Probiotics indications
Antibiotic recovery: The purpose of antibiotics is to kill harmful bacteria. Unfortunately, they are not selective in their action, and frequently kill normal bacteria as well, resulting in disruption of the bacterial flora, which causes diarrhoea and other intestinal disturbances. Replenishing the normal flora with beneficial bacteria during and after antibiotic therapy seems to minimize the disruptive effects of antibiotic use.
Irritable Bowel Syndrome: Irritable bowel syndrome (IBS) is a functional bowel disorder that can be characterized by symptoms of abdominal pain, cramps, gas, bloating, diarrhoea and constipation. Surveys indicate the prevalence is somewhere between 10-20% of the adult population and that the condition is diagnosed 3 times more often in women than men (FDA Consumer Magazine, July-Aug, 2001). Very few controlled studies have ever been conducted evaluating the effects of probiotics on IBS symptoms. Some symptom relief (primarily from diarrhoea, abdominal pain or bloating) has been reported in studies published to date. The natural intestinal Bifidobacterium populations have been shown to be much lower in people afflicted with IBS. Some studies have shown that supplemental B. infantis alleviates symptoms of IBS in woman. Lactobacilli spp. such as plantarum are also being investigated for the potential beneficial effects for IBS patients.
Inflammatory bowel disease (IBD): IBD is often confused with IBS but is much more serious. IBDs such as ulcerative colitis (chronic inflammation of the colon) and Crohn’s disease (an inflammation that can affect any part of the GI tract and which inflames the entire wall of the involved bowel), are serious intestinal diseases that can ultimately lead to the surgical removal of the colon. In 2005, over 450,000 patients were identified to be suffering with ulcerative colitis in Europe and about the same number have been diagnosed with Crohn’s. About 30 per cent of people with ulcerative colitis eventually undergo surgery, typically after 15 to 25 years of the disease. Patients with ulcerative colitis have a significant risk of developing colon cancer.
The causes of these diseases are not known, but there is a hypothesis that intolerance to the normal flora (bacteria) in the gut, leads to inflammation and the resulting pathological changes. Antibiotics have long been used to treat IBD, but with limited success. The role of gut flora in the progression of these diseases has led some researchers to study the impact certain probiotic bacteria might have, on maintaining the state of reduced inflammation that occurs during remission stages of the diseases. Several controlled clinical trials have shown that consumption of certain strains of Lactobacilli eg. rhamnosus and casei. can result in an improvement in symptoms of IBD, pouchitis and ulcerative colitis and extend the disease-free remission period.
Studies also have documented this effect on the remission of pouchitis*.
*Pouchitis is inflammation of the ileal pouch, which is a pocket created from part of the intestine of colitis patients, who have had surgery to remove a portion of their bowel, for the purpose of collecting stools.
Lactose Intolerance: The inability of adults to digest lactose, or milk sugar, is prevalent worldwide. People of northern European descent are unique in retaining the ability to produce the lactose-digesting enzyme, lactase, into adulthood. Consumption of lactose by people who produce insufficient lactase in the small intestine, can result in symptoms of diarrhoea, bloating, abdominal pain and flatulence. These symptoms are due to the undigested lactose reaching the large intestine and being fermented by the colonic microbes. This fermentation can produce gases and disruptions that lead to watery stool.
The consumption of dairy products is important for supplying calcium and preventing osteoporosis, for people with lactose intolerance this can be facilitated by the consumption of probiotic bacteria.
It has been documented scientifically, that many lactose intolerant individuals are better able to consume fermented dairy products, such as yogurt, with fewer symptoms than the same amount of unfermented milk. Yogurt theoretically contains about the same amount of lactose as milk, but the lactic acid bacteria used to make yogurt produce lactase which digests the lactose before it reaches the colon, and thus no mal-absorption is experienced. In addition to yoghurt starter cultures, probiotic bacteria L. acidophilus and Streptococcus thermophilus have been shown by several studies to improve digestion of lactose.
Allergies/eczema: Atopic eczema is an allergenic, chronic disease affecting increasing numbers of people in developed countries. In Europe the prevalence of atopic eczema has been reported to be 2-18%. It is believed that an increased focus on hygiene hinders the build up of natural immunity and intestinal flora, and jeopardizes the immunological mechanism of tolerance; without which there may be an over-reaction to harmless antigens.
Immune responses in newborn babies are dominated by Th2 cytokines. During the first year of life, the immune responses normally shift to Th1-based immune reactions due to continuous exposure to various antigens. However unfortunately for some infants this transition doesn’t happen and the Th2 remains dominant. As a result of this, these babies can develop atopic eczema.
Probiotics may induce tolerance by the immune system, and thereby exert a preventive effect on development of hypersensitivity and allergies, including food allergies.
A resent study, made by Cell Biotech, showed that probiotic bacteria have a positive effect in the treatment of patients with atopic eczema. The study was made with L. rhamnosus, L. plantarum, L. casei, and B. lactis – and showed a positive effect for 50 % of patients after 8 weeks. Other studies suggest that probiotics may enhance the endogenous barrier mechanisms of the gut and alleviate intestinal inflammation, providing a useful tool for treating food allergies.
Immune enhancement: The immune system provides our primary defence force against microbial pathogens that have entered our bodies. The immune system is extremely complex, involving both cell-based and antibody-based responses to potentially infectious agents.
Immunodeficiency can result from certain diseases e.g., cancer or AIDS, and to a lesser extent from more normal conditions such as old age, pregnancy or stress. Autoimmune diseases such as allergies, rheumatoid arthritis and inflammatory bowel conditions, can also can occur due to the activity of a misdirected immune system.
Studies suggest that probiotics can enhance the immune responses by, activating immunoreactive cells (e.g. macrophages, lymphocytes), increasing levels of cytokines and increasing natural killer cell activity (NK) and/or increasing levels of immunoglobulins.
Several strains of lactobacilli are used for immune enhancement, incl. acidophilus, rhamnosus, casei and plantarum, and some bifidum strains, for instance lactis and infantis, are used.
Adherence and colonizing abilities of strains are also important for the potential immune boosting effects.
Traveller’s diarrhoea: Traveller’s diarrhoea typically results from contaminated food or water. Approximately 80% of cases of traveller’s diarrhoea are caused by bacterial entero-pathogens. Salmonella, Escherichia coli, Staphylococcus aureus, and Listeria produce intestinal problems like nausea and cramping, and Shigella causes the intense abdominal pains of dysentery.
The severe diarrhoea triggered by these bacteria leads to dehydration, reduced absorption of nutrients, and also destroys the microflora.
In general, taking antimicrobial medication, such as antibiotics or bacteriocins, to prevent TD is not recommended. However, studies show that prophylactic intake of probiotic bacteria, such as Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, Steptococcus thermophilus etc., prior to travelling, can reduce the risk of TD. According to several studies these strains of lactic acid bacteria will stimulate our immune response and thereby heighten the defence system against invasive pathogens.
Detoxification: A hectic lifestyle, bad eating habits, antibiotics, travel or excessive partying can unsettle the digestive system. Beneficial bacteria that colonise the intestinal tract act to promote the normal functioning of digestion, efficiently removing toxins and helping to prevent digestive upsets, stimulating and maintaining the natural immunity of the body. Probiotic bacteria are natural inhabitants of the intestines and are found in the healthy gut of all humans. Probiotics such as Bifidobacterium bifidum, Lactobacillus casei and Lactobacillus rhamnosus can help to ensure that there are enough bacteria to perform this cleansing function.
Bacterial Vaginosis (BV): BV is the name of a condition in women where the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of Gardnerella vaginalis, Mobiluncus spp., Mycoplasma hominis or other anaerobic micro-organisms, which leaves the protective Lactobacilli bacterium unable to adequately perform its normal function. This imbalance is often accompanied by discharge, bad odour, pain, itching and burning.
BV can be found in association with other vaginal infections, including Chlamydia, Trichomonas and yeast vaginitis, making diagnosis extremely difficult and treatment problematical.
The loss of vaginal Lactobacilli appears to be the major factor in the cascade of changes leading to bacterial vaginosis and relapses are associated with failure to establish a healthy vaginal flora dominated by Lactobacilli.
Studies have shown that daily oral intake of probiotic strains Lactobacillus rhamnosus and Lactobacillus acidophilus, resulted in some asymptomatic bacterial vaginosis patients reverting to a normal Lactobacilli dominated vaginal microflora.
