Should I take a probiotic for gut health?

A probiotic supplement may seem like a good idea to improve gut health. In fact, one of the most common questions I am asked is “should I take a probiotic?” Whilst there is research that has found probiotic supplements to improve a number of health related symptoms and conditions (including gut health, IBS, diarrhoea, skin and immune health, mental health), is a probiotic supplement right for you? Let’s explore further…

WHAT ARE PROBIOTICS?

Probiotics are non-pathogenic live beneficial microorganisms, or “good bacteria”. Many (but not all) of these bacteria are part of the normal human gut microbiome and some are also found in the stomach, small and large intestines (colon) and vaginal canal. We even have bacteria on our skin, in our nostrils, and mouth.

Some of the most commonly used probiotics you may have heard of include Lactobacillus, Bifidobacterium, and Saccharomyces boulardii (a yeast). Each of these family of bacteria have several individual species, which in fact, all play different roles in the human gut.

BENEFITS OF PROBIOTICS

Probiotics improve gut health in a variety of ways including:

• blocking pathogenic bacteria from adhering to and residing in the gut;

• enhancing intestinal immune response to fight off pathogens entering the gut;

• maintaining production of short chain fatty acids (SCFAs) - these are produced by good bacteria and are essential for gut, body and brain health;

• reducing inflammation;

• repairing intestinal permeability (i.e. “leaky gut”);

• improving electrolyte absorption.

Probiotics have been used to treat:

• diarrhoea (including acute, traveller’s and post antibiotic use);

• constipation;

• Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) (however results from studies are mixed);

• leaky gut, dysbiosis (imbalance or overgrowth of gut bacteria), and SIBO (small intestinal bacterial overgrowth);

• dermatitis;

• colic;

• mastitis;

• reducing the risk of allergy and atopy in infants (when used during pregnancy and breastfeeding);

• urinary tract infections and vaginal infections;

• repopulating the gut after parasites, infections, food poisoning, and antibiotics;

• anxiety and depression.

WHAT PROBIOTIC SHOULD I TAKE?

The gut microbiome and symptoms and conditions related to the gut are highly complex, and not even that well understood. In saying that, different strains of probiotics have been studied and found to provide relief or treatment for specific conditions. For example, Lactobacillus Acidophilus helps to prevent urinary tract infections (UTI) and vaginal yeast infections. Whilst Saccharomyces Boulardii may alleviate allergy and asthma and improves immunity.

Most over the counter probiotics are “broad spectrum”, meaning you’re just adding a whole heap of bacteria into your gut, which may not actually be helpful and in some cases can worsen symptoms as it throws out your balance of bacteria or just adds too much bacteria that your gut doesn’t need. Same goes for drinking Kombucha on the daily. Ever found yourself incredibly bloated after a Kombucha?

If you're experience gut and digestive symptoms, it's best to work with a qualified Clinical Nutritionist who is trained in Nutritional Medicine and supplementation, as they will have a detailed understanding of what is evidence-based and effective for the specific symptoms and concerns you have.

We can also order functional tests such as a Complete Microbiome Mapping or GI Map test for in depth details of what is going on with your gut function and microbiome. This ensures we can target nutrition, supplementation and lifestyle treatment specifically to get to the root causes of your symptoms for long term results.

HOW CAN I IMPROVE AND MAINTAIN MY GUT HEALTH?

For a healthy gut, the best place to start is by eating prebiotic and small amounts of probiotic foods, as well as a variety of different types of fibre. Prebiotics and fibre feed the good bacteria in your gut, which in turn produce SCFAs that improve the gut lining and improve overall body health.

Prebiotic foods:

- vegetables and fruits, especially onions, leeks, garlic, artichoke, asparagus, broccoli, cabbage, bananas, apples, konjac root, peas

- oats, wheat bran, barley, chickpeas

- flaxseed and chia seed

Probiotic foods:

Kefir, yogurt, miso, tempeh, kimchi, saurekraut, pickled veg, natto.

OTHER CONSIDERATIONS FOR GUT HEALTH

Some of the factors that impact your gut health to consider include antibiotic use, antacids, oral contraceptive pill, stress, food intolerances and allergies, environmental toxins, low stomach acid (hypochlorhydria).

References:

Islam S. U. (2016). Clinical Uses of Probiotics. Medicine, 95(5), e2658. https://doi.org/10.1097/MD.0000000000002658

Suez, J., Zmora, N., Segal, E., & Elinav, E. (2019). The pros, cons, and many unknowns of probiotics. Nature medicine, 25(5), 716–729. https://doi.org/10.1038/s41591-019-0439-x

Wilkins, T., & Sequoia, J. (2017). Probiotics for Gastrointestinal Conditions: A Summary of the Evidence. American family physician, 96(3), 170–178.

Wieërs, G., Belkhir, L., Enaud, R., Leclercq, S., Philippart de Foy, J. M., Dequenne, I., de Timary, P., & Cani, P. D. (2020). How Probiotics Affect the Microbiota. Frontiers in cellular and infection microbiology, 9, 454. https://doi.org/10.3389/fcimb.2019.00454