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Probiotics and Prebiotics

There are two absorption systems in your body. Food that is easily broken down is absorbed into your upper intestinal tract. If you cannot absorb a particular food, it goes to the lower intestinal tract (colon), where bacteria in your colon ferment it to smaller products that can be absorbed.

Your colon is loaded with good and bad bacteria. Bad bacteria such as clostridia that are kept in check by good bacteria. If you take an antibiotic that knocks off the good bacteria, the clostridia can overgrow and cause diarrhea.

The good bacteria break down soluble fiber to form chemicals such as short chain fatty acids that are absorbed into your bloodstream and travel to your liver where they block the liver from making cholesterol and help to prevent heart attacks. These short chain fatty acids also reduce inflammation, so they help to control the bloody diarrhea and ulcers caused by Crohn's disease. They also reduce swelling and pain of arthritis, diabetes and psoriasis, and some studies show they may even improve your immunity to help you to kill germs.

If you wish to encourage the growth of good bacteria in your colon, you have two choices: probiotics or prebiotics. Probiotics are living microorganisms, the good bacteria, that live in the colon and reduce inflammation and help prevent and treat Crohn's disease, psoriasis, arthritis, and perhaps even certain types of cancers. Prebiotics are nondigestible food ingredients that cannot be absorbed in the upper intestinal tract and travel to the colon where they serve as a medium to encourage the growth of the good bacteria.

Live-culture yogurt is a readily available source of good bacteria. However, the lactobacilli that are in live cultures of yogurt will not colonize in your intestines, so they disappear if you stop eating yogurt every day. Most yogurt products do not contain live cultures; read the labels carefully.

One strain of good bacteria that has been studied extensively and has been shown in controlled scientific studies to have the ability to colonize in the intestines is called lactobacillus GG. It was isolated from intestines of humans by two professors at Tufts Medical School named Sheldon Gorbash and his colleague named Golden, hence the name lactobacillus GG. They have patented their product and make a lot of money from it.

Several studies show that Lactobacillus GG can help control the frequency and severity of infectious diarrhea in children. Diarrhea that is often caused by taking antibiotics can be prevented by taking either Lactobacillus GG or Saccharomyces boulardii with the antibiotics. A probiotic preparation (VSL=3 - 6 g/day) that uses a combination of three species of Bifidobacterium, four strains of Lactobacillus and one strain of Streptocccus has been shown to maintain remission in ulcerative colitis as well as in preventing the postoperative recurrence of Crohn's disease. Taking probiotic compounds is well tolerated and safe.

Prebiotics are found in certain foods that are not completely absorbed in your upper intestinal tract pass to your colon and form the food that encourages growth of the good bacteria. Soluble fiber is the part of these foods that is most likely to encourage the growth of good bacteria. Prebiotic supplements are available, but it is easier and cheaper just to eat plenty of the foods that provide this benefit. Good sources of soluble fiber are whole grains, beans, seeds, vegetables and nuts.  See Should You Take Probiotics?

The use of probiotics in gastrointestinal disease. Canadian Journal of Gastroenterology, 2001, Vol 15, Iss 12, pp 817-822. KL Madsen. Univ Alberta, 536 Newton Bldg, Edmonton, AB T6G 2C2, CANADA

Checked  9/22/18

May 12th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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