Friendly Probiotics

Many of us think of bacteria as creepy little critters that must be eradicated. They are the reason we wipe our kitchen counters and wash our hands before sitting at the dinner table. But some bacteria are essential for our health.

Probiotics are a major class of these “friendly bacteria” and many people have questions about what they are, what they do, and how to be sure we are getting them.

What They Are

Probiotics are lactic acid-producing bacteria that normally inhabit the gastrointestinal tract and other mucous membranes in the body. There are two main groups: bifidobacteria and lactobacilli. Within these groups there are various species and strains, each with their own beneficial effects.

In general, the presence of these friendly bacteria in the gastrointestinal (GI) tract helps us to digest foods, produce some nutrients, protect the digestive tract from infection from pathogenic (disease-causing) organisms, and–as more recent research suggests–regulate immune function.

How to Get Them

There are many probiotic supplements; some fermented foods (such as yogourt) also contain friendly bacteria. For a therapeutic effect and/or a consistent dose, supplements are ideal, as foods are less consistent in their probiotic content and contain far fewer beneficial bacteria.

How to Take Them

There is some disagreement on how to take probiotics, although I am usually happy if my patients just take them consistently. The ideal time to take probiotic supplements is after a meal, since the pH of a full stomach is higher (less acidic) than when it is empty; this can help prevent damage to the probiotics, allowing more of them to reach the intestine.

The length of time that a probiotic will remain in the body varies by the ability of that probiotic to adhere to the cells of the GI tract, so taking a probiotic regularly and in two to three doses per day is a good way to ensure consistent probiotic levels.

How Much to Take

For treating specific health complaints, doses up to the hundreds of billions have been used in adults, with no adverse effects. For general health promotion and maintenance, much lower doses (two to 10 billion in adults) are adequate. For young children and infants, consult with your health care provider for appropriate recommendations.

Who Needs Them

Many factors can disrupt GI flora, and many conditions can benefit from them, so supplementation can be helpful for most people.

Age (over 45)

As we age decreased amounts of bifidobacteria and anaerobes and increased enterobacteria species are seen in the gut, which may contribute to reduced immunity; supplementation may improve immunity impairments.

Diet

Most people do not regularly consume a variety of fermented foods. Oligosaccharides such as inulin (found in onions, leaks, artichokes, and asparagus), which help to feed and increase numbers of bifidobacteria, may also be lacking in many modern diets.

Antibiotics

These medications often disrupt the balance of the GI flora, allowing pathogenic organisms to overgrow and cause illness.

Low Stomach Acid

This condition can lead to bacterial overgrowth and imbalance in gut flora. Low stomach acid is seen with increasing age, but can also occur with drugs that inhibit stomach acid secretion, such as those used in the treatment of Helicobacter pylori (ulcers) or gastro sophageal reflux disease (GERD).

Who knew bacteria could be friendly? Now that you know, consider incorporating some of these bacterial helpers in your diet.

Probiotics May Help with These Health Complaints

• inflammatory bowel disease (IBD)
• clostridium difficile diarrhea, associated with antibiotic use and a growing problem in hospitals
• atopic dermatitis (eczema) symptoms in children
• infectious diarrhea, particularly in children attending daycare or who are in hospital