Gut feeling

Probiotics: Found in supplements and food, these microorganisms foster ‘good’  bacteria

By Jessica Arsenault Rivenburg

Probiotics have been increasingly hailed as a cure-all for the digestive tract, and even for some non-digestive ailments.

But are they really the wonder supplement many think they are?

Probiotics are live, active microorganisms found in the digestive tract and also in some foods that are considered “good” bacteria, explained Crystal Hein, registered dietitian and owner of Crystal Clear Nutrition, PLLC, in Herkimer.

“Ultimately, probiotics are good for gastrointestinal health,” Hein said, adding that they help balance the flora, or bacteria, of the intestines.

They are made up of a genus bacteria species and a strain, she said. Common probiotic names include Lactobacillus, Bifidobacterium, Streptococcus, Escherichia, Enterococcus, Bacillus and Saccharomyces, which is a yeast.

There’s no question probiotics do offer benefits to many people in various situations, said Dave Murray, pharmacist at Kinney Drugs in Ilion.

Doctors prescribing antiobiotics, particularly those in a strong dose or to be taken over a long course, often prescribe a probiotic to be taken along with it. This is because antibiotics kill all bacteria, the bad and the good, Murray explained. Killing the good bacteria in the gut can lead to stomach and bowel discomfort and diarrhea. Taking a probiotic alongside the antibiotic helps restore the flora and counters side effects, he said.

But that doesn’t mean probiotics are only for those taking antibiotics. While probiotics are still being tested and studied to see what health benefits they might have, they do appear to be beneficial for inflammatory bowel disease, irritable bowel syndrome, management of ulcerative colitis and constipation, said Hein.

Studies also indicate supplements appear to have a positive impact on vaginal and urinary tract health, eczema and lactose intolerance. Some have even claimed the supplements have helped symptoms of asthma, arthritis and celiac disease. However, recent studies indicate probiotics probably do not affect such health issues.

Many people opt to take a daily probiotic supplement to assist digestion, reduce gas and bloating, boost immunity and aid in bowel regularity.

“We’ve seen a number of patients struggle with recurring constipation. They tried increasing fiber and taking stool softeners without much effect,” Murray said. “But then they try a probiotic, and within days the issue has resolved itself.”

Time of adjustment

As with all things, there can be side effects for some, which, coincidentally, can include gas and bloating, Murray noted. These side effects are not common and usually resolve themselves within a week or two as the body adjusts to the change in internal flora.

“Different probiotics perform different functions in the body and different strains have been shown to be effective for specific conditions,” Hein said. “This area of nutrition needs more research regarding effectiveness and safety, and amounts to obtain health benefits. You should check with a medical professional to determine which probiotic strain is best.”

For those looking to add a probiotic supplement to their diet, drug store shelves offer no shortage of options. There exist capsules, gummies, chocolates and powder packets in a dozen mainstream brands. The amount of probiotics within each is measured in what is called CFU’s, or colony forming units. The potential problem lies in that the CFU count printed on the box is the amount that existed at the moment of manufacture, Murray explained. As the product goes through temperature changes in transport and sits on the shelf in a store, the CFU count is most likely diminishing.

Hein suggests looking for packaging that says “live and active cultures.”

“It is important to use reputable brands,” she stressed. “Look for the USP verified mark seal. This indicates the supplement has met specific stringent requirements for quality and safety.”

Murray specifically recommends the probiotic Florajen to all his patients, he said, as it is kept in the refrigerator and therefore maintains its live and active culture count more reliably. In most drug stores, customers must ask for Florajen at the pharmacy counter.

Apart from supplements in pill form, probiotics can be found in fermented foods such as yogurt, kefir, sauerkraut, miso, tempeh and kimchi.

“Most probiotics are safe for most healthy people,” Hein said. “However, certain medications may interfere with the effectiveness. It is a good idea to check with your health care provider or pharmacist. They can tell you how much to take, what strains are best for your condition, the best timing, and medication interactions.”

“For those people under medical supervision, those with a weakened immune system or those with a compromised gastrointestinal system, you should also check with a doctor,” she said. “There is not a one-size-fits-all approach when using probiotics. I think caution needs to be taken when using probiotics in large combinations at high doses until there is sufficient scientific evidence supporting this.”


Prebiotics vs. Probiotics

While probiotics are “good” bacteria, prebiotics are found in food components that promote the growth of helpful bacteria in the gut

Probiotics need prebiotics in order to work.

Prebiotics are typically high-fiber foods that act as food for human microflora. Prebiotics are used with the intention of improving the balance of these microorganisms.

Prebiotics include fructooligosaccharides, such as inulin fiber and galactooligosaccharides. People can include more prebiotics in their diet by eating more fruits, vegetables and whole grains, particularly bananas, leeks, onions, garlic, asparagus, artichokes, soybeans, whole wheat products, legumes, dandelion greens and root, Brewer’s yeast and mushrooms.

Prebiotics and probiotics can be paired together either in supplement form, or in the food a person eats, such as bananas in yogurt or stir-frying asparagus with tempeh.

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