Can Probiotics Treat GI Conditions?

Can probiotics treat gastrointestinal conditions?

August 20, 2020

Important Points:

Probiotics
Ulcerative colitis
Diarrhea

Can probiotics treat gastrointestinal conditions?

Yes. Probiotics treat bacterial diarrhea, including antibiotic-associated diarrhea. They also help constipation, ulcerative colitis and irritable bowel syndrome. They do not improve diarrhea caused by viral infections such as rotavirus.

Schedule Now Call (314) 481-5000

What are probiotics?

Probiotics are products that contain microorganisms. These microbes are like the good bacteria that normally live in the human gut. Probiotics work by restoring the balance of the GI flora (the bacteria in your gut). That balance gets thrown off by lifestyle, diet, toxin exposure or long antibiotic use. The gut and the immune system are closely tied together. So restoring balance in the gut helps your body defend itself against inflammation and infection.

How are probiotics used and regulated?

Probiotics have long been seen as a safe and effective alternative to conventional medicine for gut problems. They have been shown to work for diarrhea, both the infectious and the antibiotic-associated kinds. They have also been shown to work for ulcerative colitis and irritable bowel syndrome. There is much evidence that they work. Yet there are still no clear rules doctors can follow for using them on patients. That is mostly because they are fairly new and more than one agency regulates them.

When probiotics are sold as dietary supplements, they are regulated by the US Food and Drug Administration’s Center for Food Safety and Applied Nutrition. When they are used as drugs to treat disease, the US FDA oversees them. It uses Current Good Manufacturing Practices and the drug approval process.

What conditions do probiotics treat?

Acute bacterial diarrhea and Antibiotic-associated diarrhea

Acute bacterial infectious diarrhea responds to probiotic treatment. Cochrane reviewed over 63 randomized controlled trials. Researchers found that probiotics cut the length of diarrhea by about 25 hours, without any negative side effects. They also found that probiotics can lower the risk of traveler’s diarrhea by as much as 15 percent. For that, you start probiotics two days before travel and keep taking them for the whole trip. Note that probiotics seem to work only on diarrhea caused by bacteria. They do not help diarrhea caused by a virus, like the kind associated with rotavirus. Another study of over 3,938 people looked at children given probiotics. Their risk of antibiotic-associated diarrhea dropped by at least 11 percent.

Ulcerative Colitis

Probiotics can also be used to support treatment for ulcerative colitis. One meta-analysis pooled 23 randomized controlled trials with 1,763 adult participants. Probiotics raised the remission rate by 12 percent. Another Cochrane review found that probiotics matched mesalamine, a standard drug for ulcerative colitis. There was no significant difference between the two.

Constipation

Probiotics can treat constipation well. This is true of the ones that contain the probiotic Bifidobacterium. A randomized controlled trial tested 165 adults. Yogurt with the Bifidobacterium probiotic eased their constipation.

Necrotizing enterocolitis

Necrotizing enterocolitis is a serious condition. The tissue of the gut is damaged and starts to die. It commonly affects babies who are born early. The group treated with probiotics did better than a control group. Their risk of severe necrotizing enterocolitis was lower, by as much as 0.43. Their death rate was also lower, by 0.65.

Are probiotics safe?

Probiotics are generally considered safe. Still, it is wise to use caution in people with weak immune systems. The Agency for Healthcare Research and Quality looked at over 24,615 people in total. It did not find a significant rise in reported side effects or adverse effects versus the control group. But these studies only covered short-term use. The long-term effects are still mostly unknown. Some groups should be careful not to overuse probiotics. These include people with weak immune systems, like those with cancer. A systematic review of 17 studies covered 1,530 cancer patients. It found five cases of probiotic-associated bacteremia (bacteria in the blood), confirmed by blood culture.

Like any other treatment, you must weigh the risk against the benefits. Based on the current evidence, it would seem that probiotics have a positive future in treating gut diseases.

Frequently asked questions

Should I take probiotics for diarrhea?

Yes, when the diarrhea is bacterial or caused by antibiotics. A Cochrane review looked at more than 63 trials. Probiotics cut bacterial diarrhea by about 25 hours, with no negative side effects. In children, they cut the risk of antibiotic-associated diarrhea by at least 11 percent. They do not help diarrhea caused by viruses such as rotavirus.

Should I take probiotics if I have digestive issues?

It depends on the problem. Probiotics treat bacterial and antibiotic-associated diarrhea. They also help constipation, ulcerative colitis and irritable bowel syndrome. They do nothing for viral diarrhea. If your immune system is weak, for example during cancer treatment, use them only with caution. That is because this is the group in which probiotic-related bloodstream infections have been confirmed.

What is the best probiotic for constipation?

Bifidobacterium. In a randomized trial of 165 adults, yogurt with the Bifidobacterium probiotic eased constipation. For ulcerative colitis, probiotics as a group raised remission rates by 12 percent across 23 trials. In a Cochrane review, they also matched mesalamine, a standard drug for the disease.

What are the negative side effects of taking probiotics?

For most people, very few. The Agency for Healthcare Research and Quality looked at 24,615 participants. It found no significant increase in side effects compared with control groups. Two limits matter. First, those studies covered short-term use only, so long-term effects are still unknown. Second, among 1,530 cancer patients, five cases of probiotic-associated bacteremia (bacteria in the blood) were confirmed by blood culture.

Necrotizing enterocolitis

Constipation

Probiotics for treating acute infectious diarrhea

http://www.cochrane.org/CD003048/INFECTN_probiotics-for-treating-acute-infectious-diarrhoea

Probiotics for Gastrointestinal Conditions: A Summary of the Evidence.

https://www.ncbi.nlm.nih.gov/pubmed/28762696