Category Archives: prebiotic

April is IBS Awareness Month

IBS Awareness Month, observed every April, is an annual campaign aimed at increasing awareness and understanding of irritable bowel syndrome.

IBS is a functional gut disorder, which means that the bowel simply does not work as it should. Around 10% of the population suffers with this disorder, and sufferers can experience a number of intermittent symptoms including diarrhoea, constipation, gas, bloating and lower abdominal pain. While the condition is not thought to damage the bowel, it has a significant impact on quality of life (1).

Before IBS is diagnosed by your doctor it is important that he or she rules out other digestive conditions such as Crohn’s or Ulcerative Colitis which are inflammatory bowel diseases.

For many, treatments such as anti-spasmodics offered by the GP have limited success. Sufferers can be left feeling helpless, and do not always have the information they need to manage the condition.

IBS: Four Steps to Digestive Health

1. Optimise digestion

Chewing food thoroughly and eating in a slow and relaxed manner can help improve the first stage of digestion by increasing levels of digestive enzymes and helping them to work more effectively. Plant enzyme formulas, such as papaya enzymes in Caricol, may also be helpful in optimising digestion, and have been found to improve symptoms of IBS (2).

2. Restore gut bacteria

Many studies have drawn attention to a link between IBS and overgrowth of pathogenic bacteria in the gut. Probiotic formulas can help to crowd out these problem bacteria, improving digestion, decreasing inflammatory response and restoring proper balance in the digestive tract. Strains of Lactobacillus and Bifidobacter look particularly promising as natural agents aimed at improving symptoms of IBS (3,4).

Prebiotic foods, such as asparagus, garlic, leeks and bananas can also be helpful as a regular addition to the diet. Prebiotics feed the friendly bacteria in your gut helping it to proliferate.

3. Repair and protect

April is IBS awareness month
April is IBS Awareness Month

While IBS is not classed as an inflammatory condition. However, recent research published in the journal Gastroenterology has actually found ‘mini-inflammations’ in the gut mucosa of IBS patients. This inflammation is thought to upset the sensitive balance of the bowel and cause hypersensitity of the enteric nervous system leading to IBS symptoms. Lead researcher Prof. Schemann explains: “The irritated mucosa releases increased amounts of neuroactive substances such as serotonin, histamine and protease. This cocktail produced by the body could be the real cause of the unpleasant IBS complaints.”

Natural measures to help repair and protect the gut lining, such as supplementing glutamine or omega-3 oils could help reduce this localised inflammation, improving IBS symptoms.

4. Identify trigger foods

While food choices are not the cause of IBS, they can certainly trigger symptoms. Trigger foods can vary from person to person, but common culprits include wheat, fatty of fried foods, milk and coffee. Keeping a diary of your diet and symptoms can help to identify trigger foods. Eliminating possible trigger foods from your diet should be done in a safe and healthy way, and guidance from a nutritional therapist can be helpful for those who need support with this.

The management of IBS requires a personalised approach, as what works for your neighbour may not be the best option for you. It is important to persevere in order to find the right approach. Hopefully international campaigns such as IBS Awareness Month should encourage sufferers to find the information and help they need to manage the condition effectively.

References

1. Amouretti M et al (2006)  Impact of irritable bowel syndrome (IBS) on health-related quality of life (HRQOL). Gastroenterol Clin Biol.  Feb;30(2):241-6.

2. Muss et al (2012) Papaya preparation (Caricol®) in digestive disorders. Biogenic Amines Vol. 26, issue 1 (2012), pp. 1–17.

3. Clarke G et al (2012) Review article: probiotics for the treatment of irritable bowel syndrome – focus on lactic acid bacteria. Alimentary Pharmacology & Therapeutics 35:4. pp. 403–413.

4. Technische Universitaet Muenchen (2010, August 20). Proof that a gut-wrenching complaint — irritable bowel syndrome — is not in your head. ScienceDaily. Retrieved March 29, 2013, from http://www.sciencedaily.com­/releases/2010/08/100819141950.htm.

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Probiotics – What are they and do you need them?

Probiotics, or ‘friendly bacteria’, are live microorganisms, which when consumed in adequate amounts, are thought to confer health benefits on the human body. Taking a daily probiotic supplement could not only help with your digestion, but could also spark off other feel-good factors, such as good skin health, immunity and wellbeing.

Digestion
Probiotics are key to the digestive system. They help the body to produce digestive enzymes (such as lactase) which breakdown certain food substances (in this case, lactose, found in dairy products.) This is why topping up your levels of probiotics on a daily basis can help with food intolerances.

Probiotics support the digestive system, and various research has shown that these microorganisms can help to encourage bowel regularity, and discourage digestive disorders or conditions such as diarrhoea (1,2), bloating (3) , or constipation(4,5).

High Quality Probiotic
A High Quality Probiotic such as OptiBac For Daily Wellbeing EXTRA Strength can help line the gut wall with good bacteria to fend off pathogens.

Immunity
Probiotics are thought to support the immune system thanks to the ‘barrier effect’. A high quality probiotic is tested for its ability to bind to cells on the gut wall lining. When you supplement with plenty of probiotics they begin to coat your gut wall, taking up space on this lining. This means that when pathogens (harmful microorganisms) enter the body, they reach the gut and have fewer points on the gut wall upon which they can adhere. It’s effectively a competition for space, between the good guys and the bad! The more good guys (probiotics) you have lining your gut wall, the fewer bad guys (pathogens) you should have in turn. This is known as the barrier effect; taking a daily probiotic can support this process.

Probiotics also improve the absorption of vitamins and minerals into the bloodstream. After all there’s no use taking lots of vitamins if your body is not absorbing them. This improved vitamin uptake provides essential support for the immune system, and what’s more, means that a probiotic nicely complements any other daily supplements you may take.

Skin health
Probiotics are also thought to help support healthy skin, as often acne or spots are caused by bad bacteria, or toxins in the body. Supporting your gut with friendly bacteria means that the body will digest foods more efficiently (producing fewer toxins in the first place) and what’s more, probiotics help to displace toxins or bad bacteria in the gut (through various mechanisms, including the barrier effect mentioned above.) Probiotics have even been shown to help with atopic allergies such as eczema (6). Supporting your gut health from the inside should hopefully see you benefiting on the outside too.

Frequency of Use
Some specific probiotics can be effectively taken as a ‘one-off’ treatment, for example Saccharomyces boulardii to support gut health in those suffering from diarrhoea. However if you’re taking probiotics for general support to your digestion, immunity, energy & skin, best to take them every day for at least a few months; giving your gut time to top up its friendly bacteria levels. Many people safely and happily take probiotics on an ongoing basis for years.

 

References:

1. McFarland, L.V. & Bernasconi, P. (1993) Saccharomyces boulardii: A Review of an Innovative Biotherapeutic Agent. Microbial Ecology in Health and Disease; Vol. 6 pp. 157-171.
2. Hochter, W. et al (1990) Saccharomyces boulardii in acute adult diarrhea. Efficacy and tolerance of treatment. Munchener Medizinische Wochenschrift; Vol. 132 (12) pp. 188-192
3. Paineau, D. (2007) Regular consumption of short-chain fructo-oligosachharides improves digestive comfort with minor functional bowel disorders. Br. J. Nutr. Aug 13:1-8 [Epub ahead of print]
4. Matsumoto, M. et al. (2001) Effect of Yoghurt with Bifidobacterium lactis Bb-12® in Improving Fecal Microflora and Defecation of Healthy Volunteers. Journal of Intestinal Microbiology; 14(2): pp. 97-102
5. Pitkala, K.H et al. (2007) Fermented cereal with specific bifidobacteria normalizes bowel movements in elderly nursing home residents. A randomized, controlled trial. Journal of Nutritional Health and Aging; 11(4): pp.305-311.
6. Isolauri, E., et al., Probiotics in the management of atopic eczema. Clin Exp Allergy, 2000. 30(11): p. 1604-10.

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How can probiotics support your immune system?

It is generally accepted nowadays that probiotic microorganisms are helpful for digestion, but people are just beginning to understand that these ‘friendly microorganisms’ can support the immune system as well.  For example, one great way to maintain your children’s health in the back to school period is by supporting their gut with a high quality kid’s probiotic.

The gut can be seen as the gateway to a healthy body.  When we have good numbers of friendly bacteria in the gut, we perform our digestion with ease, effectively absorbing vitamins and minerals into the bloodstream.  But that is not all probiotics help with!

OptiBac Probiotics - For Daily Immunity
Probiotics in the gut provide a ‘Barrier Effect’ against pathogens.

Probiotics in the gut provide a ‘Barrier Effect’ against pathogens.(1) When the body has a healthy balance of ‘friendly bacteria’ or probiotics, these can help to protect the body from ‘bad bacteria’ or pathogens, by coating the gut wall lining and competing with pathogens for space.  When probiotics limit the ability of pathogens to adhere to the gut wall lining, this automatically limits the bad bacteria’s ability to grow, as bacteria need to bind before they can multiply and proliferate.

Probiotics also stimulate both the body’s innate immune response & acquired immune response.  Statistically over 70% of the body’s immunity is based in the gut, and our friendly bacteria play a significant role in the gut and in working with the body’s immune system.  Specific strains such as Lactobacillus acidophilus Rosell-52 have been shown in-vitro to stimulate the growth of white blood cells such as macrophages and in turn lymphocytes, which attack foreign microbes and cancer cells.  Probiotics have also demonstrated abilities to stimulate the production of useful antibodies such as Immunoglobulin M (IgM) and Immunoglobulin A (IgA);(2) which plays a critical role in the mucosal immunity.

Prebiotics (the food source for probiotics) such as fructooligosaccharides (FOS) enhance the production of short-chain fatty acids, such as butyrate, which has been shown to inhibit the growth of harmful bacteria as well as to significantly inhibit the growth of cancerous colon cells.

So in a nutshell, probiotics & prebiotics help to support your immunity by fortifying the body’s natural defences, out-populating harmful bacteria, and by promoting the production of immune cells in the body.

OptiBac Probiotics For your child’s health (For children from 6 months to 12 years) is a probiotic & prebiotic made especially for children, and has been clinically trialled for its benefits in immunity.   This supplement was found in a randomised, double-blind, placebo-controlled study to decrease the risk of common childhood infections by 25%.(3) The study was conducted only on children who had suffered recurring digestive and immune infections throughout the previous winter; hence showing even greater potential for supporting immunity in children.   Three month daily supplementation with For your child’s health was found to significantly lessen the risk of infections, and reduce days missed from school.  It is also worth noting that the types of infections reduced were not only gastrointestinal, but also ear-nose-throat (ENT).

It’s also important to support your own gut health as well as your children’s.  OptiBac Probiotics For daily immunity is a blend of both super antioxidants and probiotics.   Vitamin C, Grape Seed, Green Tea and Pine Bark Extract are all natural & organic ingredients which help support your immunity by inhibiting the production of free radicals which can harm body cells & compromise immunity. Additionally, the probiotics help the body to absorb the antioxidants into the bloodstream.

Alternatively For daily wellbeing EXTRA Strength provides a high strength daily probiotic dose, containing 20 billion micro-organisms per capsule. The daily wellbeing EXTRA Strength and the daily immunity can be safely taken together throughout the winter months for added immune support.

Looking after your gut means looking after your immunity too –  Easy!

Written by Lou Bowler, BHSc (Naturopathy)

References

1.  Isolauri, E., et al. (2001) Probiotics: Effects on immunity. American Journal of Clinical Nutrition. Vol.73, No. 2, 445-450s, February 2011.

2.  Perdigon, G., Alvarez, S., Rachid, M., Aguero, G & Gobbato, N., (1995) Immune System Stimulation by Probiotics. Journal of Dairy Science. Vol 78, Issue 7. Pp 1597 – 1606.

3.  Cazzola, M. et al. (2010) Efficacy of synbiotic supplementation in the prevention of common diseases in children: a randomised, double-blind, placebo-controlled study;  Therapeutic Advances in Respiratory Disease 0ctober 2010 Vol. 4 no. 5 pp.271- 8.

 

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Probiotics for Digestive Health and Candida

Probiotics
Probiotics are a valuable part of a healthy diet (1)

Probiotics are a valuable part of a healthy diet, and may play an important role in sustaining overall intestinal health.  Many people suffer from the effects of intestinal imbalances which makes a focus on probiotics essential.  Prevention of imbalance before it occurs is clearly a better alternative to treating the often unpleasant symptoms.  Using probiotics is a safe, cost-effective, “natural” approach that may help act as a barrier against microbial infection.

The importance of digestive health

Digestive health is an important yet often ignored factor for our overall health.  If you haven’t been feeling yourself lately it is possible that this may be related to your digestive health.  Many health professionals and nutritionists believe that to be truly healthy we need a healthy digestive system and yet it is not an aspect many usually concentrate on.  If there is a problem with your digestive system, your body might not be able to absorb enough nutrients from your food, which can cause you to suffer from a number of different problems.

Friendly flora perform a number of constructive functions in the intestinal tract.  One main function is to help prevent occasional good/bad flora imbalance.  The “good” flora do this by crowding out the “bad” in the intestinal tract.

Candida

Each and every one of us carries Candida albicans in the digestive tract.  Candida, a single celled organism, produces more than a hundred different toxins which can be absorbed through the intestinal wall and in turn cause your body issues.  Provided these tiny yeast like organisms are kept under control by beneficial microbes and the immune system, they should do us no harm.  However, if there is an imbalance in the intestine, this could lead to Candida cells growing at a rate that is out of control leading to a number of problems.  This occurs when intestinal balance is disorientated by an impaired immune system, the use of antibiotics and stress or high carbohydrate diets, birth controls, diabetes and pregnancy. (2)

When Candida starts to proliferate, they become capable of penetrating the intestinal wall and leaking out into the body through the bloodstream, this can lead to  a negative effect on our health and overall wellbeing.  Some of the symptoms associated with Candida are:

•    Anger outbursts
•    Irritability
•    Headaches
•    Constant tiredness and exhaustion
•    Anxiety
•    Mood swings
•    Obsessive compulsive disorder (OCD)
•    Intense cravings for sugars, sweets, and breads
•    Itchy skin
•    Frequent stomach pains and digestion problems
•    Skin problems (skin infections, eczema, psoriasis, acne)
•    Foggy brain / Trouble concentrating (3)

Treating Candida with probiotics

Threelac
ThreeLac may alleviate the yeast overgrowth symptoms faster than other treatment methods.

You can adjust the amount of yeast in your body through diet however it is not as easy as many people may think.  You would have to significantly reduce and even completely cut out sugar and high-carbohydrate foods.  Although most people can do this, they can’t sustain it for long and depriving themselves of these foods can often result in binge eating behaviour which is counter productive.  The more sugar you intake the more fuel you give yeast to grow in your body.

Although probiotics are naturally available in yoghurt, one of the most effective natural options for reducing yeast is a probiotic supplement such as ThreeLac as they are teeming with good live bacteria.  Because probiotics may help reduce the symptoms of yeast overgrowth it is an easier method than adhering to a very strict diet regimen.  Many women who suffer from thrush, “especially those who have undergone repeat antibiotic treatment, find probiotics to be really helpful in preventing recurrence and treating these conditions.” (4)

ThreeLac provides selected beneficial microflora for the purpose of replenishing needed friendly flora to promote intestinal health, a powerful probiotic formulation of three potent microflora in a lemon-powder base.

•    Bacillus coagulans: A probiotic organism that may help control occasional digestion and stomach problems.
•    Bacillus subtilis: A probiotic organism that may help crowd out “bad” flora in the intestines.
•    Enterococcus faecalis: The Enterococci constitute a major genus within the lactic acid bacteria group, and exists naturally in the human digestive tract. This effective probiotic bacteria is the result of formulation under strict laboratory conditions.

One of the benefits to using ThreeLac is that it may alleviate the yeast overgrowth symptoms faster than other treatment methods.  Also for those people who are lactose intolerant, yoghurt is not always an option so a probiotic such as ThreeLac could be an effective alternative.  A healthy digestive system directly relates to a healthy immune system and our overall wellbeing.

1. Image courtesy of Ambro.

2.  http://www.ecandida.com/candida-albicans.

3.  http://www.ghthealth.com/

4.  Ani Richardson, “ Natural remedies for the treatment and prevention of vaginal thrush infection“, bodykind blog, 05/082009.

Written by Mike Pye

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Probiotics in pregnancy may reduce the risk of eczema in children

Previous evidence has suggested that probiotics (‘friendly’ gut bacteria) given to pregnant women at risk of having children with atopic dermatitis (a type of eczema), and then their infants, seems to reduce the incidence of eczema in the children.  A recently published study in the British Journal of Dermatology (1) took place to examine whether probiotic supplements given to non-select pregnant women (not just those at risk of having a child with eczema) could prevent eczema in the child’s first two years. 

 

In the study (1) women received a probiotic milk or placebo (milk which did not contain probiotics) from 36 weeks of pregnancy to three months postnatally during breastfeeding (all the mothers breastfed their children). The probiotic milk contained the probiotic strains Lactobacillus rhamnosus GG, Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. lactis Bb-12. Children with an itchy rash for more than four weeks were assessed for eczema.  After two years of age, all the children were assessed for various conditions such as atopic dermatitis, asthma and allergic rhinoconjunctivitis.  The results showed that children of the women who drank the probiotic milk during and after their pregnancy had a 40% reduced incidence of eczema.

The results showed that probiotic bacteria reduced the incidence of eczema in children up to age two years by 40 percent. And the kids in ‘probiotics group’ who did have eczema, had less severe cases,” explains Christian Kvikne Dotterud, a student in the Medical Student Research Programme at the Department of Community Medicine at NTNU (2).

The study was conducted by researchers at the Norwegian University of Science and Technology (NTNU), Norwegian University of Science and Technology,  it is part of a larger research project at the university called the Prevention of Allergy Among Children in Trondheim, or PACT, an ongoing population-based intervention study in Norway focused on childhood allergy (2).

One of the study researchers said (2)Our study is the first to show that certain probiotic bacteria given to the mother during pregnancy and breast-feeding prevents eczema,”. Previous studies have shown that probiotics taken by pregnant mothers and then by their children may prevent eczema, but this is the first study to show a preventative effect when the mother alone consumed the probiotics.  It is thought that the probiotic bacteria, taken by the mothers, affects the composition of breast milk in a positive way.

The researchers of this study used a variety of strains of probiotics.  In the press release they say “There is reason to believe that it is beneficial for your health to consume a variety of bacterial strains with documented efficacy, rather than unilateral influence of only one bacterial strain”.  One of the strains of bacteria used in the probiotic milk drink was  LGG ®, (Lactobacillus rhamnosus GG)  which is currently the probiotic bacteria that are most extensively studied and researched in terms of human health in the world.  It has been shown that LGG ® contributes to good gut function and a stronger defense against unwanted bacteria and viruses in the stomach. At present there are more than 500 published articles on LGG ® in international journals and more than 30 doctoral theses have been completed on LGG’s ® effect on health. More than 40 countries in different parts of the world market products with LGG ® (2).  The probiotic milk also a contained a strain of Bifidobacteria, which have also been used in numerous research studies.

Evidence is continually accumulating for the use of probiotics (and prebiotics) for health.  It is important to talk to your doctor or midwife before beginning any supplement regimen during pregnancy or when breastfeeding.

(1) C. K. Dotterud CK et al.  2010.  Probiotics in pregnant women to prevent allergic disease: a randomised, double-blind trial.   British Journal of Dermatology E-Pub prior to print.  10.1111/j.1365-2133.2010.09889.x

(2)Press release.   Norwegian University of Science and Technology.  http://www.ntnu.edu/probiotic-use-in-pregnancy

Written by Ani Kowal

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Probiotic drink may help reduce infections in children

Probiotics, or so called ‘friendly bacteria, have been heavily researched for over ten years now and many studies,  support their use for prevention and treatment of gastrointestinal diseases as well as a whole host of other issues such as eczema and even childhood cold and ear infections.  A recently published study (1) has found that  a yoghurt-like drink containing probiotics might reduce the rate of common sicknesses such as flu, diarrhoea, ear infections and sinusitis in children who are in day-care.

Probiotic Drink
Probiotics might reduce the rate of common sicknesses such as flu, diarrhoea, ear infections and sinusitis in children/

The researchers (1) of the study were evaluating whether a fermented dairy drink containing the probiotic strain Lactobacillus casei DN-114 001 could reduce the incidence of common infectious diseases in children.  Over 600 children attending day-care, aged between 3-6, were involved.  Children were given a fermented dairy drink containing a specific probiotic strain or a matching placebo drink which contained no probiotics for 90 consecutive days.  The study was double blind, neither the study coordinators, the children, nor the parents knew which drink was given to which participant until the study ended.  Parents had telephone interviews with researchers during the trial in addition to keeping a daily diary of their child’s health.

Results (1) showed that children taking the probiotic containing drink had a 19% lower rate of common infectious diseases compared to those children drinking the placebo drink.  Specifically, those who drank the probiotic drink had 24% fewer gastrointestinal infections such as diarrhoea, nausea and vomiting and 18% fewer upper respiratory tract infections such as ear infections, sinusitis and throat infections.  To date this is the largest known probiotic clinical trial to be conducted in the United States (2).

Although the results are interesting and worth further investigation the researchers note that there was no reduction in the number school days missed by children taking the probiotic drink.  In a press release (2) one of the authors said “Our study had mixed results,”. “Children in school or daycare are especially susceptible to these illnesses. We did find some differences in infection rates but this did not translate to fewer missed school days or change in daily activity. It is my hope that safe and tolerable ways to reduce illnesses could eventually result in fewer missed school days which means fewer work days missed by parents.” “It is important that more of these products are put under the microscope by independent academic researchers,”.

For more information about probiotics, and also prebiotics (food that stimulates the growth of the beneficial bacteria already present in the colon) please read my previous blog posts.  Any research that may potentially reduce the amount of antibiotics that are prescribed is very much needed.  A recent study (3) published in the British Medical Journal has found that patients whose doctors over-prescribe antibiotics may develop drug resistance that lasts up to a year.  This is dangerous since it puts them and the population at risk when treatment for more serious infection is needed.  The study was a review that included over 24 research trials.  The authors concluded that “Individuals prescribed an antibiotic in primarycare for a respiratory or urinary infection develop bacterialresistance to that antibiotic. The effect is greatest in themonth immediately after treatment but may persist for up to12 months. This effect not only increases the population carriageof organisms resistant to first line antibiotics, but also createsthe conditions for increased use of second line antibioticsin the community”.

It is thought that overuse of antibiotics in Europe and the USA is creating widespread antibiotic resistance which can threaten vital medical treatments.  Antibiotics are vital for all kinds of serious illnesses from cancer therapy to intensive care and post-surgery.  However, if antibiotics are used too often for less serious issues the bacteria start to build up resistance against them, then when they are needed in serious treatment they are less effective.  Multi drug-resistant bacteria have become a growing problem in hospitals worldwide, with the most well known probably being the so called ‘super bug’  MRSA methicillin-resistant Staphyloccus aureus.  The more antibiotics are prescribed for minor illness the more the bacteria will become resistant.  Any treatment that may prevent antibiotic prescription for minor illness is welcomed and I look forward to seeing more research on the use of prebiotics and probiotics for the prevention of colds, flu and minor infection.

(1)Merenstein D et al.  2010. Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study A patient-oriented, double-blind, cluster-randomized, placebo-controlled, clinical trial. Eur J Clin Nutr, E-Pub prior to print.  May 19, 2010 DOI: 10.1038/ejcn.2010.65

(2)PressRelease Georgetown University Medical Center (2010, May 19). Yogurt-like drink DanActive reduced rate of common infections in daycare children. ScienceDaily. Retrieved May 20, 2010, from http://www.sciencedaily.com­ /releases/2010/05/100519081329.htm

(3) Céire Costelloe C et al.  2010.  Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis.  BMJ 2010;340:c2096  doi:10.1136/bmj.c2096

Written by Ani Kowal

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‘Friendly’ bacteria for the treatment of IBS symptoms

April is International IBS (irritable bowel syndrome) awareness month.  IBS describes a combination of symptoms including constipation, diarrhoea, abdominal pain/discomfort, nausea and vomiting, feelings of fullness, gas and bloating.  Sufferers often feel embarrassed by the condition which generally develops in individuals between the ages of 20 and 30 and affects around 20% of the population.  IBS also appears to be more common in women than men. There is no single remedy for irritable bowel syndrome, individuals find that their symptoms are provoked by a variety of different foods and situations, with stress and other emotional issues being common triggers.

International Irritable Bowel Syndrome (IBS) Awareness Month is organised by the International Foundation for Functional Gastrointestinal Disorders (IFFGD). IBS is common with worldwide prevalence estimated at 9% to 23%. Although the condition is associated with heavy economic and social burdens, many people remain undiagnosed and unaware that their symptoms indicate a medically recognised disorder.  For more information about IBS and the IFFGD please visit the IFFGD website there you will find information on the symptoms of IBS, available treatments, special IBS diets and more.

Lepicol - Healthy Bowels Formula - 350g Powder
Products like Lepicol contain Psyllium Husks, Prebiotics and Probiotic Cultures including Lactobacilli and Bifidobacterium bifidum which can support IBS symptoms

The causes of this uncomfortable condition are unclear and complex.  However, an imbalance in intestinal bacteria is frequently implicated.  Often IBS develops after a bout of gasteroenteritis or repeat courses of antibiotics (which kill off the vast majority of intestinal bacteria).  The bacteria in the digestive system of individuals suffering from IBS seems to be different to healthy people with fewer ‘beneficial/friendly’ bacteria such as Bifidobacteria and Lactobacilli being present in those with IBS.

Growing evidence suggests that probiotics (as well as prebiotics and synbiotics), supplemental beneficial bacteria, seem helpful in managing IBS.  Probiotics may help by reducing the level of inflammatory chemicals (cytokines), implicated in IBS.  Imbalances in gut bacteria can lead to chronic low-level inflammation in the intestines and the measurable presence of inflammatory markers in the bloodstream.   However, there are complications with the scientific studies that have taken place to date as it seems that the type of bacterial probiotic supplement used may be responsible for the degree of improvement noted in IBS sufferers.  Supplements containing Bifidobacteria seem to be especially effective.

 

Some definitions:

A probiotic is a supplement containing live friendly bacteria which aim to improve intestinal bacteria balance.  Probiotics are available as yoghurts, fermented milks, fortified fruit juices and freeze dried capsules/powders.

A prebiotic is a food that stimulates the growth of the beneficial bacteria already present in the colon.  Fructooligosaccharides (FOS) which can be bought as powders are the most common prebiotics available.  Natural prebiotics can be found in asparagus, onion, chicory and garlic.

Synbiotics are a mixture of probiotics and prebiotics.

Recent reviews of evidence (1,2,3,4) for the usefulness of probiotics in the treatment and alleviation of symptoms of IBS all seem to concluded that there are good quality medical trials to back up their usefulness.  The review papers also suggest that there is a solid link between alterations in the bacterial composition of the gastrointestinal tract (gut) and IBS.  The problems that are flagged up is that there are so many different probiotics available of varying quality.  Not all probiotics are the same and further studies are needed to discover what the best strains/types of bacteria are.

One review paper published this year (3) looked at the randomised controlled trials available for the use of probiotics in IBS.  19 trials in 1650 patients with IBS were identified. Trial quality was generally good.  When the data was collaborated it was found that probiotics were statistically significantly better than placebo in treating IBS.  The authors conclude that “probiotics appear to be efficacious in IBS, but the magnitude of benefit and the most effective species and strain are uncertain”.  A study published last year (4) found that the most solid evidence for the use of probiotics in IBS was with Bifidobacterium infantis (specifically B. infantis 35624).  This probiotic showed repeated efficacy, with improvements noted in bloating, pain or discomfort, and bowel habit.   Other probiotics may prove beneficial in the future, but well designed studies are needed to clarify effectiveness.

If you are suffering with IBS it may well be worth trying a Bifidobacterium probiotic supplement.  Keep the supplement in the refrigerator and take the dose away from hot food, since heat can kill the beneficial bacteria.  It is also worth looking for a probiotic that also contains FOS (a prebiotic) since this may help the bacteria to establish in the gut and may also have a positive effect in itself.

In addition to the IFFGD  website mentioned above please visit  the Gut Trust the national charity for people with Irritable Bowel Syndrome in the United Kingdom.

The Gut Trust say  “We support people like you, who are coping day to day with IBS; a condition that is misunderstood, often stigmatised and which can chronically affect your everyday life.  We support people with Irritable Bowel Syndrome in several ways. For our members, we offer a telephone helpline staffed by medical and nursing specialists and on-line medical advice and consultation, factsheets on all aspects of IBS, online support, can’t wait cards and travel cards to facilitate access to toilets at home and abroad, a quarterly magazine, and an interactive and frequently updated website that includes our unique fully comprehensive Self Management Programme to help you live life to the full with IBS

 

References

(1) Parkes GC et al.  2010.  Treating irritable bowel syndrome with probiotics: the evidence. Proc Nutr Soc. 2010 Mar 18:1-8. [Epub ahead of print]
(2) Ghoshal UC et al.  2010.  Bugs and irritable bowel syndrome: The good, the bad and the ugly. J Gastroenterol Hepatol. 2010 Feb;25(2):244-51.
(3) Moayyedi P et al.  2010.  The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010 Mar;59(3):325-32.
(4) Brenner DM et al.  2009.  The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review. Am J Gastroenterol. 104(4):1033-49; quiz 1050.

Written by Ani Kowal

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Probiotics may be useful in preventing festive indigestion

Christmas parties and festivities are ongoing at this time of year and this often means large meals and plenty of rich food.  Indigestion is a common side-effect of over-indulgence for many people.  Indigestion will typically occur 1-2 hours after eating and symptoms may include:

* Abdominal Pain centred in the upper abdomen
* Rumbling noises
* Excessive wind/flatulence
*A feeling of fullness, distension of the stomach or bloating

Alcohol, coffee, cigarette smoking and some pharmaceutical drugs such as aspirin and ibuprofen can also irritate the digestive system and cause indigestion.  During stressful situations or stressful periods of time we are also more susceptible to this complaint.

It may sound simple but chewing is really important when eating a large meal.  Chewing food properly before swallowing it really does help prevent indigestion.  Our saliva contains enzymes that start digesting food within the mouth, even before it hits the stomach.  Chewing food properly enables these enzymes to mix thoroughly with our food.  Chewing also physically breaks food up into smaller pieces which make it easier to be further broken down by our stomach acid.

Another good way to prevent indigestion is to avoid drinking a lot of fluid during a meal.  Excess liquid with a meal seems to dilute stomach acid and enzymes which digest food, making the digestive process a little less efficient.

Probiotics can help with festive indigestion
Probiotics can help with festive indigestion

A recent study (1) has found that taking a probiotic supplement is also a good way of reducing indigestion related symptoms.  The study was well designed and involved 61 adults who were given a supplement containing probiotic bacteria or a placebo (‘dummy’) pill for four weeks.  The researchers wanted to look at the effects on indigestion symptoms such as abdominal pain, distention, flatulence.  None of the participants had any diagnosed gastrointestinal diseases.

Individuals who got the probiotic supplement(1) had significant improvements in their abdominal pain scores and some improvement in their feelings of abdominal distension.  The authors of the research study conclude that the probiotic product “was effective in improving the quality of life and reducing gastrointestinal symptoms in adults with post prandial [after eating] intestinal gas-related symptoms and no GI [gastrointestinal] diagnoses”.

Taking a supplement containing prebiotics and probiotics regularly may be useful in preventing symptoms such as pain, bloating and flatulence.  These supplements are safe to take long term and have also been linked to improving many digestive complaints as well as benefiting health in other ways.

A probiotic is a supplement containing live friendly bacteria which aim to improve intestinal bacteria balance.  Probiotics are available as yoghurts, fermented milks, fortified fruit juices and freeze dried capsules/powders.  A prebiotic is a food that stimulates the growth of the beneficial bacteria already present in the colon.  Fructooligosaccharides (FOS) which can be bought as powders are the most common prebiotics available.  Natural prebiotics can be found in asparagus, onion, chicory and garlic.  Often supplements will contain both prebiotics and probiotics together and these may well be worth trying for a few weeks to see if indigestion symptoms are helped.

Take time to really enjoy your meals this Christmas.  Not rushing when eating not only adds to the enjoyment but can actually help prevent overeating since the stomach has time to send signals to the brain to indicate feelings of fullness.

(1)Kalman DS et al.  2009.  A prospective, randomized, double-blind, placebo-controlled parallel-group dual site trial to evaluate the effects of a Bacillus coagulans-based product on functional intestinal gas symptoms.  BMC Gastroenterol.  18;9:85.

Written by Ani Kowal

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Probiotics for the prevention of eczema in children

Earlier this year I wrote a couple of posts concentrating on the accumulating evidence which suggests that probiotic (‘friendly’ gut bacteria) supplements may be useful to boost the immune system.  In children, studies have shown that probiotic and prebiotic (food supplement that feeds the good bacteria in the digestive system) supplements may be useful in preventing recurrent ear infections and also the common cold.



A recently published study (1) has found that prebiotic and probiotic supplements, which improve the intestinal bacterial balance, may be particularly important in preventing eczema in susceptible infants.  It has been thought for a while now that modification of the intestinal bacterial balance could be an important approach to preventing allergic disease.  This particular study aimed to look at the prevention of allergic disease in high-risk children (children with parents and/or siblings with allergic conditions).  The probiotic bacteria was given to pregnant mothers of high-risk children, ie where there was a positive family history of allergic disease, and then to the infant children for the first 12months of life.  This was a controlled trial so there were some mothers/children who were given a placebo, they did not receive a probiotic supplement. 



Parental-reported eczema during the first 3 months of life was significantly lower in the intervention group compared with placebo (1).  The authors conclude their study by reporting “This particular combination of probiotic bacteria shows a preventive effect on the incidence of eczema in high-risk children, which seems to be sustained during the first 2 years of life. In addition to previous studies, the preventive effect appears to be established within the first 3 months of life



If there are allergies in your family and you think that your child may be at risk of developing eczema or asthma then you may consider taking a probiotic and probiotic supplement during pregnancy and also giving an infant probiotic supplement (there are many available) to your baby during the first year to two years of life.  Please talk to your doctor or health professional before beginning a supplement regimen during pregnancy or with an infant child


A fairly recent study (2) assessed the safety of feeding probiotic supplements to newborn infants and found that such supplements were safe and seemed to increase resistance to infections during the first 2 years of life.  The study was well designed and began with pregnant mothers who were given either a mixture of probiotics or placebo for 4 weeks before they were due to give birth.  Their babies were given the same probiotics in conjunction with a prebiotic or placebo for 6 months after birth.  925 infants were involved and followed up for 2 years.  During the 6-month supplement intervention, antibiotics were prescribed less often in the prebiotic/probiotic group than in the placebo group and throughout the 2 year follow-up period, infections occurred less frequently in the group receiving these supplements.



Eczema is an inflammatory skin condition thought to be related to other allergies, such as asthma.  Due to the inflammatory nature of the condition it is thought that long chain omega 3 fatty acids may also be particularly useful in treating the condition, I have previously written about this here, as well as in the post relating to asthma.



(1) Niers L et al.  2009.  The effects of selected probiotic strains on the development of eczema (the PandA study).  Allergy.  64(9):1349-58.
(2) Kukkonen K et al.  2008.  Long-term safety and impact on infection rates of postnatal probiotic and prebiotic (synbiotic) treatment: randomized, double-blind, placebo-controlled trial. Pediatrics. 122(1):8-12.
Written by Ani Kowal

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Evidence links prebiotics to reduced appetite and increased satiety

In July this year I wrote about the link between the bacteria in the digestive system and obesity.  The human adult gut contains up to 100 trillion microbial organisms and it certainly seems sensible to ensure that these are mainly made up of ‘friendly’ good bacteria.  The type of bacteria in the digestive system seems to have an effect on the entire body and not just the health of the gut.



A recent study (1) has found that prebiotic supplementation was associated with reduced appetite sensation after a meal.  Prebiotics act as food for the good ‘friendly’ bacteria in the digestive system and previous studies (2) suggest that prebiotics in the diet may reduce our energy and food intake, increase satiety, reduce hunger and appetite and reduce total daily calorie intakes.  Prebiotics may also have positive effects on blood sugar balance in the body which can also impact appetite.  This recent research (1) was set up to see whether prebiotic supplements affected the hormones associated with satiety.  The study was very small but well designed and provided interesting results.  Prebiotic treatment was associated with a three fold reduction in hunger rates and an increase in hormones which are associated with feelings of satiety/fullness. 



In past blog posts I have mentioned many nutritional ways that can help to keep us feeling satisfied after a meal and may hence prevent over eating, or even cravings (which are often related to blood sugar imbalance).



Again, I would like to stress that obesity is a complex disease involving many factors with no miracle cure and no easy solutions – I am not about to disillusion anyone by inferring that bacterial balance is a major factor and probiotic or prebiotic supplements are the cure.  However, gut bacteria may well be having some kind of impact on the development of excess body weight in some people.  What we eat does affect the composition of the microorganisms that are present in our digestive systems and in turn these microorganisms can have an effect on the health of our body.  A review paper (2) stated that “probiotic and prebiotic supplements may be useful in order to positively change the gut bacterial balance and help prevent and treat overweight but that these manipulations should clearly not be viewed as a substitute for a healthy diet and exercise”.



Further conclusive evidence needed, however prebiotics (such as FOS) and probiotics do seem to positively change the composition of bacteria in our digestive systems and affect overall health.  Supplements are readily available but should not be seem as a quick-weight loss fix.  A healthy diet and lifestyle is of paramount importance for weight control and overweight prevention and treatment.



Another factor to mention here is fibre (since prebiotics are a form of fibre), a high fibre diet can also help with feelings of fullness and therefore prevention against over-eating.  A recent study (3) in young people (aged 11-17) at high risk of obesity found that an increase in total dietary fibre intake was associated with decreases in fat tissue.  A decrease in fibre was associated with significant increases in fat tissue, this was noted even if the decrease in fibre was small (about 3g).  The authors of the study conclude that “Small reductions in dietary fiber intake over 1–2 y can have profound effects on increasing visceral adiposity [fat mass]”. 


A diet that is high in fibre has been linked to numerous health benefits in most areas of the body from the: heart, where it seems to have positive effects on blood pressure and risk of heart disease; digestive system where it seems to be useful to sufferers of irritable bowel syndrome (IBS), constipation and diverticulitis and the immune system where there seems to be a link with reduced risk of cancer.  A high fibre diet also appears to be very useful in blood sugar control and also appetite control as it gives us the feeling of fullness and helps to control satiety.  The recommended daily intake for fibre in the UK is currently set at 18g/d, however for optimal health many experts regard at least 25g per day as necessary.  In the UK our average intake is low at only 12g/d.  Foods that are naturally high in fibre are also a really important part of a healthy diet e.g. vegetables, fruits, beans/pulses, nuts/seeds and wholegrains.


 


(1)Cani PD et al.  2009.  Gut microbiota fermentation of prebiotics increases satietogenic and incretin gut peptide production with consequences for appetite sensation and glucose response after a meal.  Am J Clin Nutr.  90:1236-1243
(2) DoBaise JK et al.  2008.  Gut microbiota and its possible relationship with obesity.  Mayo Clinical Processings.  83:460-469
(3) Davis JN et al.  2009.   Inverse relation between dietary fiber intake and visceral adiposity in overweight Latino youth.  Am J Clin Nutr.  90:1160-1166
Written by Ani Kowal

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