutrients. 2019;11(3):635. Published 2019 Mar 15.
Over time, probiotics have become a popular point of interest for patients looking to promote self-care and enhance their immune system. They are classified as living microorganisms that can offer added health benefits when consumed in the proper amount. Patients have been seeing the benefit of incorporating probiotics and prebiotics into their daily regimen. Thus, leading to more companies marketing probiotics as an over-the-counter supplement to help maintain the intestinal microbiome. More research is being done to find out the benefit of using probiotics and their potential use in obesity, diabetes, and inflammatory bowel disease. Patients do not only have to worry about how to incorporate probiotics into their lifestyle, but also which strains of organisms may better suit their needs.
In the human body, there are approximately 100 trillion microorganisms that reside in the gut and perform many different functions. However, certain types of bacteria cannot survive in very low pH environments like the stomach (i.e. harmful or beneficial). The main role of the probiotics is to help the bacteria that is beneficial to the body survive in acidic environments to grow, proliferate, and maintain homeostasis. A study has shown that patients who have been diagnosed with IBD have witnessed relief of symptoms of diarrhea, prevention of constipation, and improvement of their immune system. The interaction between the intestinal microbiota and a patient’s immune system can influence glucose levels that may cause insulin resistance and lipid metabolism. Studies have also shown that in obese patients who consume high-fatty meals, elevated levels of T cells can be seen in the gut to possibly fight off “infection” and inflammation caused by harmful bacteria.
The most common strains of microorganisms used in probiotics are Saccharomyces, Bifidobacterium and Lactobacillus which are often used to prevent infectious diarrhea. The next generation of probiotics (i.e Faecalibacterium and A. muciniphila) are also marketed to promote reduction in inflammation, improvement in glucose regulation, and strengthening of the gastrointestinal tract. However, patients should be aware that not all probiotics are equal in strength and function. This is due to the different mechanisms of the microorganisms and the effect that they have on the body. Probiotics may also influence cognitive function for patients who have psychiatric disorders. For example, microorganisms seen in the gut of depressed patients are less rich and diverse and have an increase in proinflammatory cytokines. Another example is that patients who suffer from irritable bowel syndrome and take probiotics have seen a reduction in anxiety that may be caused by the IBS. Other potential areas that probiotics may be used for is the elimination of drug resistance for antibiotics and protection of the skin. Overall, there appears to be clinical benefit for patients to take probiotics because of the effects that it has on gut microbiota such as strengthening the immune system, improvement of overall health, and alleviation of gastrointestinal symptoms caused by underlying diseases. However, overuse of probiotics is harmful to patients as well. It can cause bacteremia, sepsis, or endocarditis especially in those who have severe inflammation with certain organs. Patients must take the probiotics as directed.
Kim SK, Guevarra RB, Kim YT, Kwon J, Kim H, Cho JH, Kim HB, Lee JH. (2019). Role of Probiotics in Human Gut Microbiome-Associated Diseases. J. Microbiol. Biotechnol, 29, 1335-1340. https://doi.org/10.4014/jmb.1906.06064
Probiotics are over-the-counter medications that have a combination of bacteria and yeast that benefits the gastrointestinal tract in patients. The bacteria is live and is beneficial- there are good and bad bacteria in the body. The bad bacteria are the ones that cause the body to get sick. There are also good bacteria in the GI tract that aid the body in digesting food. Probiotics are a combination of that good bacteria that is found in the body that help keep the body healthy and regular.
Probiotics assist in the body’s microbiome, which is a diverse community of microorganisms that are unique to every single person. No two people have the same microbiome. It is a community of trillions of microbes which include bacteria, fungi, viruses, and protozoa. For a microbe to be considered a probiotic it must be isolated from a human, be able to survive in the intestine after being taken orally, have proven benefits to the person, and be safe to consume.
The main purpose of probiotics is to maintain a healthy balance in one’s body. It naturally occurs in the body. However, when bad bacteria are entered into the body, the balance is thrown off and sometimes supplemental probiotics are required to restore that balance.
Some common types of probiotic bacteria are Lactobacillus, Bifidobacterium, and Saccharomyces boulardii. There is a large amount of research actively happening to learn more about the human microbiome and the benefits of probiotics. Probiotics are being researched in people with diarrhea, constipation, Inflammatory bowel disease, irritable bowel syndrome, yeast infections, urinary tract infections, eczema, and even sepsis.
Often those taking antibiotics are recommended to take probiotics alongside. Since many broad-spectrum antibiotics can also the balance between good and bad bacteria within the GI tract, doctors recommend a patient to pick up a probiotic when they pick up their antibiotic at the pharmacy. The probiotic must not be taken with the antibiotic at the same time because the antibiotic will kill the good bacteria in the probiotic. They should be taken several hours apart from each other. This decreases the instance of diarrhea in patients taking an antibiotic for an infection
When the effects of probiotic use were looked at in nursing home patients taking antibiotics for an infection. 20% of nursing home patients taking antibiotics and a probiotic experienced diarrhea while 36% of patients experienced diarrhea that did not receive a supplemental probiotic. While 20% is still a large percentage of patients experiencing this side effect, it is much less than those patients that were not on a probiotic supplement.
Probiotics are also found in foods and drinks naturally. Fermented foods like yogurt and pickles are great sources of probiotics. Fermented drinks are also a great source. Dinks like kombucha and kefir help introduce extra probiotics into a patient’s diet. Other foods that offer probiotics into the diet include cottage cheese, sourdough bread, kimchi, and miso soup.
Probiotics: What is it, Benefits, Side Effects, Food & Types. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/14598-probiotics. Published March 9, 2020. Accessed January 29, 2021.
Van Wietmarschen HA, Busch M, van Oostveen A, Pot G, Jong MC. Probiotics use for antibiotic-associated diarrhea: a pragmatic participatory evaluation in nursing homes. BMC Gastroenterol. 2020;20(1):151. Published 2020 May 13. doi:10.1186/s12876-020-01297-w
The medical advent of probiotics is a term that has been coined to put a name to “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” In the twenty years following the official definition of probiotics, they have grown exponentially in popularity for their numerous claimed uses. The introduction of probiotics is an astounding breakthrough and could potentially lead to more nuanced research on the translational benefits of animal to human microbiology. The supposed health benefits of probiotics includes the strengthening of the patient’s immune health while also promoting gastrointestinal wellbeing. The supposed benefits touted by probiotic users & companies begs the question: what exactly is a probiotic and how can it provide healthy results?
Probiotic is a blanket term used to classify living microorganisms that can be taken and introduced to the body system; many probiotics contain microorganisms that are already a part of the body’s natural flora. This is due to the fact that many probiotic believers claim that medications such as antibiotics that deplete the natural flora makes the patient’s body susceptible for complicated infections such as C. difficile. By taking a probiotic, a patient will be able to replenish their natural flora to prevent a complicated infection from occurring. A common probiotic is lactobacillus.
Lactobacillus is considered a “good” or “friendly” microorganism that resides in the gastrointestinal and urinary tracts. By supplementing lactobacillus in probiotic form, the patient is able to enhance overall gut health to ensure facilitated digestion. Such probiotics are helpful for those who struggle with irregular bowel movements and digestion. Lactobacillus is most commonly used for diarrhea, including infectious diarrhea and diarrhea in people taking antibiotics (antibiotic-associated diarrhea). Some people also used lactobacillus for general digestion problems, a long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS), excessive crying in infants (colic), long-term swelling (inflammation) in the digestive tract (inflammatory bowel disease or IBD), inflammation of the colon, and many other conditions.
While probiotics are a new introduction to the medical scene, their use has proven to be effective in managing many symptoms related to dietary health. By using them as a supplement, patients are able to prevent further complications that could arise due to a colonization infection while also preventing flare-ups for numerous digestive-related illnesses. Overall, the use of probiotics is a new-age advent that only supplements the clinical data found through many years of research and while there is still plenty that researchers need to learn about probiotics, their use could prove to be vital in combating symptoms that impact a patient’s quality of life.
Probiotics are generally used to promote good gut health with the introduction of healthy bacteria into a patient’s digestive system to aid in digestion and the prevention of infection. These bacteria already live in the gut but some patients with certain disease states like Crohn’s disease and Ulcerative colitis or patients that have an imbalance in their gut may need supplementation of these bacteria and therefore need a probiotic. While probiotics can be introduced into the body naturally, prebiotics are factors that are introduced into the body that aid in the growth of probiotics. Probiotics are given in many different scenarios. For example, if a patient is given antibiotics to ward off an infection, it is essential to give a probiotic because the antibiotic kills both the good and bad bacteria of the gut. Without these bacteria the patient is at a disadvantage in absorbing the full amount of nutrition from their meals and prevent inflammation or autoimmune response if the body senses it is at a deficit. Probiotics can also aid in the prevention of diarrhea and other gastrointestinal associated side effects when a patient is taking antibiotics. Of the types of probiotics, Lactobacillus acidophilus, known as Bacid, is the most commonly referred to probiotic that is thought to serve as an immune booster, prevent potential infection and promote digestion of dairy product in lactose intolerant patients. Bifidobacterium bifidum, referred to as VSL #3, is similar to Lactobacillus acidophilus helping in digestion and prevention of infection particularly in those patients with irritable bowel syndrome (IBS). Saccharomyces boulardii, known as Florastor, is also a commonly referred to probiotic that is used for restoration of healthy gut flora post antibiotic use. In addition to the common over the counter (OTC) probiotics, many foods contain probiotics as well and should be incorporated into a patient’s diet to promote a healthy lifestyle. Foods such as yogurt, cheese and other dairy products include probiotics and are an excellent source of them. Those that are lactose intolerant would opt for the probiotic supplement route or pickles as those patients are generally not able to tolerate dairy foods. In those patients that are able to tolerate probiotic rich foods, they may aid in digestion, preventing diarrhea and infections. Many clinical studies have proven effectiveness of probiotics in treatment for diseases like obesity, insulin resistance syndrome, type 2 diabetes and non-alcoholic fatty liver disease. Some studies have shown the benefit of prophylaxis of probiotics in different types of cancer and managing side effects associated with some cancers. Since probiotics are thought to have a role in preventing infection, it is also theorized that probiotics have potential in eliminating cancerous cells or cells that are precancerous. Clinical studies have shown that probiotics may lead to remission of ulcerative colitis, but no positive effect on Crohn’s disease has been shown. This may be due to the fact that ulcerative colitis only occurs in the colon while Crohn’s can occur anywhere along the entire digestive tract where the probiotic may not target directly. The diseases themselves are not completely understood but are associated with chronic and recurrent infections or inflammation of the tissue, so probiotic use is generally recommended in both conditions, even in Crohn’s especially when a large part of the colon is involved and the patient is experiencing symptoms like diarrhea.
Markowiak P, Śliżewska K. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients. 2017;9(9):1021. Published 2017 Sep 15. doi:10.3390/nu9091021
Thank you for your discussion. In Italy, probiotics are dispensed with every antibiotic prescription. They have yogurt makers and starter kits as well. This photo was taken during a UCONN CE program entitled "The Mediterranean Diet." UCONN runs this CE program every 2 years.
Probiotics are a type of bacteria that are considered friendly or good bacteria. They live in our body and assist with many functions including helping with our digestion and preventing infections. Probiotics are able to enter our body naturally. Prebiotics are different from probiotics because they are pills that contain food for your probiotics to grow. There are many studies that have been conducted on numerous different probiotics and their benefits for the body. Researchers believe probiotics work in a few different ways. One way is by maintaining a healthy bacteria community within your digestive tract. Taking antibiotics can lower the amount of good bacteria in your stomach, so there is reason to believe that probiotics during infections can help. Probiotics can also prevent diarrhea and other unpleasant side effects in patients with certain diseases and in those taking antibiotics. Studies have been done to see if there is a benefit for stomach infections, ulcerative colitis, irritable bowel syndrome and allergies. Probiotics are also thought to boost your immune system.
There are a few different types of probiotics that are available. Lactobacillus acidophilus (Bacid) is the most common type of probiotic strain that helps boost your immune system and can help patients who are lactose-intolerant with digestion. Bifidobacterium bifidum (VSL #3) is similar in effect to Lactobacillus acidophilus because it helps with digestion, including irritable bowel syndrome. It may protect against certain infections as well. Saccharomyces boulardii (Florastor) is another common probiotic that can be used for restoration of healthy intestinal bacteria for antibiotic use. There are also many foods that contain probiotics that can be part of a healthy diet with a possible probiotic benefit. Any food with active cultures contain probiotics. Some examples are yogurt, miso, cheeses, pickles, fermented and fortified milk and more. If you are able to tolerate these foods, many of them can be part of your healthy diet. These foods can possibly help maintain healthy digestion, prevent diarrhea, reduce allergies and prevent infections, but they definitely can be part of a healthy diet. These foods can be an easy way to add probiotics into your diet for a healthier lifestyle.