Probiotics are a dietary supplement that contain live nonpathogenic organisms that are meant to provide gastrointestinal and whole-body benefits. Probiotics can be taken in a capsule or powder form but are also present in fermented foods and dairy products, such as yogurt. The proposed mechanism of action is to supplement the gastrointestinal microbiome to aid in maintaining a healthy balance between the symbiotic and pathogenic gut flora. There is growing interest and clinical research on the importance of an immunologic equilibrium in the gastrointestinal impact and its importance on all aspects of health. There is a wide variety of bacterial and yeast strains that can be found in probiotics, and based on the composition of the product, probiotics can provide different effects (Williams N.T.).
The most commonly occurring species are the lactobacillus and Bifidobacterium bacteria and the saccharomyces yeast. These are the most clinically studied species in humans for their benefits in a wide range of acute and chronic conditions. Probiotics are often recommended as adjunct treatment when patients are receiving antibiotics, as well as in gastrointestinal disorders such as clostridium difficile infections and associated diarrhea, ulcerative colitis (UC), irritable bowel disease (IBD), and necrotizing enterocolitis. C. difficile diarrhea benefits from higher colony forming units (CFUs) rather than the content of the probiotic. Studies recommend that greater than 10 billion CFUs has more benefit in faster recovery times. In UC, IBD, and necrotizing enterocolitis, Bifidobacterium is a preferred species for patients to see benefits. The use of probiotics has also been studied for hepatic encephalopathy and colic as well, but clinical studies have not concluded specific benefits of any particular formulation or strain. Additionally, doctors and pharmacists can recommend that patients take probiotics as an adjunct to antibiotic regimens to mitigate secondary infections and gastrointestinal side effects due to broad- spectrum effects of antibiotics (Wilkins, T.).
It is important to note that despite the popular of probiotics, these products are not subjected to the same level of regulation by the U.S. Food and Drug Administration (FDA) as prescription medications. This is because many probiotics available on the market are labelled as dietary supplements, and thus do not need FDA approval to be sold commercially. Additionally, the ‘structure and function’ health claims on the label of these products are not reviewed by the FDA, and therefore are not clinically- backed health claims despite ongoing support and research for clinical use. (Degnan F.H.).
The increasing popularity of probiotics in promoting and supporting optimal health coincides with the increasing research regarding the gut microbiome and its deep connections to one’s overall health, and therefore probiotic use is something that may be appealing to patients as an adjunctive therapy to their pharmacological management.
Citations:
Degnan F. H. (2008). The US Food and Drug Administration and probiotics: regulatory categorization.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 46 Suppl 2, S133–S151. https://doi.org/10.1086/523324
Wilkins, T., & Sequoia, J. (2017). Probiotics for Gastrointestinal Conditions: A Summary of the Evidence.American family physician, 96(3), 170–178.
Williams N. T. (2010). Probiotics.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 67(6), 449–458. https://doi.org/10.2146/ajhp090168
Probiotics
Probiotics are a dietary supplement that contain live nonpathogenic organisms that are meant to provide gastrointestinal and whole-body benefits. Probiotics can be taken in a capsule or powder form but are also present in fermented foods and dairy products, such as yogurt. The proposed mechanism of action is to supplement the gastrointestinal microbiome to aid in maintaining a healthy balance between the symbiotic and pathogenic gut flora. There is growing interest and clinical research on the importance of an immunologic equilibrium in the gastrointestinal impact and its importance on all aspects of health. There is a wide variety of bacterial and yeast strains that can be found in probiotics, and based on the composition of the product, probiotics can provide different effects (Williams N.T.).
The most commonly occurring species are the lactobacillus and Bifidobacterium bacteria and the saccharomyces yeast. These are the most clinically studied species in humans for their benefits in a wide range of acute and chronic conditions. Probiotics are often recommended as adjunct treatment when patients are receiving antibiotics, as well as in gastrointestinal disorders such as clostridium difficile infections and associated diarrhea, ulcerative colitis (UC), irritable bowel disease (IBD), and necrotizing enterocolitis. C. difficile diarrhea benefits from higher colony forming units (CFUs) rather than the content of the probiotic. Studies recommend that greater than 10 billion CFUs has more benefit in faster recovery times. In UC, IBD, and necrotizing enterocolitis, Bifidobacterium is a preferred species for patients to see benefits. The use of probiotics has also been studied for hepatic encephalopathy and colic as well, but clinical studies have not concluded specific benefits of any particular formulation or strain. Additionally, doctors and pharmacists can recommend that patients take probiotics as an adjunct to antibiotic regimens to mitigate secondary infections and gastrointestinal side effects due to broad- spectrum effects of antibiotics (Wilkins, T.).
It is important to note that despite the popular of probiotics, these products are not subjected to the same level of regulation by the U.S. Food and Drug Administration (FDA) as prescription medications. This is because many probiotics available on the market are labelled as dietary supplements, and thus do not need FDA approval to be sold commercially. Additionally, the ‘structure and function’ health claims on the label of these products are not reviewed by the FDA, and therefore are not clinically- backed health claims despite ongoing support and research for clinical use. (Degnan F.H.).
The increasing popularity of probiotics in promoting and supporting optimal health coincides with the increasing research regarding the gut microbiome and its deep connections to one’s overall health, and therefore probiotic use is something that may be appealing to patients as an adjunctive therapy to their pharmacological management.
Citations:
Degnan F. H. (2008). The US Food and Drug Administration and probiotics: regulatory categorization. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 46 Suppl 2, S133–S151. https://doi.org/10.1086/523324
Wilkins, T., & Sequoia, J. (2017). Probiotics for Gastrointestinal Conditions: A Summary of the Evidence. American family physician, 96(3), 170–178.
Williams N. T. (2010). Probiotics. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 67(6), 449–458. https://doi.org/10.2146/ajhp090168