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What are probiotics and can they aid GI health?

Probiotics may help with a variety of GI disorders, from irritable bowel syndrome to inflammatory bowel diseases, like ulcerative colitis and Crohn’s disease.

Probiotics may sound like the newest buzzword among the health-conscious, like ancient grains or superfoods, but probiotics differ in the fact that they are extremely small, living organisms that are often bacteria, but can also be organisms like yeasts. The probiotics currently on the market are foods or dietary supplements.

Probiotics are being studied for their potential benefit in a variety of ways, such as preventing infections, boosting the immune system, and maintaining healthy skin and a healthy nervous system. Researchers are still trying to fully understand how probiotics work, in which people they work, and what their specific health benefits are. Much of the discussion around the potential positive effects of probiotics centers on their ability to aid gastrointestinal (GI) health.

When it comes to gut health, probiotics may:

  • Stop harmful bacteria from attaching to your gut lining and growing there
  • Send signals to your cells to build up the mucus in your gut and help it act as a barrier against infection
  • Stop toxins released by certain bacteria that can make you sick
  • Promote the growth of other bacteria that can improve your health

Can every person with GI issues take probiotics?
Although the idea of probiotics is not new, the scientific community is still learning which bacteria are best for a particular health issue or symptom. To date, the FDA has not approved any probiotic product to treat medical conditions. Therefore, probiotics should not be considered a replacement for GI treatments prescribed by your doctor.

There are many different bacterial species and strains that could be probiotics but may only work for certain people with certain conditions. Some bacteria may be most helpful in combination with certain other bacteria. Probiotic products vary in cost, but higher prices do not necessarily mean the probiotics are higher in quality or better in performance.

Does this sound complicated yet? Don’t worry; navigating the world of probiotics may be complicated on your own, but working closely with your doctor to understand which probiotics may be the best fit for you, based on your particular needs and concerns, can make it a lot easier.

Below is a list of common GI disorders and what we know so far about probiotics for people with these conditions. Final approval, however, should always come from your doctor, who knows your medical history best.

Irritable bowel syndrome (IBS)

  • IBS can cause diarrhea (loose stool), constipation (hard stool or trouble passing stool) or both.
  • Bifidobacterium infantis, Saccharomyces boulardii, Lactobacillus plantarum and a blend of bacteria are some probiotics that have been studied in people with IBS that may help reduce symptoms such as the sensation of bloating (swelling).

Inflammatory bowel disease (IBD)

  • IBD is an issue of the immune system triggering inflammation in the digestive tract. This can cause pain, diarrhea, weight loss and blood in your stool.
  • Studies suggest that certain probiotics including E. coli Nissle, and a mixture of the strains of Lactobacillus, Bifidobacterium and Streptococcus may help lessen inflammation.
  • Ulcerative colitis may be more responsive to the effects of probiotics than Crohn’s disease.

Infectious diarrhea

  • Infectious diarrhea is caused by harmful bacteria, viruses or parasites.
  • Lactobacillus rhamnosus and Lactobacillus casei may be helpful in managing diarrhea caused by rotavirus, which often affects babies and small children.
  • Many strains of Lactobacillus and a strain of the yeast Saccharomyces boulardii may help shorten the course of infectious diarrhea.

Antibiotic-related diarrhea

  • Antibiotics target harmful and beneficial bacteria. Sometimes taking an antibiotic can cause infectious diarrhea by lowering the number of beneficial microorganisms in your gut. Bacteria that may not otherwise give you any trouble, can grow out of control.
  • It is important to note that most antibiotic-associated diarrhea is not infectious, but rather is a result of lowering the number of beneficial microorganisms in your gut.
  • Health care providers may recommend probiotic foods or supplements to patients during or after treatment with antibiotics. The reason is that probiotics are thought to preserve beneficial microorganisms that may be targeted by antibiotics and maintain that patient’s microbiome.
  • For instance, Clostridium difficile (C. difficile) is a major cause of diarrhea in hospitalized patients and people in long-term care places, like nursing homes. C. difficile. tends to come back even after treatment with antibiotics, but there is research that shows taking probiotics, such as Saccharomyces boulardii, may help prevent this.
  • In people who are generally healthy, after taking antibiotics, their gut bacteria will recover on their own over time to a state generally thought to be stable, though it may not be identical to that person’s microbiome before antibiotics.
  • However, recent research shows that in certain people, taking probiotics during or after antibiotics may actually delay the recovery of their gut bacteria. Researchers do not yet know if this delay makes any difference in their health.

Where can I find probiotics, and how do I take them and store them? 
Probiotics products commonly contain bacteria from two groups, Lactobacillus and Bifidobacterium. They naturally occur in foods like yogurt, kefir, sauerkraut or kimchi, but can also be purchased as supplements in pill or powder form. Probiotic foods and supplements are available at the supermarket, pharmacy, or health food store, and can be ordered online. Store your probiotic according to the directions on the package. After purchasing your probiotic, be sure to ask for any additional advice from a health care professional before you start taking them.

What are any side effects?
Mild side effects, like gas and bloating, are possible, but don’t last very long. Side effects that are more serious may include allergic reactions to the probiotics, or to the ingredients included with the probiotic products. Many of the studies published on probiotics do not discuss side effects in great detail, so there may be other concerns that are currently unknown.

For people who are generally healthy, the common viewpoint is that probiotics are safe to take, but not much is known about long-term use. Probiotics can possibly cause an infection in people with weak immune systems, so keeping your doctor informed of any new health initiatives, especially if this applies to you, is very important.

If you your doctor has recommended that you take probiotic foods or supplements, take it as described to maximize the benefits and prevent them from lasting for only a short time.

Where can I obtain more information?
The American Gastroenterological Association has a patient resource page about probiotics, provided by experts in the field, but consulting your doctor is always a great place to start.

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