Probiotics and Gut Health

by Stanley J. Pietrak, MD, Gastroenterology
October 29, 2020

Those with nagging digestive issues have probably heard or read about probiotics and prebiotics by now. Often touted as a cure-all for digestive worries, they seem to pop up everywhere these days—from yogurt to baby formula to pet food!

So, do they live up to the hype? That’s actually difficult to say, given the current limited amount of reliable data supporting them as a treatment option.

But they may very well be an unnecessary addition to most people’s diets. In fact, the American Gastroenterological Association (AGA) recently issued a statement recommending against their use in any but a few specific digestive health issues. Let’s answer a few common questions:

Exactly what are probiotics and prebiotics?

Believe it or not, our guts have been home to a thousand different bacteria, fungi and microscopic organisms called protists since the day we were born. Approximately 30 or 40 of these will influence 99% of our digestive health. These helpful organisms are known as probiotics. Yogurt and sauerkraut are some examples of probiotic-rich foods.

Prebiotics, on the other hand, are fiber-rich foods like fruits, vegetables and whole grains that help the probiotic strains to grow and flourish in the gut.

Why the hype about them?

Probiotics can be helpful in many ways. Without them, the complex digestive process would run less smoothly. They help break down the food we consume to produce vitamins and amino acids that regulate our body’s functions. Plus, they also promote immune functions in the gastrointestinal (GI) tract and protect us against harmful pathogens. There is evidence they may even help to improve mental health.

Why are the right bacteria in the gut so important?

Let’s say your colon contracted a C difficile infection. The probiotic microbiota already present in your gut would likely fight it off successfully. But if you’re perhaps taking a high-powered antibiotic or other medication that suppresses the immune system, or if you have a chronic disease, bad bacteria may be able to grab hold and do damage within the gut. This is why it’s so important to consistently maintain good gut microbes through a healthy diet.

There’s not much conclusive evidence that probiotics are effective, says Dr. Stanley Pietrak. A healthy diet is still the best solution. https://bit.ly/2IWA4FT via @MedStarWHC
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So why the current pushback against probiotics from the AGA and others?

That’s the tricky part. There are so many formulations of single- and multi-strain probiotics—and so many different recommended dosages with randomized research trials—that it’s still difficult to conclude their effectiveness as a viable treatment option. This is a relatively new area of ongoing research, so there’s not much scientific evidence to refer to.

Is there any documented proof they’re helpful?

Yes. A type of probiotic called VSL#3 was found to be beneficial in rigorous studies in a small group, such as ulcerative colitis patients with surgically removed colons. Subsequent inflammation within the remaining part of their small intestines responded to treatment with VSL#3. But since testing involved a very small group, there is no way to standardize the result.

If I do want to try probiotics, what should I choose?

If you really want to try probiotics for minor digestive issues, go for the multi-strain type, and continue with it only if you start feeling better. Otherwise, it’s too early in our research to prescribe a particular type for a specific condition and discuss the pros and cons.

Are there any natural remedies for improving gut health?

Yes, absolutely. To be specific, there currently aren’t many options for accurate food-sensitivity testing, but we do know that, in 75% of people living with functional GI disorders, dietary triggers can worsen symptoms. So, it’s a little difficult to point out which foods may cause those triggers and which to continue eating.

The general rule: eat healthy. Consume less processed food, red meat, alcohol, fats and sugars. Switch to more natural foods, like fresh fruit, vegetables and other fiber-rich options instead.

To sum up, in 2020, there isn’t much conclusive research on the efficacy of probiotics. We can’t definitively state they are a good treatment for specific GI disorders, although the risk in trying them seems low at this point. If you choose to give them a try, stick to the multi-strain varieties and see if they work for you. Most importantly, eat a healthy diet full of natural food for long-term benefits.

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Category: Healthy Living     Tags: Ga-1lgood gut bacteriagut healthprobiotics