The manipulation of the gut microbiota is complex and may cause bacteria-host interactions.[7] Though probiotics are considered safe, some have concerns about their safety in certain cases.[7][40] Some people, such as those with immunodeficiency, short bowel syndrome, central venous catheters, cardiac valve disease and premature infants, may be at higher risk for adverse events.[5] In severely ill people with inflammatory bowel disease there is a risk of the passage of viable bacteria from the gastrointestinal tract to the internal organs (bacterial translocation) as a consequence of bacteremia, which can cause adverse health consequences.[7] Rarely, consumption of probiotics by children with lowered immune system function or who are already critically ill may result in bacteremia or fungemia (i.e., bacteria or fungi in the blood), which can lead to sepsis, a potentially fatal disease.[6]
The discovery of the benefits of probiotics began with sour milk. Today we have many other options to get various bacteria from our foods, although it's not as simple as just adding them to the food. For there to be health benefits, the microorganism has to be able to survive the passage through the gastrointestinal tract, survive the food manufacturing process, and grow and survive during the ripening or storage period. Also, the bacteria must not negatively affect product quality and be included on the Generally Recognized as Safe (GRAS) list.

Your gut comes in continuous contact with important nutrients your body needs, but also toxins, food additives, microbes, and drugs that regularly pass through your digestive tract. Your gut has a huge task to not only serve as a porous filter for the building blocks of life but also to keep out all the detrimental substances you may be exposed to. Beyond being a gatekeeper, your gut digests food and absorbs nutrients, maintains an immune barrier, and helps you detoxify, all while maintaining the correct balance of healthy flora or probiotic (from the Greek pro = "for"; biota = "life") bacteria.
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Contrasting antibiotics, probiotics were defined as microbially derived factors that stimulate the growth of other microorganisms. In 1989 Roy Fuller suggested a definition of probiotics that has been widely used: "A live microbial feed supplement which beneficially affects the host animal by improving its intestinal microbial balance."[61] Fuller's definition emphasizes the requirement of viability for probiotics and introduces the aspect of a beneficial effect on the host.
Importantly, patients with gastrointestinal conditions are not the only ones taking probiotics. 3·9 million people in the USA alone regularly take probiotic supplements, with promised benefits ranging from improved digestion and immune function to improved mental health and prevention of heart disease. However, evidence for these benefits is lacking, and because probiotics are often sold as supplements, manufacturers in many countries are not required to provide evidence of their safety and efficacy to regulatory bodies. The ubiquity of probiotic products would suggest that, at worst, they are harmless. Nevertheless, some safety concerns have been raised, including the risk of contamination, possibility of fungaemia or bacteraemia (particularly in immune-compromised, elderly, or critically ill individuals), small intestinal bacterial overgrowth, and antibiotic resistance. Adding to concerns, clinical trials of probiotics have not consistently reported safety outcomes.
"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav says. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects."
To qualify as a probiotic, certain criteria need to be met: a bacterial strain must be fully identified, be safe for ingestion, adhere to the luminal mucosa, colonize the gut, and possess documented health benefits (Table 2). A probiotic should be delivered in a formulation that is stable when stored. The colony number of bacteria and viability need to be reliable and they must survive the acid and bilious environment in the upper GI tract before they reach the small intestine and colon. Since the quality and content of probiotics have not been regulated, it is difficult to accurately assess their efficacy and safety.
Probiotics have become buzzy in recent years: Celebrities including Lauren Conrad and Anna Paquin have been spotted carrying bottles of kombucha, a probiotic-containing fermented tea, and the probiotics market has been growing rapidly as more people pursue better health by taking probiotic supplements. Prebiotics are attracting notice too, but you may still be unsure of what exactly prebiotics and probiotics are. Here's what you need to know about them to decide whether taking supplements is right for you.
In 2015, the global retail market value for probiotics was US$41 billion, including sales of probiotic supplements, fermented milk products, and yogurt, which alone accounted for 75% of total consumption.[42] Innovation in probiotic products in 2015 was mainly from supplements, which produced US$4 billion and was projected to grow 37% globally by 2020.[42] Consumption of yogurt products in China has increased by 20% per year since 2014.[43]

Caution needs to be taken by everyone who chooses to take these supplements, but this is especially true for children, pregnant women, elderly people, and people with compromised immune systems. For people with compromised immune systems due to disease or treatment for a disease (such as cancer chemotherapy), taking probiotics may actually increase one's chances of getting sick. It has been shown that the use of various probiotics for immunocompromised patients or patients with a leaky gut has resulted in infections and sepsis (infection of the bloodstream). One case of bacteremia (bacteria in the bloodstream) was recently found when someone with active severe inflammatory bowel diseases with mucosal disruption was given Lactobacillus GG. Always speak with a doctor before taking any supplement under these circumstances.

This dairy-free, gluten-free, vegetarian probiotic delivers live microorganisms, protected in stomach acid-resistant capsules to ensure effective delivery throughout your digestive system, from the stomach through your small intestines. The result is the repair and sustained maintenance of your intestinal micro-ecology, which in turn helps support healthy immune response and bowel regularity.
Because of the way bacteria spread from the rectum to the vagina and urinary tract in women, probiotics have been a proposed remedy for urinary tract infection (UTI) in women. A 2012 review confirmed that probiotics seem to be effective in preventing recurrent UTIs, but more research is required before a determination can be made. The healthy strains of bacteria that help achieve this are also somewhat less common, which means proper treatment could be logistically complicated.
However, it’s not just digestive woes that probiotics can help address. A clinical case series followed 300 patients who took a probiotic mixture of L. acidophilus and L. bulgaricus. They documented that 80% of acne patients had some degree of clinical improvement, particularly effective in inflammatory acne. Later, an Italian study involving 40 patients found L. acidophilus and B. bifidum supplementation produced better clinical outcomes in acne as well as better tolerance and compliance with antibiotics [2].
Years after Mechinkoff’s experiments, scientists began conducting tests which involved feeding strains of bacteria to humans and rats and observing changes in the fecal microbiota to measure the changes of the intestinal flora. Researchers soon found that L. acidophilus was especially beneficial when implanted in the human digestive tract and could confer a multitude of health benefits, including relief from constipation.
Did you know that bacteria might actually keep you healthy? It all just depends on the type of bacteria. In this case, we’re talking about the benefits of probiotics. Probiotics benefits are some of the most widely researched natural solutions to gut health. For years, scientists and physicians have observed the many benefits of probiotics for not just the gut, but for the entire body.
Probiotics are safe in the amounts you normally find in food. In general, most healthy adults can safely add foods or dietary supplements that contain probiotics to their diets. Some individuals might experience gas (flatulence), but that generally passes after a few days. But which strains of bacteria are most helpful or which doses are best isn't always known. And if you are lactose intolerant, you can experience stomach discomfort if you try to get your probiotics from dairy products. In that case, consider using a dairy-free probiotic.
In the gastrointestinal tract, L. plantarum can help regulate immunity and control inflammation. A 2007 study found that the probiotic could suppress an inflammatory response in the gut. Perhaps most significantly, a double-blind placebo-controlled study over four weeks concluded that L. Plantarum 299v provided effective symptom relief, especially of abdominal pain and bloating, in patients with IBS [1].
In their second act, probiotics—both in food and supplement form—are being promoted as a magic wellness bullet, said to defeat allergies and depression, boost immunity, and even combat chronic conditions like Alzheimer's, diabetes, and migraines. As a result, they're no longer limited solely to foods that naturally contain them (such as yogurt and fermented fare like kimchi and miso); everything from bottled water to tortilla chips is being laced with the friendly microbes.
Probiotics seem to be all the rage these days. With many purported benefits and a relatively low risk of side effects, manufacturers are taking advantage of booming business opportunities. Rather than leave your health in the hands of big business, it is important that you be as educated as possible about the best types of probiotics so you can choose what is right for you and your family.
Probiotics help tip the balance back in favor of the good bacteria. In doing so, they may provide some relief if you have irritable bowel syndrome (IBS), ulcerative colitis, acute infectious diarrhea, and diarrhea associated with antibiotic use or Clostridium difficile (C.diff) infection. They also can boost your immunity, fight inflammation and potentially have beneficial effects on cholesterol. 

^ Newlove-Delgado TV, Martin AE, Abbott RA, Bethel A, Thompson-Coon J, Whear R, et al. (2017). "Dietary interventions for recurrent abdominal pain in childhood". Cochrane Database Syst Rev. 3: CD010972. doi:10.1002/14651858.CD010972.pub2. PMID 28334433. Overall, there is some evidence to suggest that probiotics may be effective in the treatment of RAP, in terms of improving pain in the shorter term. Clinicians may therefore consider probiotic interventions as part of themanagement strategy for children with RAP (Recurrent Abdominal Pain). However, we were unable to recommend the optimum strain and dosage of probiotic based on this review. The evidence for the effectiveness of probiotics was based largely on shorter-term outcomes. Further trials are required to assess whether improvements in pain are maintained over the longer term; these trials should also consider the importance of using validated and consistent scales to measure pain and other outcomes.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric.
In 2015, the global retail market value for probiotics was US$41 billion, including sales of probiotic supplements, fermented milk products, and yogurt, which alone accounted for 75% of total consumption.[42] Innovation in probiotic products in 2015 was mainly from supplements, which produced US$4 billion and was projected to grow 37% globally by 2020.[42] Consumption of yogurt products in China has increased by 20% per year since 2014.[43]
“This supplement contains the probiotic L. fermentum, which has been shown in a small handful of studies to reduce symptoms of mastitis,” says Lauren Manaker, MS, RDN, a dietitian in Charleston, SC. “One study suggests that the use of this probiotic is more effective than antibiotic therapy!” That explains why it’s one of the best probiotics for women suffering from mastitis—inflammation or infection caused by a blocked milk duct.
One of the best-studied effects of probiotics has been on the reduction in diarrhea severity and duration. Probiotics can prevent as well as reduce duration of several types of diarrhea. Lactobacillus has been found to be a safe and effective treatment for children with acute infectious diarrhea. Certain probiotics may also offer a safe and effective method to prevent traveler’s diarrhea, but research in this area is emerging.
What’s more, RAW Probiotics are exactly what they purport to be – raw! They’re uncooked, untreated and unadulterated, and have no fillers or binders. You also won’t find any displeasing carriers, such as maltodextrin or dextrose. And since RAW Probiotics are kept in temperature-controlled cold storage through delivery and until they make it into your fridge, you can be sure your probiotics “arrive alive.”
But before you start reaching for the calcium supplements, there may be a more effective way to support your bone health. Like many other parts of the body, the health of your bones is closely tied to the health of your gut, especially your intestines. Temporary intestinal inflammation can trigger an immune response in which your body releases interleukins, proteins that have an immune function but also absorb bone tissue. If the temporary inflammation remains unaddressed, these molecules can take a toll on your bones, eventually weakening them.14
During an outbreak of shigellosis in 1917, German professor Alfred Nissle isolated a strain of Escherichia coli from the feces of a soldier who was not affected by the disease.[57] Methods of treating infectious diseases were needed at that time when antibiotics were not yet available, and Nissle used the E. coli Nissle 1917 strain in acute gastrointestinal infectious salmonellosis and shigellosis.[58]
Taking relatively high doses of these probiotic strains before, during, and after antibiotic treatment can help your microbiome get back on its feet: B. Lactis, B. Infantis, L. Acidophilus, L. Casei, L. Bulgaricus, L. Paracasei, L. Rhamnosus GG, and S. Boulardii. Our antibiotic combatant MegaFood MegaFlora has six of these strains, as well as eight others. One serving contains 20 billion CFUs to replenish the good bacteria.

Probiotics, like all strategies for helping promote your health, might not work for everyone. People have different diets, the microbes colonizing their gut are specific to each of us and everyone’s physiology is unique. Research often shows that some people respond to a specific probiotic strain and others do not. So if you feel a probiotic is something you’d like to use, one strategy is to try a product for about a month. If you don’t see a benefit, then perhaps it’s not the right one for you.


Probiotics are clearly incredibly supportive, but they can't do their work alone. To make sure that you're getting the most out of your microbes, it's important that you give them the support they need to work. You've got lots of options for supporting your gut health, from dietary changes to probiotic supplementation, but make sure you're at least covering the following bases. 

If you are thinking about taking a probiotic or prebiotic and are unsure where to start or what to take, ask for help from a specialist. There are so many products available on the market it can be difficult to decide which to choose. The evidence is very much linked to the supplement so whether it’s a powder, tablet or drink you’re looking for, choosing the right one should depend on the symptoms you’re experiencing.
DNA-testing matches identity at a foundational, genetic level, so you know you’re getting the exact strains listed. New Chapter’s DNA-testing also verifies that you receive the specific strains researched for specific benefits: our strains boost immune defenses and enhance digestion, including bowel regularity and reducing occasional gas, bloating, diarrhea & constipation.*
Probiotics are live bacteria that are present in yogurt, other fermented foods, and in pills. They are promoted as a benefit to the human digestive system. Normally you have trillions upon trillions of bacteria within the colon. Normally we ingest bacteria every time we swallow. Many of these swallowed bacteria may be beneficial while most are simply innocuous and cause no problems. The question for everyone who takes a probiotic much beyond yogurt is whether they really are a health benefit. Here is what we know medically about probiotics.
All probiotic strains are manufactured through fermentation, and are then freeze-dried before blending with fructooligosaccharides (FOS). The result is a shelf-stable (two years at room temperature), nitrogen-filled probiotic of human origin: a probiotic that easily adapts to your body, and is both acid- and bile-resistant to survive the acidic environment of the human stomach. In other words, a probiotic that fulfills its promises.
Gut flora makes up 70 to 80 percent of the human immune system. Too much bad bacteria can inflame and destroy intestinal walls, enter the bloodstream, and trigger a multitude of health issues — constipation, depression, skin problems, autoimmune disease, and even bad breath. Adding good bacteria protects the digestive tract from the harmful bacteria in sugars, pesticides, and saturated fats.
The other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn't function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn's disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, H. pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it's never too late.
DNA-testing matches identity at a foundational, genetic level, so you know you’re getting the exact strains listed. New Chapter’s DNA-testing also verifies that you receive the specific strains researched for specific benefits: our strains boost immune defenses and enhance digestion, including bowel regularity and reducing occasional gas, bloating, diarrhea & constipation.*
Yes! Beneficial yeast is a probiotic, defined as a microorganism that supports human wellness. (Probiotic means “for life.”) Saccharomyces boulardii is a remarkable yeast that can significantly support your whole internal ecosystem. It helps reduce problematic yeasts, such as Candida, and replenishes healthy gut flora.* While many probiotic supplements only deliver friendly bacteria without yeast, Probiotic All-Flora contains 5 billion CFU of beneficial yeast for complete support.
Myriad factors – antibiotics, diet, stress, and age, among them – affect the balance of diverse microbes present in your gut. While you can replenish your gut bacteria by eating well and incorporating natural probiotics (ex. yogurt and kefir) into a healthy diet, these processes can take weeks or months; taking a regular probiotic is an easy and effective way to ensure your gut (and immune system) stays healthy, always.
Probiotics are a therapeutic class being increasingly used for a variety of GI disorders. Probiotics appear to alter intestinal microflora and may exert their effect(s) by a variety of mechanisms. Many species of probiotics exist and it is generally accepted that all probiotics are not created equal. Efficacy may be due to a single strain or multiple strains or a combination of different probiotics. There is good evidence to support the efficacy of S. boulardii and LABs and the combination of the two for AAD, VSL#3 for pouchitis, and B. infantis 35624 for IBS. Probiotics decrease the duration of symptoms in acute infectious diarrhea. Probiotics, including E. coli Nissle 1917, LGG, and VSL#3 are as effective as standard therapy (mesalamine) in inducing or maintaining remission in UC or CD. When added to standard therapy, probiotics do not provide additional benefit compared with standard therapy alone. Most probiotics tested to date are not more effective than placebo in inducing or maintaining IBD remission.
Garden of Life RAW Probiotics are some of the most popular out there – and for good reason. Let’s start with the basics: You’ll get 85 billion CFUs and 31 to 33 probiotic strains out of your daily, whole-food, gluten-free, soy-free probiotic, which helps support the immune system, a healthy thyroid, nutrient absorption, digestive function, and a healthy microbial balance.
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Despite the uncertainty, foods enriched with probiotics and probiotic supplements are increasingly popular in the U.S. Finding probiotic supplements in grocery and health food stores is easy. For example, you may already know that yogurt contains probiotic bacteria such as lactobacillus and bifidobacteria. Many clinical studies suggest these bacteria relieve symptoms related to lactose intolerance.
While the logic behind probiotics might seem sound, it is clear that we have a long way to go before understanding the complexity of the microbiota and the effects—both good and bad—that probiotics might have. All individuals have a unique gut microbiome, and the effects of different bacteria on different people are likely to be highly variable; as such, probiotic use might even need to be personalised for optimal benefits. Commercially available products might not contain the correct strains or quantities of bacteria to provide benefits, and most probiotic supplements contain only single strains, vastly oversimplifying the complexity of the microbiota. While taking a supplement for improved health is certainly an attractive prospect, those looking to aid their gut microbiota might be better served by consuming a healthy, varied diet. In the meantime, rigorous clinical trials are needed to substantiate potential health benefits and to confirm whether probiotics are elixirs or just empty promises.

Probiotics can help protect against common gynecological conditions such as bacterial vaginosis, candidiasis, and urinary tract infections, says Jennifer McDaniel, MS, RDN, CSSD, a dietitian in St. Louis, MO. “Bacteria can pass through our digestive system into the vagina, so we have the opportunity to consume probiotics that can benefit our vaginal health. L. rhamnosus GR-1 and L. reuteri RC-14 are evidenced-based probiotic strains for women’s urogenital health. Not only do they disrupt the infection of a range of unhealthy bacteria and yeast in the vagina, they offer benefits to the vagina and reduce the risk of problems such as bladder infections.” Fem Dophilus, made by Jarrow Formulas, has the critical strains and the company adheres to the highest production standards, she says.
If you're healthy and want to stay that way... Shoot for 50 to 100 billion CFUs of a combo of lactobcillus and bifidobacterium. Starting with a large amount of CFUs will either keep you riding high (by supporting immunity) or trigger small but yucky reactions, like gas or nausea. If you notice those, scale back to 50 billion, then 20 bill, until you feel like your usual (but better) self.
Among their numerous health benefits, research shows these friendly microorganisms help prevent bowel diseases, improve your immune system, reduce traveler’s diarrhea, help you maintain a healthy weight, heal various skin conditions, improve bloating and other uncomfortable GI symptoms, and even boost your mood, helping to reduce the effects of anxiety and depression.
If these issues and many others are connected to gut health, then what elements are essential for digestive health? Consider this: According to the National Institute of Diabetes and Digestive and Kidney Diseases, upward of 60 million to 70 million Americans are affected by digestive diseases. In addition, digestive disease and disorders cost the United States over $100 billion per year.
Elevated levels of interleukin 6 (IL-6), IL-6R, IL-1Beta and tumor necrosis factor alpha (TNF-α) [Dinan et al. 2006; Liebregts et al. 2007] and a lower IL-10/IL-12 ratio [O’Mahony et al. 2005] have been reported in IBS patients in comparison to controls, suggesting that IBS may be associated with increased pro-inflammatory cytokine secretion. However, plasma cytokine levels may not necessarily reflect the expression or levels of cytokines in the mucosa of the bowel wall, but may come from activated immune cells in the spleen or liver [Nance and Sanders, 2007]. The imbalance between IL-10 and IL-12, observed in peripheral blood mononuclear cells, was confirmed at the mucosal level in a recent study by Macsharry and colleagues suggesting that this finding may be an underlying phenotype in IBS and a potential biomarker for a subset of IBS patients [Macsharry et al. 2008]. B. infantis was shown to increase IL-10/IL-12 ratio in IBS patients [O’Mahony et al. 2005] suggesting a possible mechanism by which this probiotic may exert its effect.
Possibly the most popular probiotic food is live cultured yogurt or greek yogurt made from the milk of cows, goats or sheep. Yogurt, in most cases, can rank at the top of probiotic foods if it comes from raw, grass-fed animals. The problem is there is a large variation on the quality of yogurts on the market today. When buying yogurt, look for three things: First, that it comes from goat’s, sheep milk or A2 cows milk; second, that it’s grass-fed; and third, that it’s organic.

“It is quite difficult to choose a solid top pick for probiotics because different strains have been shown to help different clinical issues,” says Rachel Fine, MS, RD, CSSD, a dietitian in New York City. “However, this supplement is a great option, with 50 billion strains.” It’s one of the best probiotics for women and supports vaginal, digestive, and immune system health. “It is best to choose a product that is well within its expiration date to ensure a higher number of viable cells,” advises Fine.
Given that you can get probiotics from the food you eat, you don't necessarily need to take a supplement, and Keatley says she prefers food sources of probiotics to supplements. However, she adds that "There are times when you really need a boost." One example might be during or after a course of antibiotics, as long as you have your doctor's OK, since antibiotics kill both good and bad bacteria: "Seeding your gut with good bacteria can lay the groundwork for a faster recovery and less constipation and diarrhea," Keatley points out. Angelone echoes Keatley's emphasis on food sources of probiotics, but also says that supplements can also play a useful role in "maintaining a healthy gut bacteria colony."
More and more evidence shows that the gut microbiota may play an important role in the development of obesity, obesity-associated inflammation and insulin resistance. Obesity and Type 2 diabetes are associated with changes in gut microbiota. Several studies describe differences between the microbiota of lean individuals and those who are obese. The potential for using probiotics in weight management and obesity and diabetes prevention is exciting. 

“I recommend this to my patients because Metagenics provides high-quality, professional-grade supplements that are scientifically formulated,” says Crystal Karges, MS, RDN, a maternal health dietitian in San Diego. “Supplementing with the specific probiotic strains in this product can help maintain healthy vaginal microflora and support urogenital health. Recent research has found that consuming probiotics during pregnancy may reduce the chances of premature birth and preeclampsia in late pregnancy.”
Did you know that bacteria might actually keep you healthy? It all just depends on the type of bacteria. In this case, we’re talking about the benefits of probiotics. Probiotics benefits are some of the most widely researched natural solutions to gut health. For years, scientists and physicians have observed the many benefits of probiotics for not just the gut, but for the entire body.
Myriad factors – antibiotics, diet, stress, and age, among them – affect the balance of diverse microbes present in your gut. While you can replenish your gut bacteria by eating well and incorporating natural probiotics (ex. yogurt and kefir) into a healthy diet, these processes can take weeks or months; taking a regular probiotic is an easy and effective way to ensure your gut (and immune system) stays healthy, always.
We started our search with the most popular products from major supplement retailers like Amazon, Drugstore.com, GNC, and Whole Foods. That gave us over 200 supplements. With so many options, we then narrowed our search to 70 probiotics whose purity, potency, and projected efficacy have been vetted by an independent lab like ConsumerLab, Labdoor or the National Science Foundation (NSF). Those labs test — among other things — supplements’ actual composition against labels, verifying ingredient lists are truthful and that contaminants aren’t present. Because supplement claims aren’t regulated by the Food and Drug Administration (FDA), we wanted to make sure someone was testing whether they worked as described.
Because chronic inflammation is at the root of many diseases and health conditions, the fact that probiotics exert this effect in the gut, where 80 percent of the immune system lies, is crucial. The immune-boosting benefits of probiotics seem to be particularly helpful for the quality of life of seniors. Currently, research is underway to test whether probiotics can “reduce inflammation and improve gut immune health in HIV-positive individuals” who haven’t yet undergone treatment.
Crohn’s disease. The literature on the induction and maintenance of remission in CD is heterogeneous and difficult to interpret (Table 4). Partly, this is due to the unclear definition of extent of inflammatory involvement in patients who were studied and a small number of patients included in the trials. Furthermore, very few studies examined the additive effect probiotics may have on active CD. In one study with only 11 patients, probiotics provided no additional benefit to steroids and antibiotics in inducing remission [Schultz et al. 2004]. An open-label study with 10 patients who were refractory to prednisolone and aminosalicylates, were tried on a combination of probiotics (B. breve, B. longum, and L. casei) and a prebiotic (psyllium) simultaneously. A complete response was found in 6 of 10 patients without any adverse consequences [Fujimori et al. 2007]. More controlled studies have been performed on the maintenance of remission in adults with CD (Table 4), but in general these studies fail to show any benefit of probiotic administration [Schultz et al. 2004; Guslandi et al. 2000; Malchow, 1997]. Data are even more robust on the prevention of relapse following surgical intervention, but again probiotics fail to prevent endoscopic or clinical recurrence (Table 4) [Chermesh et al. 2007; Van Gossum et al. 2007; Marteau et al. 2006; Prantera et al. 2002]. Several meta-analyses and systematic reviews have shown that probiotics were ineffective in maintenance of remission in CD [Rahimi et al. 2008; Rolfe et al. 2006].
In the small, new study, the researchers isolated 10 bacterial strains — five species of Lactobacillus bacteria, and five species of Enterococcus — in samples from 34 babies, identifying the strains as good candidates for crafting a probiotic cocktail of microbes that could survive in a human host's gut and stimulate SCFA production, according to the study.
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