Once you get your diet and lifestyle in check, if you are still struggling with health issues, you might need to look at your gut.
Population research has shown that a diverse gut microflora, whereby many strains of bacteria are present, is the key to a healthy gut. As 70 per cent of the immune system is housed in the gut, establishing this as a health goal makes sense.
It is easy in this instance to head to the pharmacy or health food store to find a probiotic to add to your daily regime. Probiotics are live microorganisms present in our gut which help keep a healthy gut environment, and can offer health benefits when taken orally in adequate amounts.
However, there are no guarantees that popping a probiotic capsule is going to have a beneficial effect. It could in fact cause more issues for people if they are prone to irritable bowel symptoms (IBS) or have been diagnosed with inflammatory bowel disease (IBD).
While having a diverse microbiota is important, an inflamed or irritated bowel could indicate that your digestive system is reacting to even the good bacteria (also called commensal bacteria), and the addition of a probiotic could spur an immune response.
If you have begun to take a probiotic only to experience more inflammation or digestive upset, this may indicate the commensal bacteria isn’t getting along well with your immune system to begin with. That is one of the reasons that underlies not being able to tolerate probiotics.
Why would the gut of a person most in need of healthy bacteria respond unfavourably to a good dose of bacteria from a probiotic?
The gut is a biological system, and it may be that the immune system in these people are forming adaptive responses to try to diminish the commensal population because the immune system doesn’t get along with it.
While we don’t know for sure, it is suggested that the addition of the probiotic could be killing the bad bacteria (which is great), but allowing for good bacteria to grow, which the immune system is not responding well to. It may be there is just an overgrowth of one strain of commensal bacteria, or it might be a few.
How do we navigate the vast number of probiotics and establish which one is the right one? We can class probiotics into four categories.
- Lactobacillus Bifidobacterium – in various forms, found in yoghurt as well as sold as a probiotic.
- Saccharomyces boulardii – a type of yeast produced from lychees and mangosteen, resistant to many antibiotics.
- Soil based organisms - bacteria that originate from the soil.
- E coli nissil 1917 - non pathogenic bacteria that helps fight pathogenic forms of E coli.
If you are someone who has established digestive concerns (such as IBS or IBD), then it is recommended you try a probiotic of each of these different classes to establish if there is going to be a negative reaction to any of them.
If you are generally healthy, then you could absolutely take them altogether and likely suffer no adverse consequences. For example, while the lactobacillus is healthy, an overgrowth of this in your gut could result in bloating after taking it. You should expect some bloating when you embark on probiotics – any change in the gut environment will affect how your digestive system reacts.
However, if your bloating lasts for more than five or so days, this indicates that this probiotic isn’t for you. If you can’t find any class of probiotic that sits well with you, then you may be a part of a small subsection of the population that doesn’t deal well with probiotics and you probably shouldn’t use them.
It is important to take the probiotics outside of any prebiotic fibres. Prebiotics are dietary fibres that help promote changes in the composition and/or activity of the GI gut bacteria, favouring the beneficial bacteria. These fibres are found in foods including onions, garlic, asparagus, artichoke, chicory root, leeks and oats.
While it seems intuitive to include prebiotics with the probiotics (to feed the gut bacteria), those people who are sensitive (for example, those with IBS or IBD) will react to this.
A small amount of prebiotic fibres may be okay – perhaps below the range of 1000mg, though studies show that for a healthy population, up to 5g (or 5000mg) is not going to provoke any negative consequences.
Everyone is different, so this does require some monitoring. Use probiotic sparingly then find the minimum effective dose required to keep you there in the long term. In addition, broaden your diet so the diversity of prebiotic fibres is greater, to maintain the health of your commensal bacteria and keep them happy, which clearly benefits us (their host).
As Hippocrates is famous for saying “All disease begins in the gut.” The more we look after these little critters, the happier we will be in the long term.