A few weeks ago, I spoke to you about the microbiota , the millions of bacteria that coexist with us in perfect harmony, and that play important functions such as protecting our organism from potentially harmful microorganisms, controlling the proliferation and differentiation of intestinal cells, produce vitamins etc, and whose imbalance (dysbiosis) seems to be responsible for multiple diseases.
In that post, I gave you a series of recommendations to take care of our bacteria ... but what if that is not enough? What if we need something more to recover an extremely damaged flora?
Phillips’ Colon Health Probiotic Capsules
Today I talk about probiotics, but before ... I'm going to do a bit of history (which you already know I like):
We have proof of the use of fermented milk for the treatment of gastrointestinal infections since, at least, the year 76 BC ., Note that it is not something new, it has rained since then.
In 1901, Metchnikoff proposed the theory that the gut microbiota could be modulated in a beneficial way for the organism by the oral administration of the bacteria involved in the fermentation of yogurt, since these would be able to suppress the putrefactive bacteria, and that for this reason, the Bulgarian peasants (great lovers and consumers of yogurt) would be so long-lived. He published his observations in the book "Prolongation of Life" ... a visionary, do not you think?
yogurt
In 1909, Isaac Carasso , another visionary, but in this case of business, created the trademark Danone in Barcelona, and began to market the yogurt, which until then, was dispensed in pharmacies and was used to prevent or alleviate various disorders (diarrhea, constipation, cystitis, dermatitis, colitis ...)
In 1965, Lilly and Stillwell introduce the term probiotic, and define it as "that factor of microbiological origin that stimulates the growth of other organisms."
So, as you can see, probiotics are not new ... their properties have been known for centuries, but more and more research is being done on them, different strains are cultivated and commercialized and new benefits are discovered, hence the title of the post … what's new Old man?
But what are they exactly?
Before "getting into work" ... I think it is necessary to differentiate three concepts :
- - Probiotics : They are live microorganisms that when delivered in adequate amounts promote health benefits in the body of the individual who consumes them.
- - Prebiotics : Selectively fermented ingredients that give rise to specific changes in the composition and / or activity of the gastrointestinal flora, thus conferring benefits to the health of the host
- - Symbiotics : Products that contain both probiotics and prebiotics
The Spanish Society of Probiotics and Prebiotics (SEPYP), establishes a series of conditions in its consensus document to be able to speak properly of probiotics:
- They are living microorganisms that, when administered in adequate quantities, confer a benefit on the health of the recipient.
- The substances "constituents of" or "produced by" microorganisms can not be considered probiotic.
- To be able to talk about probiotics, it must be demonstrated scientifically, through studies carried out in human population and with adequate scientific methodology, which produces beneficial effects in the organism.
- Laboratory studies are essential and provide a lot of information, but they are not enough to ensure a benefit in humans.
- The health effects demonstrated for a strain are not extrapolated to other strains of the same area.
- A strain that proves to be effective for an indication does not have to be valid for others. Thus, the effectiveness of some strains is amply demonstrated for gastrointestinal indications, others are effective for the prevention of infections etc.
- The scientific evidences demonstrated on a population (for example children), can not be extrapolated to others (for example elderly people, pregnant women ...)
Why do I tell you this?
Because not everything we think is a probiotic is , not all probiotics are the same or are worth for the same things ... and it is important to differentiate and not assume that what goes well for the neighbor of the fifth will go well with me ... as with all drugs, go.
What are its main properties?
- They are able to survive in the gastrointestinal tract and adhere to the epithelium (the most superficial layer of the intestine)
- They are able to modulate / change / improve the gut microbiota.
- Decrease intestinal permeability, getting the intestine to function properly (intestinal permeability gives for another post, only I advance you that seems to be involved in many pathologies)
- They produce changes in the immune system, modulating and / or stimulating it ... and therefore have (or could have) an effect on infections and autoimmune diseases.
- Its use is safe in humans
What are the main microorganisms that deserve to be called probiotics?
- Strains of bacteria belonging to the genera Bifidobacterium and Lactobacillus
- Strains of bacteria that belong to other genera, such as Enterococcus, Streptococcus, Escherichia coli and Bacillus cereus
- Non-pathogenic yeasts, mainly Saccharomyces cerevisiae and Saccharomyces boulardii
What has been shown to be useful?
On this occasion, I will not put all references to the studies that I name (the post would be too long) ... but if someone is interested in any particular, ask and send it.
Diarrhea.
- Acute diarrhea secondary to infectious gastroenteritis is common in children and can be serious. The administration of Lactobacillus rhamnosus strain GG has been shown to be useful in children, since it significantly reduces the duration of diarrhea, especially when the cause is the dreaded rotavirus . The effect of probiotics in adults is less studied, but some strains (such as Enterococcus faecium SF 68) have been shown to be effective in these cases. Lactobacillus GG, Lactobacillus casei DN-114001 and Saccharomyces Boulard are effective in the prevention of some types of acute diarrhea, both in adults and children.
- The diarrhea associated with antibiotics appears in approximately 20% of consumers of the same, and it is thought that it is due to the alteration that they produce on the intestinal flora, after all, that is their mission , to kill bacteria; The problem is that it also ends with the "good" bacteria, causing the bad ones to proliferate. It has been shown that the use of Saccharomyces boulardii or Lactobacillus rhamnosus, while antibiotic therapy lasts, prevents or shortens diarrhea secondary to erythromycin, clindamycin or ampicillin, among others. In addition, the efficacy of Lactobacillus casei DN-114 001 in hospitalized adults for the prevention of diarrhea associated with antibiotics and Clostridium difficile diarrhea is demonstrated.
- Traveler's diarrhea ... diarrhea that can spoil more than one holiday, and that is usually due to infection by Escherichia coli, Salmonella spp, Shigella spp, and Campylobacter spp, could improve with the use of probiotics, although the results of several studies do not They are, still conclusive .
- Radiation-induced diarrhea , could be improved with the use of preparations that include Lactobacillus casei, Lactobacillus acidophillus, Lactobacillus plantarum, Lactobacillus delbrueckii, Lactobacillus bulagricus, Bifidobacterium longum, Bifidobacterium brevis, Binfantis, Saccharomyces thermophilus (450 × 109) ... although it is not perfectly demonstrated .
Constipation.
The bifidobacteria present in some dairy products can reduce intestinal transit time, which benefits in case of constipation.
Intestinal Inflammatory Disease.
It is thought that inflammatory bowel disease (IBD) occurs because, in genetically predisposed people, the intestinal flora itself triggers an exaggerated and chronic inflammation of the intestinal wall . In these patients, in addition, profound alterations have been found in the microbiota, so the administration of specific probiotics can be very useful, especially in case of pouchitis and ulcerative colitis.
- In the case of Crohn's disease, the benefit is not perfectly demonstrated.
- Irritable bowel syndrome / colicky pain.
- Several studies show the efficacy of different strains when it comes to improving pain, distension of the abdomen and flatulence (Bifidobacterium and combinations).
- Lactobacillus reuters seems to be effective in some cases of infant colic.
- Necrotizing enterocolitis.
Supplementation with probiotics in preterm infants (before week 33 of gestation), seems to reduce the risk of necrotizing enterocolitis and death due to this cause.
Lactose intolerance.
Lactose intolerance, both permanent and transient (after suffering from gastroenteritis, for example), affects a significant number of people. It is produced by the lack of lactase , the enzyme responsible for digesting lactose (milk sugar), which, when it reaches the large intestine, is fermented by the bacteria that live there, producing short-chain fatty acids and gas, and as a consequence: cramping pain, flatulence and diarrhea.
However, many people intolerant to lactose (eye, not all), perfectly tolerate fermented milk products (yogurt, kefir ...), and this is due, no more or less, to the probiotics present in these foods: lactobacilli ( containing lactases) since yogurt moves more slowly through the intestine than milk (giving time for their lactases to digest much of the lactose) .... Now you know why doctors advise taking yogurt after a gastroenteritis .
One of the "niches" of the human microbiome is the breast, and from these microorganisms the baby benefits during the entire duration of breastfeeding.
But in this area, as in others, when there is an imbalance (a dysbiosis) and start to proliferate pathogenic microorganisms against the beneficial ... problems arise.
In recent years, much progress has been made in the investigation of the infectious complications that occurred during the breastfeeding period, and it has been demonstrated that all of them can be solved or improved considerably with the use of specific probiotics ... I attest: during my 3 prolonged lactations I have suffered some of them, and, in my case , they worked perfectly.
In the case of mastitis, for example, treatment with probiotics could be started early and, if it does not improve in a couple of days, associate an antibiotic to which the bacteria that are typically responsible for this condition are sensitive (for this reason, ideal is to make a crop).
In case of breast abscess, it is almost always necessary to perform drainage and to regulate antibiotics, but the addition of probiotics to the treatment improves the evolution.
And the rest of complications, usually respond favorably, yes, if they appear, you should always check with your midwife or doctor to control the evolution of the picture.
Improvement of the immune response.
Probiotics, as I have already mentioned, have a protective effect against pathogenic microorganisms, since they prevent them from proliferating and reinforce the barrier effect of the intestinal wall.
But it is also that they are able to increase the activity of several types of cells (macrophages and lymphocytes) that are part of our immune system (which is what defends us from viruses, bacteria, etc.) and stimulate the response of this system.
Atopic disease / Allergies.
Some strains of specific probiotics have shown efficacy for the treatment and prevention of atopic eczema:
Thus, if there is a history of severe atopic dermatitis, it has been proven that, during the last month of pregnancy, the mother is given specific strains of Lactobacillus, as long as the delivery is vaginal (this is the only way for the baby acquire maternal flora), and the mother maintains breastfeeding as long as possible, the risk of atopy is greatly reduced.
Other studies show that the use of probiotics in the first months of life can improve the symptoms of atopic disease in infants at risk of allergies.
Vaginal infections
Most of the vaginal infections are produced by Candida Albicans , which is a yeast (a fungus), which is part of our normal vaginal flora, but which, under certain circumstances (taking antibiotics, decompensated diabetes, high-carbohydrate diets) carbon ...), can proliferate and produce the annoying candidiasis.
Well, many strains of Lactobacillus, help the treatment and prevention of recurrent infections by said yeast, plus they can also improve bacterial vaginosis.
Other effects in the process of demonstrating or not sufficiently demonstrated:
Weightloss.
People with overweight and obesity, have a characteristic intestinal flora, different from that found in thin people as I explained here and here .
In addition, several studies show that when performing a transplant of feces of obese mice to thin mice, the latter begin to gain weight.
For all this, it seems sensible to think that some strains of probiotics could be beneficial in the treatment of obesity ... and that is what is investigated:
- It seems that they inhibit the absorption of fat , since when consuming them, the amount of fat excreted in the faeces increases, this fact could also be responsible for the improvement in the lipid profile (decreasing the "bad" cholesterol or LDL and the triglycerides and increasing the "good" cholesterol or HDL)
- They increase the production of GLP-1 , which has a satiating effect and favors weight loss.
- The bacterium L. gasseri can reduce abdominal fat by 8.5%
Eradication of Helicobacter Pylori.
Although more studies are needed, it is very possible that the use of probiotics as adjuvants to the classic treatments (antibiotics associated with antacids), increases the success rates.
Acute pancreatitis
The administration of synbiotics in patients with severe acute pancreatitis seems to improve the prognosis of these patients.
Colorectal cancer:
Studies in animals show the reduction of cancer risk by supplementation with strains of lactobacilli and bifidobacteria that can modify the microbiota.
Other studies show that high consumption of dairy products can reduce the risk of colon cancer due to its antitumor activity.
Others:
Currently, there are many publications that ensure that its use can be beneficial in dental diseases (caries, periodontitis ...), endometriosis or other gynecological pathologies, preoperative gastrointestinal surgeries, urinary tract infections, hypercholesterolemia, hypertension, diabetes, autism ... the list is vast , although more studies are needed to confirm them.
But nothing is perfect ...
Do not forget that probiotics do not work the same in all people, nor all are valid for all things.
These are medicines, and although they are safe and generally well tolerated, we must remember that they must always be prescribed by a doctor and that they can have side effects (digestive discomfort, bloating, gas) that usually disappear in a few days.
In addition, its use is contraindicated in people who have a depressed immune system (patients undergoing immunosuppressive drugs, with immunodeficiency syndromes ...), since introducing bacteria or fungi into their bodies (even if they are potentially beneficial), could be dangerous.
The results are usually not immediate, sometimes you have to take them for weeks to get the desired effect.
And finally, its use must be limited in time ... let's not forget that they are drugs and that they are also microorganisms.
In short ... they have great advantages, they have shown great benefits over many diseases and situations more or less pathological, but not all are worth for the same, are not indicated in all people, and always, must be prescribed, and controlled by a doctor, at the right doses and for a limited time ... remember that they are not candy !.