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What Are Probiotics and Why Do I Need Them?

I am using more and more probiotics in my practice, for problems as wide-ranging as “tummy viruses” to ulcerative colitis and most everything in-between. Here’s a little primer on what they are and what they do.

Prepared for the subscribers of
Pharmacist’s Letter / Prescriber’s Letter to give to their patients.
Copyright © 2006 by Therapeutic Research Center

What are probiotics?
Probiotics are live, “friendly” organisms that live in the intestine. They help decrease “unfriendly”
bacteria and viruses that cause diseases such as diarrhea. Examples of probiotics include Lactobacillus,
Bifidobacteria, and Saccharomyces boulardii.

For what conditions are probiotics effective?
Certain probiotics have been shown to be beneficial for preventing and treating some types of diarrhea, including diarrhea caused by antibiotics. Probiotics also seem to help some bowel diseases such as ulcerative colitis and irritable bowel syndrome.
Some yogurts that contain the probiotic Lactobacillus might also help women who get frequent vaginal yeast infections. However, eating yogurt doesn’t seem useful for preventing vaginal yeast infections caused by antibiotics.

What probiotic products are available, and how do I choose one?
Not all probiotic products are the same. Some do not contain what they say on the label. Others do not contain enough live organisms to be effective. And some probiotics work better for certain conditions than others. Clearly, product selection is important. To prevent diarrhea caused by antibiotics, choose Culturelle (Lactobacillus GG) or Florastor (Saccharomyces boulardii). You can also try these products for prevention of traveler’s diarrhea. Start taking them a few days before travel, and continue them for the duration of your trip. Yogurt is a source of probiotics, but not all yogurts contain the right kinds of organisms. Choose a
product with the National Yogurt Association’s “Live and Active Cultures” seal on the label (e.g., Dannon, Yoplait). You will need to eat about 8 oz twice daily to prevent antibiotic-associated diarrhea. To prevent frequent vaginal yeast infections, try 6 oz daily of a yogurt containing Lactobacillus acidophilus.
VSL#3 is a probiotic mixture used for certain bowel conditions such as ulcerative colitis and irritable bowel syndrome. It may help reduce stomach pain and bloating if you have irritable bowel syndrome. Studies published just this year (2009) have documented VSL #3 and Align as very effective for bloating and cramping.

What are the side effects of probiotics?
In some people, probiotics can cause stomach and intestinal upset, including gas and bloating. These usually improve with time.

Are there any drug interactions with probiotics?
Antibiotics are used to reduce harmful bacteria in the body. They can also reduce friendly bacteria like Lactobacillus and Bifidobacteria. If you are using these probiotics or yogurt, you should take them at least two hours before or after the antibiotic. The calcium in yogurt can also decrease the effectiveness of some antibiotics. You may need to allow more than two hours between eating your yogurt and taking your antibiotic. Check with your pharmacist for the best way to avoid this interaction. Saccharomyces boulardii is a fungus. Medications for fungal infections help reduce fungus in and on the body. Taking Saccharomyces boulardii with medications for fungal infections can reduce its effectiveness. Some medications for fungal infections include Diflucan, Lamisil, Sporanox, and others.

Who should not take probiotics?
For healthy people, routine use of probiotics to maintain bowel health is unnecessary. There is a small risk of infection with probiotics. If you have a weakened immune system you should not take probiotics unless you’ve checked with your healthcare professional. If you are pregnant or breastfeeding, you
should get approval from your healthcare professional before taking any probiotic other than yogurt.
Detail-Document #220704
−This Detail-Document accompanies the related article published in−
July 2006 ~ Volume 22 ~ Number 220704
More. . .
Copyright © 2006 by Therapeutic Research Center