Health benefits of taking probiotics
Bacteria have a reputation for causing disease, so the idea of tossing
down a few billion a day for your health might seem — literally
and figuratively — hard to swallow. But a growing body of scientific
evidence suggests that you can treat and even prevent some illnesses
with foods and supplements containing certain kinds of live bacteria.
Northern Europeans consume a lot of these beneficial microorganisms,
called probiotics (from pro and biota, meaning “for
life”), because of their tradition of eating foods fermented
with bacteria, such as yogurt. Probiotic-laced beverages are also big
business in Japan.
Enthusiasm for such foods has lagged in the United States, but interest
in probiotic supplements is on the rise. Some digestive disease specialists
are recommending them for disorders that frustrate conventional medicine,
such as irritable bowel syndrome. Since the mid-1990s, clinical studies
have established that probiotic therapy can help treat several gastrointestinal
ills, delay the development of allergies in children, and treat and prevent
vaginal and urinary infections in women.
Self-dosing with bacteria isn’t as outlandish as it might seem.
An estimated 100 trillion microorganisms representing more than 500 different
species inhabit every normal, healthy bowel. These microorganisms (or
microflora) generally don’t make us sick; most are helpful. Gut-dwelling
bacteria keep pathogens (harmful microorganisms) in check, aid digestion
and nutrient absorption, and contribute to immune function.
The best case for probiotic therapy has been in the treatment of diarrhea.
Controlled trials have shown that Lactobacillus GG can shorten
the course of infectious diarrhea in infants and children (but not adults).
Although studies are limited and data are inconsistent, two large reviews,
taken together, suggest that probiotics reduce antibiotic-associated
diarrhea by 60%, when compared with a placebo.
Probiotic therapy may also help people with Crohn’s disease and
irritable bowel syndrome. Clinical trial results are mixed, but several
small studies suggest that certain probiotics may help maintain remission
of ulcerative colitis and prevent relapse of Crohn’s disease and
the recurrence of pouchitis (a complication of surgery to treat ulcerative
colitis). Because these disorders are so frustrating to treat, many people
are giving probiotics a try before all the evidence is in for the particular
strains they’re using. More research is needed to find out which
strains work best for what conditions.
Probiotics may also be of use in maintaining urogenital health. Like
the intestinal tract, the vagina is a finely balanced ecosystem. The
dominant Lactobacilli strains normally make it too acidic for
harmful microorganisms to survive. But the system can be thrown out of
balance by a number of factors, including antibiotics, spermicides, and
birth control pills. Probiotic treatment that restores the balance of
microflora may be helpful for such common female urogenital problems
as bacterial vaginosis, yeast infection, and urinary tract infection.
Many women eat yogurt or insert it into the vagina to treat recurring
yeast infections, a “folk” remedy for which medical science
offers limited support. Oral and vaginal administration of Lactobacilli may
help in the treatment of bacterial vaginosis, although there isn’t
enough evidence yet to recommend it over conventional approaches. (Vaginosis
must be treated because it creates a risk for pregnancy-related complications
and pelvic inflammatory disease.) Probiotic treatment of urinary tract
infections is under study.
Probiotics are generally considered safe — they’re already
present in a normal digestive system — although there’s a
theoretical risk for people with impaired immune function. Be sure the
ingredients are clearly marked on the label and familiar to you or your
health provider. There’s no way to judge the safety of unidentified
In the United States, most probiotics are sold as dietary supplements,
which do not undergo the testing and approval process that drugs do.
Manufacturers are responsible for making sure they’re safe before
they’re marketed and that any claims made on the label are true.
But there’s no guarantee that the types of bacteria listed on a
label are effective for the condition you’re taking them for. Health
benefits are strain-specific, and not all strains are necessarily useful,
so you may want to consult a practitioner familiar with probiotics to
discuss your options. As always, let your primary care provider know
what you’re doing.
September 2005 Update
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