Probiotics have shown promise for a variety of health purposes, including prevention of antibiotic-associated diarrhoea, prevention of necrotising enterocolitis and sepsis in premature infants, treatment of infant colic, treatment of periodontal disease, and induction or maintenance of remission in ulcerative colitis.

• Good nutrition is important to supply the intestinal flora with all the needed macro- and micronutrients [Image: Freepik/timolina].

PROBIOTICS VERSUS ANTIBIOTICS

It is common knowledge that “pro” means “for” and “anti” means against. In medicine we are bombarded with medicines and terms that are in the “anti” classes. This includes antibiotics, anti-allergy, anti-depressants to mention a few. Let’s investigate the other side of the coin.

GASTROINTESTINAL TRACT

The gastrointestinal tract includes all the different structures from the mouth to the rectum and anus. In an adult the tract is about five metres long and harbours more than 500 different species of microorganisms. The number of organisms varies dramatically by anatomical region. The stomach produces gastric acid and has few aerobic organisms. Aerobe or aerobic organism is used to describe the organism that can survive and grow in an oxygenated environment.

The colon, in sharp contrast to the stomach, has an abundant number of anaerobe or anaerobic organisms. Anaerobe describes the organism that can survive and lives in an environment of virtually no oxygen. It is this environment that probiotics and “pro-organisms” play an important role to maintain the biosis of the gastrointestinal tract.

DYSBIOSIS

The term “dysbiosis” describes a gastrointestinal tract with a disrupted balance.

CAUSES

When the gut is dysbiotic, the “bad” or disease-causing bacteria begin to thrive over the “good” flora that keeps the gastrointestinal tract functional. The following can cause dysbiosis:

  • Antibiotic treatment: Antibiotics inhibit or eradicate good and disease-causing bacteria. The “bad” organisms have the opportunity to grow unopposed.
  • Alcohol: Alcohol is a disinfectant and antiseptic. Misuse of alcohol can also cause a disruption in the delicate balance of the intestinal flora
  • Infections: Parasitic, bacterial, and viral infections can cause overgrowth in the gastrointestinal tract.
  • Poor nutrition: Good nutrition is important to supply the intestinal flora with all the needed macro- and micronutrients.
Dysbiosis has been associated with the following illnesses:
  • Inflammatory Bowel conditions
  • Chronic fatigue syndrome
  • HIV infections

CONSEQUENCES AND SYMPTOMS

The symptoms of dysbiosis are not always obvious and can lead to a number of physiological health problems throughout the body. The following may be present with a disrupted flora balance:

  • Diarrhoea or constipation: When the normal flora is edged out, some of the basic biological functions of digestion begin to slow down and diarrhoea or constipation can appear.
  • Bloating and flatulence: One of the main functions of the intestinal flora is digestion. Compromised digestion and fermentation will cause bloating and flatulence
  • Intoxication: The “bad” bacteria produce additional waste products with which the body needs to deal. This is an additional burden and one may end up with the accumulation of toxic waste products. These toxins have been associated with depression, asthmatic wheezing, and other health problems.
  • Immune system changes: Immune dysfunction and dysbiosis often occur at the same time. These conditions can occur as a result of the infection and affect the body’s energy production at a cellular level. We can typically expect fatigue and low muscle tone.
  • Inflammation: This can be a localised inflammation which can spread to other parts of the body and have a systemic effect.
  • Altered physiology: The gastrointestinal tract is the manufacturing centre of vitamins, minerals, and some important neurotransmitters. A disruption in the tract affects all these negatively and deficiencies are evident.
  • Leaky-gut syndrome: Dysbiosis can alter the permeability of the gastrointestinal tract. This affects the absorption of ingested nutrients.
  • Autoimmune reactions: The immune system attack is focused against the body itself. There are numerous autoimmune diseases of which rheumatoid arthritis is an example.
  • Chronic infections

Armed with all this information we can investigate the treatment and preventative options available.

PROBIOTICS, PREBIOTICS AND SYMBIOTIC

The “father of probiotics” Elie Metchnikoff introduced probiotics during the early 20th century. He pictured the body as a host for bacteria and other microorganisms. Probiotics are similar to the “good” bacteria and help the gastrointestinal tract function optimally. It is important to look at the different cultures to understand probiotics fully:

  • Lactic acid bacteria (LAB): These micro-organisms are acid-tolerant and are not affected by the stomach’s acidic secretions. They are therefore able to pass through the upper gastrointestinal tract and colonise in the small intestine and colon. Within the intestines these bacteria have the ability to cling to the epithelial lining where they restore the balance. They also stimulate the production of antimicrobial compounds (acidolin, acidophilin, lactocidin, and bacteriocin), inhibit the growth of disease forming organisms, assist in the production of vitamins, and influence the immune system positively. There are many different species such as:
  • Lactobacillus acidophilus
  • Lactobacillus casei
  • Lactobacillus lactis
  • Lactobacillus paracasei
  • Lactobacillus plantarum includes the well-known strain 299V or better known as LP299V
  • Lactobacillus rhamnosus
  • Lactobacillus reuteri
  • Bifidobacteria: Acidophilus bifidus is a type of bacteria which is naturally found in the gastrointestinal tract. It is also referred to simply as acidophilus, acidophilus bifidus, and is considered part of the probiotic family.
  • Bifidobacterium lactis
  • Yeasts: Saccharomyces boulardii was first isolated by French scientist Henry Boulard during 1923. boulardii has been shown to maintain and restore the natural flora in the large and small intestine.

Prebiotics are non-digestible substances that stimulate the growth and activity of the beneficial or “good” organisms. Synbiotics refer to products that have combined probiotic and pre-biotic actions.

CONCLUSION

A healthy gastrointestinal tract is integral to overall vibrant health. It is therefore essential to restore and maintain the delicate flora of the gastrointestinal tract.