When we hear the word “bacteria,” we generally think of something bad that can make us sick (especially in these COVID-19 times). Good bacteria, however, is something that also exists and plays a pivotal role in keeping us healthy, and our immune system strong. Probiotics are the term given to this good, live bacteria. You’ve probably heard it used before, or seen it on a package of yogurt. But what do you really need to know about probiotics? Dr. Eric G. Hilgenfeldt, a gastroenterologist with Tryon Medical Partners, provides an overview on this popular topic.
Probiotics, Broken Down
Simply put, there are approximately 1,000 different species of bacteria in the lining of your gut, some considered “good” bacteria and/or yeast (probiotics), and some considered “bad.” The key is maintaining a balance of the two, and making sure that there is enough good bacteria. For example, when you’re sick, you can have an influx of bad bacteria, and the addition of probiotics may help restore the necessary balance.
“Probiotics are microorganisms that, when taken in appropriate quantities, have been shown to have benefits,” Dr. Hilgenfeldt says. “Numerous beneficial microorganisms have been isolated, down to the individual strain.”
Common types of probiotic bacteria that you may see on packaging include lactobacillus and bifidobacterium, and saccharomyces boulardii (a type of yeast).
Where Can I Find Probiotics?
Most people are able to maintain the appropriate amounts of good bacteria in their system by eating a healthy diet filled with fiber-rich foods. Think fresh fruits and vegetables, yogurt and fermented food and drinks, such as cabbage and kombucha.
While there are many probiotic supplements available (more on that later), you should address potential changes that can be made to your diet. Dr. Hilgenfeldt recommends increasing your fiber intake as a good first step.
“I’m in favor of supplementation of fiber, which is a prebiotic,” he said. “A prebiotic simply means it is the food for the beneficial microorganisms already living in our bodies. To me, it makes more sense to nourish the millions of pre-existing good strains of bacteria we already have. That being said, I do still routinely recommend probiotics as a second or third option when other therapies have either failed or not led to complete improvement.”
The probiotic market is a booming business, projected to be worth nearly $77 billion by 2025. Since they are considered a supplement, probiotics are not regulated by the FDA.
Most come in capsule form and many include fiber or contain other ingredients, like turmeric. Some need to be refrigerated, and since probiotics are living organisms, consumers should pay attention to expiration dates on the package.
“We routinely recommend Align, Phillips Colon Health, VSL#3, Flora-Q and Culturelle in our GI clinic,” Dr. Hilgenfeldt said. “We do this for two reasons. One, these brands are well-known and produced by large companies and, two, they are the most commonly found and accessible. We recommend patients rotate every 30 to 90 days to a different probiotic, as each of them contains different strains of microorganisms.”
Who Should Take Probiotics?
While probiotic supplements have been shown to be beneficial for some conditions, such as ulcerative colitis and constipation, results also seem to vary by person. Dr. Hilgenfeldt explains that this means for every positive study with an improvement in symptoms, there may be another study that shows no improvement at all.
You may have also heard of probiotics being recommended after taking antibiotics, since the prescribed medicine can kill good bacteria, as well as bad. Again, results seem to vary by person, but taking a supplement may help with preventing diarrhea.
So if you do end up taking a probiotic supplement, how do you know if “it’s working?” That’s a hard question to answer, says Dr. Hilgenfeldt.
“Simply put, if you feel better after taking them, then perhaps they are helping and if you do not, keep taking them a little bit longer to make sure you’re giving them a chance to work,” he said. “For example, if you purchase a one-month bottle, finish it. Pay close attention and keep a diary of your symptoms.”
Those adults with severe illness or compromised immune systems should avoid taking a probiotic. It is recommended that you consult with your primary care physician before adding any supplement to your diet.
There is more than meets the eye when it comes to probiotics (and don’t forget about prebiotics). Try to fuel your body with a healthy, fiber-filled diet. Pay attention to any changes in GI symptoms that may require a conversation with your doctor about whether probiotic supplements are right for you. And trust your gut.