Confused about probiotics?
Did you know there are as many bacteria is our body as human cells? Our body is full of trillions of microbes – bacteria, fungi, yeasts – that are collectively known as our microbiome and help to keep us healthy. The more we learn about them the more we realise they are fundamental to our existence. These microbes are found in our gut but also on our skin, in our mouth, urinary tract, vagina and lungs.
You may have been told that one way to support your microbes is through taking a probiotic. In this article I’ll be answering some common questions and hopefully clearing up any confusion - what is a probiotic? How can probiotics help us? Should I take a probiotic?
What is a probiotic?
The definition of a probiotic is ‘a live microorganisms that, when administered in adequate amounts, confers a health benefit on the host’. Probiotics can help support the bacteria that live within us, especially when our bacteria are challenged, for example by antibiotics, poor diet or traveling.
Probiotics are known by their genus, species and strain (for example, Lactobacillus rhamnosus GG). Probiotics can be likened to breeds of dogs; all dogs come from the same species, but breeds vary in size, shape, strength and what they can do. The same way we use different breeds of dogs for different jobs, we use different strains of bacteria for different medical conditions and goals. For example, you wouldn’t use a chihuahua for crowd control, you’d need a German shepherd. Similar with probiotics, we need to make sure we are using the right bacterial strains for the specific condition or IBD. Also, probiotics are not always helpful in IBD depending on the type and location of the inflammation and care needs to be taken when on medications like immunosuppressants.
How can probiotics help us?
A common misconception is that probiotics re-seed our gut and that to be effective a probiotic must change the composition of the microbes living in our gut. However, typically probiotics do not take up residence and they may not make any detectable change in the microbes that are normally present there. Instead, as they pass through the gut, probiotics and the substances they produce along the way, interact with our immune cells, our gut cells, dietary fibre and the microbes that already live in our gut, and that’s how they can benefit us.
Probiotics can support health in different ways
Help our immune system function properly
Keep harmful bugs in check
Aid digestion by breaking down some of the food we can’t digest (e.g. fibre)
Produce vitamins and aid in nutrient absorption
Probiotics have the potential to:
Help reduce antibiotic-associated diarrhoea
Treat infectious diarrhoea
Help manage digestive symptoms and conditions
Help with the digestion of lactose
Decrease risk or duration of common infections, including respiratory tract, gut and vaginal tract
Should I take a probiotic?
The short answer is…..it depends on you - the condition you are living with, where you are in the cycle of disease (remission or flare), and what we want to achieve.
Checklist when choosing a probiotic, think S.A.S – strain, amount, safety:
Strain - Chose a strain that has been shown to be effective in studies for the specific condition you are dealing with.
Amount - Be sure the product contains at least the level of probiotics that was used in the study. These are shown as CFU (colony forming units - the number of viable bacteria in the product). Most successful probiotic research has utilised ≥10E+9 (to the power of 9 or 9 zeros!) CFU per dose.
Safety - Probiotics are safe for most people, but talk to your doctor if you are on immune compromising medications like azathioprine, methotrexate and ciclosporin.
What about probiotic foods?
There is lots of confusion between fermented foods and beverages and the probiotic concept, but fermented foods are not officially probiotics, even though they may contain them. This is because their live microbial content and composition is undefined. However, they can still offer benefits, but that is a whole new topic which I will cover in next weeks article.
I have written a free e-book to help you find a way forward for your everyday life with Inflammatory Bowel Disease. Whether you are right at the beginning of your journey with IBD or have been living with your condition for years and feel like you have tried almost everything, there are things you can do everyday, beyond the medication you are taking, to help you take back control.