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 tract. The “good bacteria” that usually live there are medically called “normal flora”, which means they normally grow there.  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.

Probiotics

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.

There are two main bacteria that are commonly found in probiotics.

  1. 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.  
  2. 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 “fecal transplant” in which the patient consumes a formulation of donor poop.

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 Bifidobacteria 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 will help your condition. Choose a product with a large number of bacterial cells, usually over a billion per day.  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.

Resources:

National Library of Medicine PubMedHealth:  Probiotics

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023364/

Information on Probiotics for Specific Conditions

https://www.ncbi.nlm.nih.gov/pubmedhealth/c/pmh_sr/?term=probiotics

Peter Rice

Peter Rice

 

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.