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Pre- and Probiotics.  Are they worth taking?

The bacteria in our guts affect our digestion, immune system, and brain health - could pre or probiotics help get you a healthy gut?

I’ve read and heard a lot about both pre- and probiotics in the medical literature and among my own patients.  I recommend probiotics for patients while they are on antibiotics to prevent any associated diarrhea, and medical literature supports that practice. But what about other uses?  What is a prebiotic?  What’s a probiotic?  What are they supposed to do anyway?

We are just learning more about how the bacteria in our guts affects our digestion. And now we are learning the connection between our immune systems and brain health. Our “gut microbiome” is a sea of bugs that is established from the moment we come out of the birth canal and can change throughout the course of our lives. Depending on the bacteria that we have established in our guts, we may or may not experience bloating or heartburn after eating, have changes in our mood or note stomach pain. While our “belly bugs” aren’t necessarily the sole cause of any health issues, they certainly appear to play a larger part then we may have previously imagined.

Prebiotics

So what’s a prebiotic? They are substances that act as food for healthy gut bugs and generally include high fiber foods. These foods include asparagus, bananas, garlic, greens, and artichokes. Do we really need to take prebiotic supplements?  Probably not. We should just include gut healthy foods in our diet. Research hasn’t established the benefits of prebiotic supplements as of yet.

And Probiotics

What’s a probiotic?  They are foods or supplements that have live microorganisms which maintain or improve the bacteria that is or should be present in our guts.  Not every probiotic is created equal!  The trouble with studying the effects of probiotics is that the type and amount of bacteria in any supplement may vary and therefore can make comparisons difficult when teasing out benefits.  Probiotic foods include yogurt and sauerkraut.

The Benefits

What are some of the established benefits of probiotics? As I already mentioned, I will have patients take a probiotic to prevent diarrhea while they are on antibiotics. And antibiotics can kill off healthy gut bacteria. A probiotic supplement is simply replacing healthy bacteria to prevent unhealthy bacteria from flourishing in the gut, leading to diarrhea.

For people with frequent bloating or heartburn after eating associated with irritable bowel, taking a probiotic to establish healthy gut bacteria may have some benefit. People with certain inflammatory bowel conditions like ulcerative colitis may also benefit from taking particular probiotics. While we are beginning to understand that our immune system and brain health are connected to that “gut microbiome,” we still don’t know which probiotic microorganisms. We also don’t know their strains or the number of bugs might be needed to provide benefits.

As always, if you have a health condition and are considering probiotics, consult with your physician to see if they might provide any benefits.  Feel free to leave comments with your own experiences using pre- or probiotics to continue the discussion!

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