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The Truth About Probiotics And Your Gut

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You may have heard about probiotics and their benefits, but not know much about them. Well, this article should answer your questions about probiotics.


The Best Ways to Use Probiotics

A baffling selection of probiotic foods and supplements crowd the shelves of health food stores these days. The findings of recent research confirm that foods and supplements with probiotics may provide benefits for many digestive problems. Probiotics may even help promote a healthy immune system.

Choosing the right product isn’t easy, however. Here are some tips for purchasing probiotics.

Probiotics May Be Equally Effective in Any Form

Probiotics come in a variety of forms, from powders and capsules to foods such as yogurt, dairy drinks, infant formulas, cheese, and even snack bars that are supplemented with specific probiotic organisms. Any of these forms may be effective for some digestive problems as long as they contain the beneficial organisms in adequate numbers.

“Some people prefer to take probiotics in the form of food. Others prefer taking a capsule or powder,” says Stefano Guandalini, MD, a professor of gastroenterology at the University of Chicago School of Medicine. “It’s really a matter of personal preference.”

Probiotic supplements should be taken according to label directions, under the guidance of your doctor. Your doctor can advise you about which probiotics foods or supplements may help you and how often and how long you should use them.

Choose the Right Microbes for Your Needs

More important than the form of the probiotic product you use are the particular microbes that it contains. “Many different potentially useful probiotic organisms exist, including both bacteria and yeast,” says Martin Floch, MD, a leading gastroenterologist at Yale University, author of Probiotics: A Clinical Guide, and a consultant for the Dannon Company. “Their effects are very specific. Certain strains appear to be helpful only for certain conditions.”

The strains that appear to be most effective in treating infectious diarrhea, for instance, include Lactobacillus GG and Saccharomyces boulardii.

Probiotics Won’t Help All GI Problems

Convincing evidence shows that probiotics can speed recovery from infectious diarrhea. They may also ease symptoms of irritable bowel syndrome. But probiotics don’t appear to offer much benefit for people with Crohn’s disease. And although some findings for ulcerative colitis are promising, they not conclusive, according to a Yale University workshop on the clinical use of probiotics.

For some conditions, even the experts disagree about whether or not probiotics help.

There’s Still a Lot of Guesswork

Keep in mind that doctors are still learning about the best practices for probiotic use. “Gastroenterologists and especially pediatric gastroenterologists have really begun to embrace the use of probiotics,” Guandalini tells WebMD. “But there is still a lot that we don’t know.”

Doctors have only a small handful of studies to go on for information about the best dosage to prescribe, for example. And very few studies have been done comparing one probiotic against another. As research progresses, doctors are likely to know more about when and how to prescribe probiotics.

Picking Probiotics: Labels Are Important

The best place to begin evaluating a probiotic food or supplement is its label. It should include:

  • the specific genus and species of the probiotic organism or organisms it contains (Lactobacillus rhamnosus, for example)
  • the number of organisms contained in a single dose and how often you should take it (effective doses range widely, from as few as 50 million live cells for some organisms to as many as 1 trillion cells per dose for others)
  • recommended uses, based on scientific studies
  • storage information, when relevant (some forms need to be refrigerated, others have been processed to remain viable at room temperature)
  • contact information for the company

By definition, probiotics are living organisms. To make sure that the organisms in a product are still useful, look for probiotic products that are viable “through end of shelf life” rather than “at time of manufacture.”

The labels on many yogurts and some probiotic foods and supplements indicate that they contain “live active culture.” This means that the product contains living microbes. But keep in mind: Just because a product contains live active culture is no guarantee that it has health benefits.

Choose a Reliable Brand

As important as it is to read probiotic product labels, not all products live up to theirs. This is partly because probiotics are treated as supplements or foods rather than prescription medicines, so the products on store shelves are not required to meet the standards of medications. A 2002 study found that in more than one in three products, the stated concentration of bacteria differed from the actual number.

As evidence for the health benefits of probiotics gathers, the FDA is reviewing how it regulates these products. Tighter regulation could help make it easier for people to choose the right brand. For now, experts recommend choosing reliable brands with claims and recommended dosages based on scientific studies.

Don’t Expect to Need Probiotic Supplements Long-Term

Probiotic supplements can be useful when populations of healthy organisms in the intestines become disrupted. But once symptoms ease and the balance of natural organisms has been restored, most people don’t need to go on taking them. That’s good news because some supplements and foods with probiotics cost several dollars per serving.

“If you are generally healthy and you eat a healthy diet, you shouldn’t need to take a probiotic on a regular basis,” says Floch.

Distinguishing Between Food and Medicine

Some food-based probiotic products are intended to be taken for a specified period of time, not on a regular basis. But foods made with live cultures, such as yogurt and kefir, have been around for thousands of years. Enjoyed as part of a regular diet, they offer plenty of other nutritional benefits. But remember: It may be even more important to eat high-fiber foods, which help maintain robust colonies of friendly bacteria in the intestines.

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