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Probiotics - Fact or Fiction
I found this article in the September 2011 edition of "Retail Pharmacy". It's author is Dr Brett MacFarlane, a senior research officer at the Australian College of Pharmacy. I have included it here because I found the information to be informative and educational and wanted to share it with you.
Probiotics - Fact or Fiction
Humans are walking bags of microbes. We carry up to 400 different species of bacteria in our gut alone. Happy intestinal life is a harmonious interplay between these bugs.
Medications, illness, age and poor diet can unbalance the gut's microbial environment. Different probiotics are marketed to help control illness. The World Health Organisation defines probiotics as "live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host".
Probiotic preparations are popular Pharmacy sellers, but are they worth the money? Do they really make a difference to our health and wellbeing?
IBS
Irritable bowel syndrome (IBS) is a collection of irritating gut symptoms that occur together. There is no test to identify IBS. It is a functional deficit of the gut. IBS is common and is often diagnosed when a person has ongoing abdominal discomfort associated with a change in bowel habits for no apparent reason.
Sufferers feel bloated and may have diarrhoea or constipation associated with pain. IBS can remit and recur often. The cause is unknown. Treatment generally involves management of symptoms, as there is no cure and people can experience poor quality of life and spend large amounts of money experimenting with different treatments.
Altered intestinal microflora has been investigated as a cause of IBS, but evidence is conflicting. The types of microbes living in the gut of IBS sufferers are different to those in non-sufferers.
Probiotics are routinely used to help manage the condition. A recent analysis of 18 scientific studies found that probiotics help with symptoms of IBS (Moayyedi, et al., 2010). The extent of the effect was variable and the most effective species or strain could not be determined.
The leaky gut
The proposition of the existence of the 'leaky gut' is controversial. Leaky gut has been implicated in the pathophysiology of inflammatory bowel disease, IBS and coeliac disease.
Normal gut barrier function involves tight junctions between intestinal cells that defend against the infiltration of foreign matter causing inflammation and triggering immune responses.
This is potentially involved in the the diarrhoea of IBS, eczema and food allergies. Lactobacillus plantarum has been found to improve the barrier function of gut cells, indication that it may be useful in the mangement of these conditions (Karczewski, et al., 2010).
Antiobiotic assocatied diarrhoea (AAD)
Antiobiotics disrupt the normal gut microbial balance leading to changes in carbohydrate metabolism causing osmotic diarrhoea and loss of bowel wall pathogen resistance.
The occurrence of AAD is up to 40 per cent, depending on the antiobiotic studied. AAD can occur during treatment (more likly with clindamicin and amoxycillin) or for up to two months following treatment (more likely with erythromycin, clarithromycin and ciprofloxacin).
Scientific studies indicate that Lactobacillus rhamnosus GG (LGG), Saccharomyces boulardii and Lactobacillus acidophilus have the best evidence in the management of AAD (Hickson, 2011). S.boulardii is a yeast probiotic similar to yeast used i baking and brewing. It is stable at body temperature and in stomach acid, so can pass into the gut safely to do its work. S. boulardii can: inhibit harmful gut microbes and their toxins; help normal gut microbes re-establish after antiobiotic treatment; improve health of intestinal cells and regulate gut immunity.
Sutdies indicate that S. boulardii reduces the risk of AAD by almost 50 per cent and points to a beneficial effect in the management of the life threatening C. difficile (McFarland, 2010). As antibiotics do not affect S.boulardii, it can be taken safely during the course and for a few days after completing it.
Further evidence indicates that it can be effective in the prevention of travellers' diarrhoea, the management of Crohn's disease and improving eradication rates of fiardia. However more research is required.
Evidence supporting the effectiveness of yoghurt in AAD is less convincing, but a drink containing Lactobacillus casei may be effective. Probiotics can improve the tolerability and reduce the side effects of the Helicobacterpylon eradication triple therapy (Wilhelm, Johnson, & Kale-Pradhan, 2011).
Prevention of antiobiotic induced vaginal thrush
Naturally occuring lactobacilli in the vagina of healthy pre-menopausal women produce lactic acid that maintains a low pH inhibiting the growth of bacterial pathogens that cause vaginosis. While the cause of candidiasis is not completely understood, it is possibly due to altered vaginal microbial balance. Antibiotics spermicides, oral contraceptives, oestrogen therapy, diabetes, tight clothing and frequent sexual intercourse are all contributing factors.
While scientific studies indicate that oral probiotics (primarily Lactobacillus reuteri, L.rhamnosus and L. Casei) increase beneficial vaginal lactobacilli and decrease Candida albicans, evidence supporting the use of probiotics in the prevention of recurrent vaginal candidiasis is controversial (Falagas, Betsi, & Anthanasiou, 2006).
An Australian study found that 40 per cent of women with a previous history of vaginitis ahd used probiotics to prevent antiobiotic-induced vaginal thrush (Pirotta, et al., 2004). The subsequent trial found no evidence to support this. Probiotic management of bacterial vagnosis is supported.
Probiotics and allergy prevention
Increase in the occurrence of allergic disorders has been hypothesised to be due to our sterile upbringing.
The overuse of antibiotics and antimicrobial preparations plus the underexposure of children to social environments has blunted their immune responses with potential for increased incidence of allergy and atopic reactions.
The gut represents a significant proportion of our immune function. Microbes int he bowel stimulate the immune system to control apthogens leading to a variety of other immune responses.
Babies derive their gut microbes during birth and feeding. Breastfed babies tend to predominantly have Lactobacilli and Bifidobacteria while bottle-fed babies have a complex mixture including Coliforms and Bacteriodes with sidnificantly less Bifidobacteria.
Data indicates that allergic children have different gut microbes tonon-allergic children.
Allergic children have higher levels of Clostridia and lower levels of Bifidobacteria. The immune system is an extremely complicated environment and, not surprisingly, the scientific evidence for probiotic use in allergic conditions is mixed (Ozdemir, 2010).
L. rhamnosus and L. reuteri ahve been shown to be beneficial in children with atopic eczema. The role of L. Rhamnosus L. casei and Bifidobacterium lactis in reducing food allergy is also supported. The role of probiotics in the management of allergic rhinitis is generally positive.
Are all probioctics the same?
The effectiveness of probiotics is determined by the stability of the preparation: the manufacturing process can destroy the cells.
While evidence indicates that dead probiotic cells still cause immune responses, at this time the exact effects have not been determined. Some products require refrigeration while others do not. Freeze-drying (lyophilisation) can ensure the probiotic ceslls remain viable when stored at room temperature.
The beneficial effects of many probiotics are strain specific and some strains of the same probiotic species may not be effective. Therefore if the wrong strain is grown during manufacture, the product may not work.
Also, products may not stipulate the strain contained within, making it difficult to determine efficacy. Probiotics should be sourced from reputable manufacturers that utilise appropriate controls during manufacture and storage.
Do probiotics cause side effects?
The primary precautions associated with probiotic use include transfer of antiobiotics resistant genes and translocation of the probiotic cells from the gut to other areas of the body, eg, blood, lymph nodes and heart valves.
While the prevalance of this is very low, neonates, immuno-suppressed patients and people taking immune suppressant medications should only take probiotics on the advice of a physician.
In summary, scientific evidence supports the use of probiotics in IBS, Crohn's disease, coeliac disease, antibiotic-induced diarrhoea, travellers' diarrhoea, infective diarrhoea, eczema, food allergy and allergic rhinitis. It does not support probiotics in the prevention of recurrent or antiobiotic-induced vaginal thrush.
GNLD Acidophilus Plus
Acidophilus Plus is broad spectrum and provides beneficial lactobacilli in the forms of L. acidophilus, L. blugaricus, L. casei, B. bifidum and S. thermophilus.
Exclusive Gel-Gard protection system assures that bacteria are protected from stomach acid and the maximum number are delivered to the intestines where they're needed.
Available in a 60 capsule bottle $79.42
Due to the specific nature of this product I don't keep it in stock, however I can order it in for you or you can order online - go to www.wellbeing.gnld.net and place your order to be delivered direct to your door.
Hopefully the illness of the last few months has passed!
Wishing you a fabulous spring!
Regards,
Bree.
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