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Probiotics and Digestive Ailments: What We Know So Far

Probiotics and Digestive Ailments: What We Know So Far: Main Image
Specific probiotics help relieve symptoms, especially abdominal pain, in people with IBS
Probiotics are among the most popular nutritional supplements, taken mostly to treat digestive symptoms--but do they work? After examining the body of research looking at probiotics' effectiveness, a panel of experts determined that supplements with specific strains of gut-friendly microbes are beneficial in treating some digestive disorders, in particular, IBS (irritable bowel syndrome) and antibiotic-associated diarrhea.

Proven probiotic benefits

The panel was made up of primary care physicians, other healthcare providers, and a microbiologist, each with a special interest in gastroenterology. They examined 37 trials in which probiotics were used to treat digestive problems. The majority of the trials focused on IBS (19) or antibiotic-associated diarrhea (10), and the remainder (8) covered general gastrointestinal issues. They discussed the trials' findings and developed a set of conclusions, ranking the evidence for their conclusions as high, moderate, or low:

  • High:
    • Probiotics are safe in people with a wide array of digestive symptoms.
    • Specific probiotics help relieve symptoms, especially abdominal pain, in people with IBS.
    • Specific probiotics help prevent or shorten the duration of diarrhea associated with taking antibiotics.
  • Moderate:
    • Specific probiotics help relieve bloating and improve the frequency or consistency of bowel movements in people with IBS.
    • Specific probiotics help people with diarrhea-predominant IBS.
    • Probiotic treatment may improve quality of life by reducing symptoms in people with gastrointestinal problems.
  • Low:
    • Specific probiotics help relieve constipation in people with IBS.

Probiotics help people with certain digestive ailments

The panel summarized their conclusions as follows: "Overall, the randomized, placebo-controlled trials included in our analysis support, with a high evidence level, a role for specific probiotics in the management of overall symptoms and abdominal pain in patients with IBS, and for preventing or reducing diarrhea in patients receiving antibiotics."

There were no conclusions about what specific probiotics or amounts to recommend because there was little consistency among the trials they considered; however, most of the trials used strains of lactobacilli, bifidobacteria, or both.

Tips for a happy, healthy gut

In addition to considering specific probiotic supplements, people with digestive problems can take the following steps to improve digestive health:

  • Eat your probiotics. Fermented and cultured foods like yogurt, kefir, and unpasteurized sauerkraut are rich sources of lactobacilli. Regular consumption may help you maintain or recover healthy digestive function.
  • Feed your flora. The bacteria in your large intestine need lots of fiber from foods like apples and pears, garlic, onion, Jerusalem artichokes (sometimes called sunchokes), and whole grain oatmeal to flourish.
  • Personalize your diet. Many people with digestive problems feel better after finding and eliminating specific foods. Wheat and dairy are often culprits, but for some people other foods such as eggs, soy, or corn are to blame. A nutritionally oriented health practitioner can help you figure out what foods you might be better off avoiding.

(Aliment Pharmacol Ther 2013;38:864-86)

Maureen Williams, ND, completed her doctorate in naturopathic medicine at Bastyr University in Seattle and has been in private practice since 1995. With an abiding commitment to access to care, she has worked in free clinics in the US and Canada, and in rural clinics in Guatemala and Honduras where she has studied traditional herbal medicine. She currently lives and practices in Victoria, BC, and lectures and writes extensively for both professional and community audiences on topics including family nutrition, menopause, anxiety and depression, heart disease, cancer, and easing stress. Dr. Williams is a regular contributor to Healthnotes Newswire.
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