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Probiotics Confusion and Misunderstanding

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Original article printed on page 14 in the September 27-28, 2008 issue. Reprinted on page 6 in the September 5-6, 2009 issue under the title: Amateur Use of Probiotics.
Reprinted on page 26 in the August 11, 2010 issue of The Mississauga News under the feature: Health, Wellness & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Probiotics is one of those concepts that keeps re-surfacing and seems to have a small but dedicated following. It is a catchy term that is often misunderstood. The latest definition defines probiotics as “live micro-organisms, which when administered in adequate amounts confer a health benefit on the host”.

Most people do not fully realize that using a probiotic infers the ingestion of live bacteria or fungus. The basic belief in using these substances is that you might be “replacing” normal bacteria that might have been depleted or changed by a certain action. It is part of a trend in an aging population where people attempt to preserve their health using methods involving weak or untested data. Don’t forget that Listeria and Clostridium Difficile are ingested bacteria too.

To even consider probiotics, you need to understand and accept the fact that in order to function, our bodies require certain bacteria. Digestion slows to almost stagnancy in an intestine devoid of its natural bacteria. More recently, there have been some documented trends that may show some reproducible results.

In children with mild diarrhea due to infectious agents, the use of probiotics showed some promise towards a slightly quicker recovery, if very specific probiotics were used for months. The picture was not so rosy in more severe diarrhea involving bleeding. The probiotics did not change the need for hospitalization and active treatment in severe cases.

In people with milk digestion problems, a long running folk cure was to add “acidophilus” or “lactobacilli” to their diet. This is not correct and adds to the confusion. Lactobacillus acidophilus refers to a whole family of bacterial organisms. The true probiotic is the Lactobacillus GR-1 species found within this family of bacteria, and highlights the need for the consumer to look carefully before considering a product. How exactly the bacteria work to produce an effect is not completely known. They most likely secrete various agents that indirectly lead to the observed benefit.

Probiotics are probably best considered for mild intestinal ailments. There may be a role for probiotics for chronic stable phases of colitis. Even good studies suggest that they must be incorporated into the diet for long periods to show any usefulness.

I have not come across any strong evidence that would suggest taking a small amount for an acute illness makes a difference. This seems to hold true even more so for women with gynecological problems involving urinary infections. There is no good evidence that taking any probiotic can cure a urinary infection. There are concerns that probiotic use may delay diagnosis and appropriate treatment.

Antibiotics are not evil and probiotics are not the golden cure. Both concepts can comfortably co-exist. Vaginal yeast infections may respond to some probiotics, but most probiotic makers suggest long-term use to prevent yeast overgrowth rather than using them to cure.

There is no one “probiotic does all” on the market. It is as absurd as suggesting a car with only one spout in which you dump gas, oil, anti-freeze and air, and then expecting each substance to magically know where it should go. Only people, who are willing to make a full study of probiotics, should even consider using them. I was quite surprised at the number of unsubstantiated claims on the Internet in relationship to probiotics.


Related resources:
Probiotics from Wikipedia, the free encyclopedia.
Understanding probiotics by Jaclyn Newman, Canadian Living. Fight stress, digestive troubles and the harmful effects of antibiotics with probiotics, also known as "good" or "friendly" bacteria.
An Introduction to Probiotics from National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health (NIH).
Probiotics from MedicineNet. Types of probiotics, health benefits of probiotics, side effects, and foods that contain probiotics.
Probiotics: What are they? Answers from Mayo Clinic gastroenterologist Michael Picco, M.D. What exactly are probiotics? What health benefits do they offer?
Probiotics & Probiotic Supplements: Uses and Safety from WebMD.
Understanding Pros and Cons of Probiotics by Athos Bousvaros, MD, Pediatric Views, from Children's Hospital, Boston. What is the difference between probiotics and prebiotics? In what circumstances would probiotics be used? Who can use probiotics?
Acidophilus and Other Probiotics by Cathy Wong, About.com.

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