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“Antibiotics.”  A soothing sound to a sick ear.  Or sinus, or bladder. But when the collateral damage results in the destruction of normal flora, symbiotic microbes that actually are on your side, the results can be as bad or in some cases worse than what started the whole problem. 

Helpful microbes, mainly bacteria, play a fascinating and in some cases still poorly understood role in our health.  Mainly playing on the stage of our intestinal lining, they function as sentries against harmful, or pathogenic, bacteria.  If the bad guys get the upper hand, devastating and dehydrating diarrhea results.   As we’ve seen with the toxic E. coli outbreaks of ’06 and after, other organ systems including kidneys and heart can fail, resulting in death. 

Specifically, certain Lactobacillus, Streptococcus and E. coli strains can
* Help maintain a “tight” filter in the intestinal lining, limiting exposure of the immune system to allergens
* Bind and inactivate certain carcinogens
* Separate estrogen and other hormones from their bound conjugates, freeing them for recirculation into the bloodstream
* Reduce the risk of viral shedding in rotavirus infections
* Reduce antibiotic associated diarrhea
* Be an adjunct therapy in irritable bowel syndrome
* Reduce symptoms in inflammatory bowel disorders
* Reduce symptoms in lactose intolerance individuals
* Reduce the recurrence of some infectious vaginitis cases

The recurrent theme is one of recolonizing a depleted GI tract or vagina, to restore function.  We bombard our friendly bacteria with antibiotics, chlorinated water, alcohol, preservatives and other antimicrobials almost from birth.  Even pollution in the air affects our gut flora.  Some eventually pay the price with everything from intestinal disorders, to food and environmental allergies.  The best strategies for gut health involve eliminating offending agents, replacing enzymes and good bacteria (this is the probiotic), and in some cases ‘fertilizing’ the bacteria with pre-biotics, called fructooligosaccharides.

Look for products containing gut friendly and hardy strains of Lactobacillus and  Bifidobacterium, with or without prebiotics.  Prebiotics are fertilizers for the good bacteria, typically fructooligosaccharides.  Typical yogurt lactobacilli will either not survive the trip down the intestine to the colon, or will not live long if they make it.  I recommend products containing at least 5 billion viable bacteria per dose.  For maintenance, a few times a week will suffice, but for acute cases of diarrhea, or for prevention of antibiotic associated diarrhea, I recommend 2 times daily, between meals.  And always use non-chlorinated, tepid water.

Serious complications are rare, but cases of widespread fungus infection has been reported in chronically ill patients taking yeast probiotics of the Saccharomyces genus.  In general those who are generally healthy will do fine, but check with your doctor before using these products.

More commonly, some gassiness and less commonly, constipation can result, though in my experience these are transient and mild.

So, are you ready to try probiotics?  They’re one of those win win supplements for the vast majority of generally healthy folks.  Give them a try, then let me know how they worked for you.

Dr. T