“Researchers here and abroad are looking at probiotics as a promising answer to the growing problem of antibiotic resistance and abuse. To date, studies have indicated that ingested probiotics can play an important role in preventing or controlling food and skin allergies in children, bacterial vaginosis and premature labour in pregnant women, inflammatory bowel disease, recurrent ear and bladder infections, dental caries, chronic diarrhea and traveller’s diarrhea. They may even help lower cholesterol in the blood and, by degrading carcinogens, thwart the development of certain cancers.” – Jane Brody, NYT
 
The Intestinal Terrain
 
The microecology of the human gastrointestinal tract is incredibly complex, as there are at least 500 different species of microflora that are part of the normal intestinal flora. There are nine times as many bacteria in the gastrointestinal tract as there are cells in the human body. The type and number of gut bacteria play an important role in determining health and disease. A state of altered bacterial flora in the gut has become popularly know as dysbiosis. Some of the major causes of dysbiosis include; dietary disturbances, stress, antibiotic/drug therapy, malabsorption, intestinal infection, and altered pH. Warning signs of dysbiosis include; gas, bloating after meals, headaches, disturbance in bowel function, joint pain, yeast infections, fatigue, skin disorders, diarrhea, difficulty in losing weight, cravings for sweets, insatiable hunger and allergies.
 
Advanced Generation Probiotics
 
Different species in a single formula more closely approximates the normal composition of intestinal flora. As probiotic properties are different from one strain to the other, each strain will contribute specific inhibitive functions against pathogenic or putrefactive bacteria. Multi strain probiotic formulations are also recommended because each person’s intestinal flora has a unique bacterial community (very similar to fingerprints), therefore each person will react differently to the absorption of the same probiotic strain. For some persons L. acidophilus might be most effective while for others L. rhamnosus or L. casei might adapt more easily to their intestinal flora. This is why multi strain formulations are more effective than some single strain products.
 
The natural pH of an empty stomach is 1.5. After eating, stomach pH goes up between 5-6. This is critical as these strains will survive the stomach’s acidity without enteric coating and reach the intestines at full potency. Each strain has to be selected for its ability to grow in the presence of high bile levels, which is common during the digestive process. High growth in the presence of bile also maximizes probiotic potency. Antibiotic compatibility is also important. Strains should be chosen so they do not interfere with the effectiveness of antibiotics, but still protect from their adverse effects. Probiotics also have to be selected for established enzymatic activities. Lactic acid bacteria, for instance, is the type used to induce a variety of enzymatic activities that generate multiple additional health benefits.  
 
The Many Benefits of Probiotics 

• Restoring and maintaining healthy intestinal flora balance
• Limiting the growth of putrefactive and pathogenic bacteria inside the digestive system
• Helping immune system functions (60-70% of antibodies are produced in the intestine)
• Protecting gut surfaces
• Preventing and repairing a “leaky gut”
• Controlling food allergies, intolerances and other reactions
• May be helpful for some symptoms of celiac disease, Crohn’s disease, IBS and other inflammatory bowel conditions
• Controlling systematic and vaginal Candida albicans yeast overgrowth and infections
• Lowering cholesterol levels
• Improving breath 
  

Help For Immune Function as We Age
 
As immune function tends to decline with age, probiotics can be a very useful tool to enhance various aspects of immune function. It has already been shown that some strains of L. bulgaricus, S. thermophilus, L. brevis, L. acidophilus and B. bifidum can enhance cellular immune response. In one particular study the authors wanted to know if L. rhamnosus also had a profound effect on the immune system in healthy middle-aged and elderly subjects. They were looking for two indicators: PMN (non-specific polymorphonuclear) cell phagocytosis and NK (natural killer) cell activity.
 
“Our study has suggested that L. rhamnosus HN001, a strain demonstrated previously to modulate immune responses in animal models, can also enhance PMN cell phagocytosis and NK cell activity, following dietary consumption by healthy middle-aged subjects. This result is important, since cellular immune responses are known to decline with increasing age, and therefore dietary interventions that can enhance cellular immunity might be of significant value in combating the deleterious effects of aging on the immune system.”
 
The authors postulate that this strain of L. rhamnosus could help people combat infectious diseases as phagocytic activity by PMN cells is an important antimicrobial defence mechanism and NK cell killing activity may help to control viral-infected cells.¹
 
Reducing Cancer Risk
 
One of the key ways in which the body gets rid of “bad” substances, such as excess estrogen and fat-soluble toxins like pesticides and solvents, is by a process that occurs whereby the toxin is bound to a molecule called glucuronic acid and then excreting this complex in the bile. However, the bond between the toxin and its escort can be broken by glucuronidase, an enzyme produced by certain bacteria. Excess glucuronidase activity means more of the toxins are liberated from glucuronic acid and reabsorbed into the body. As a result higher glucuronidase activity in the gut is associated with an increased cancer risk, particularly the risk of estrogen dependent breast cancer. Glucuronidase activity is higher in people who eat a diet high in fat and low in fibre.
 
Taking probiotic supplements increases the proportion of lactobacillus and bifidobacteria in the gastrointestinal tract decreasing beta-glucuronidase producing bacteria. Foods known to reduce glucuronidase activity include onions and garlic, and foods that are high in glucaric acid such as apples, Brussels sprouts, broccoli, cabbage, and lettuce. For overall hormonal balance and to reduce the level of reabsorbed unbound (free) estrogen, it is critical to supplement the diet with the friendly bacteria.
 
Antibiotic Overuse
 
The indiscriminate killing of "good" and "bad" strains by antibiotics drastically upsets intestinal balance and is believed to be the culprit behind the dramatic upsurge in gastrointestinal disorders like irritable bowel syndrome and Crohn's disease in our society. The residual effects of antibiotic therapy can persist long after people stop taking their medication. Researchers did a meta-analysis on the effect of probiotic administration on people who experienced antibiotic-associated diarrhea. The results showed that diarrhea occurred as a result of antibiotic therapy in 20% (some studies indicate as high as 39%) of patients. This likelihood was decreased to 8% in patients taking any probiotic.²
 
Going on a Trip?
 
Persons travelling to foreign countries where the water and food is suspect may do well to add probiotics to their regimen.  Many people succumb to severe cramping and diarrhea in spite of the best precautions and it can certainly put a damper on any holiday. There have been reports that some strains of probiotics can reduce the incidence and severity of traveller’s diarrhea.
 
According to a recent article in the American Family Physician, “Probiotics are a more natural approach to prophylaxis of traveler’s diarrhea. Probiotics colonize the gastrointestinal tract and theoretically prevent pathogenic organisms from infecting the gut. Studies of Lactobacillus GG (Culturelle) have suggested protection rates of up to 47 percent.”³
 
Use of probiotics with antibiotics
 
If on antibiotics it’s advisable to restore the good bacteria quickly by taking probiotics two hours before or two hours after the antibiotics are given. Continue to use probiotics long after the antibiotics are finished. The good news is that use of probiotic formulas can often prevent many infections before they start, reducing the need for antibiotics.
 
In this age of super-bugs, antibiotic resistance and compromised immune systems it is more important than ever to supplement with health-enhancing probiotics for the ultimate state of health. 
 
References:

1. Ying-H. Sheih, et al., “System immunity-enhancing effects in healthy subjects following dietary consumption of the lactic acid bacterium Lactobacillus rhamnosus,” HN001, J Amer Coll Nutr, 2001; vol 20 (2): 149-156
2. Cremonini F., Di Caro S., et al., “Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea,” Aliment Pharmacol Ther, 2002; 16: 1461-1467
3. Yates, Johnnie, M.D., “Traveler’s Diarrhea,” American Family Physician, June 1, 2005; vol 71, no 11