Gastroenterology

Probiotics Are They Safe Are they Necessary

woman with hands on her mid-section

Know Your Gut Microbiome

Trillions of microscopic organisms live in our gastrointestinal tract -- mostly bacteria, but also viruses and fungi. Known as the gut microbiome, these creatures line the intestines and colon, helping with digestion, metabolism, immunity and more.

“Everybody’s microbiome is different, and when you have a have a healthy balance of beneficial bacteria in your gut, these organisms work together to keep you well,” says Sandhya Salguti, MD, Doylestown Health board-certified gastroenterologist.

About Probiotics

“Among this community of microorganisms, probiotics are a species which may have health benefits when consumed in adequate amounts. They exist in some foods, and companies manufacture and sell a variety of over-the-counter formulas,” says Dr. Salguti. “Because probiotics are categorized as food supplements, they do not receive the same rigorous testing the Food and Drug Administration requires for medications.”

How Can Probiotics Help?

Though probiotics may help, we do not have enough evidence to recommend that everyone should take them to promote gut health; however, small studies have shown that probiotics may benefit certain conditions, according to Dr. Salguti. These include:

  • Antibiotic-associated diarrhea – Loose stools following a course of antibiotics, which fight infection by killing bad bacteria and sometimes destroy good bacteria
  • Traveler’s diarrhea – Abdominal discomfort and loose stools after consuming contaminated food or water
  • Irritable bowel syndrome – A chronic condition of the colon, which causes cramping, abdominal pain, bloating, gas, constipation and diarrhea
  • Pouchitis – An inflammation of the J-pouch, an internal pouch created during surgical treatment of ulcerative colitis

It’s Complicated - and Promising

With countless combinations of microorganisms to explore, the future of probiotics and health offers seemingly endless possibilities along with some challenges.

Probiotic Pros:

  • Not considered harmful to normal, healthy people
  • Small clinical trials have proven the benefit of probiotics in certain conditions
  • Studies are evaluating additional potential benefits of probiotics

Cons:

  • Expensive, not covered by insurance and don’t benefit everybody
  • Research has been limited
  • Some people are allergic or experience side effects such as gas and bloating
  • Can be dangerous if you have a weak immune system or serious, underlying medical condition

Ask your Doctor First

“As long as you’re in good health, it’s OK to try probiotics, but first, consult your physician about the potential risks and benefits, and for suggestions about probiotic use,” says Dr. Salguti.

Who should Avoid Probiotics

“People who are immunocompromised or have serious, underlying medical conditions should avoid probiotics completely,” warns Dr. Salguti. “For these individuals, probiotics can be dangerous and lead to serious infections.”

Know Your Microorganisms

Your physician may recommend a specific probiotic combination, depending on why you are taking them. Common ingredients include:

  • Lactobacillus (bacteria)
  • Bifidobacterium (bacteria)
  • Saccharomyces (yeast)

Probiotics in Food

“Some foods contain probiotics, but not in adequate amounts, while other foods contain probiotic supplements. Always read the label to see what you are getting,” says Dr. Salguti, who shares the following pointers:

  • Yogurt is pasteurized for safety, so it doesn’t generally contain a large number of probiotic microbes, unless added by the manufacturer.
  • Kiefer contains a higher concentration of live cultures, because it is fermented and relatively resistant to lactic acid.
  • Fermented foods like sauerkraut and kombucha won’t hurt, but there’s not a lot of research to prove they help.

Eating for a Healthy Gut

“Everyone’s gut microbiome is unique, so there is no one-size-fits-all recipe for gut health, but most people can benefit from a diet that is rich in plant-based, high fiber foods such as fruit, vegetables and whole grains,” suggests Dr. Salguti.

We cannot digest fiber, so our good gut bacteria help by initiating a fermentation process that breaks down these plant-based fibers in the colon into short-chain fatty acids, which feed and support beneficial bacteria.

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About Gastroenterology

Our caring, compassionate gastroenterologists are experts in the diagnosis and treatment of disorders and diseases of the digestive system. Using advanced screening tools, state-of-the-art treatments and innovative technology, our gastroenterology team delivers comprehensive care for conditions of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. The Open Access Colonoscopy Program allows healthy patients the convenience of scheduling a screening colonoscopy without an initial office visit.

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