Health

Are Probiotics Actually Bad for Your Gut?

It Might Be Time to Rethink the Probiotic Trend

According to the American College of Gastroenterology, nearly 10 to 15 percent of people in the U.S. suffer from irritable bowel syndrome (IBS). That’s a whole lotta people either rushing to the bathroom or wishing they could rush to the bathroom, depending on if you’re more prone to diarrhea or constipation. And with the popularity of stomach issues on a seemingly never-ending rise (#thanksanxiety), the most natural (and marketed, frankly) remedy typically comes in the form of probiotics.

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You’ve seen their digestion-improving capabilities grace the labels of yogurts, kefirs, kimchis, and kombuchas, but are probiotics everything they’re cracked up to be? Not quite, at least according to leading NYC gastroenterologist Martin Wolff, MD, FACG of Summit Health.

“The bottom line is that probiotics may be helpful for some individuals with IBS for symptom improvement on a case by case basis, but aren’t regulated or well understood, and actually can carry some risks,” he says.

To break down all things probiotics, including their potentially harmful effects and the proactive steps you can take instead, we chatted with Wolff to field his expertise on what has become a seemingly overnight health fad.


What Are Probiotics?


Probiotics are live microorganisms (mostly bacteria) that are said to help your body’s community of microorganisms “return to a healthy condition after being disturbed.” The claim is that probiotics can help “digest food, destroy disease-causing cells, or produce vitamins” by mirroring those that are naturally already in your gut. Probiotics (as you probably already know) are most often found in yogurt, fermented foods, and pill form as a dietary supplement.


Why Can Probiotics Be Harmful?


“Probiotics have been used for a wide variety of medical conditions and their use is strongly encouraged by media and by the companies that make them,” says Wolff. “But despite the hype of this 40-billion-dollar-per-year industry [and rising], there is no strict oversight by the U.S. Food and Drug Administration (FDA), and so probiotic manufacturers aren’t subject to the same scientific and quality control requirements that prescription drug manufacturers have to meet.”

On top of potentially ingesting a faulty or ineffective product, Wolff explains how nonviable probiotic strains can negatively impact some patients. “There are case reports of bloodstream infections with probiotic organisms in critically ill patients. This is not common, but just something to think about!” he says. “We often use probiotics after a course of antibiotics, but one study surprisingly showed that probiotics may impede normal recolonization of the colon after antibiotics.”

Additionally, while some studies have indicated improvement in symptoms like pain, bloating, and flatulence for IBS sufferers, Wolff claims that in these cases there is a great deal of “study heterogeneity regarding sample size, indications, strains used, and outcomes measured.”

“Because of this, there just isn’t enough data to strongly recommend probiotics for most patients,” he adds.

Those diagnosed with an inflammatory bowel disease (IBD) like Crohn’s or ulcerative colitis may be the exception in rare cases.

“There are a few special circumstances in IBDs where we do use probiotics to prevent inflammation,” says Wolff.  “But in general probiotics are not used as a primary treatment for IBD.”


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What About Prebiotics?


While probiotics have certainly taken the spotlight in the health and wellness world over the past few years, plenty of new literature is being released that looks at the effect prebiotics have on the digestive system – especially when taken in tandem with their more popular cousin. However, it’s important to highlight, that while the two may sound similar, they are entirely different things.

“Prebiotics are poorly digestible foods — think ‘high fiber’-— that bacteria ingest so that they can proliferate in the gut. Probiotics are the actual bacterial strains themselves,” explains Wolff.  “A high fiber diet is a very good thing and can regulate gut permeability, cholesterol metabolisms, and blood sugar.”

For those hoping to up their fiber content through whole foods, options like beans, broccoli, whole grains, and berries can do the trick. You can also add a scoop of psyllium husk to a smoothie or bowl of oatmeal for added digestive benefits, but be sure to consult a gastroenterologist to discuss whether any dietary changes may affect your stomach.


What Are Alternatives for Good Gut Health or Precautions to Take?


So if you’re not reaching for probiotics what should you turn to? Over-the-counter remedies like Pepto-Bismol and Imodium may be temporary fixes for digestion woes, but Wolff is a bigger fan of lifestyle changes in the form of the low FODMAP diet.

“The microbiome, which weighs about two pounds, is an invisible, highly complex bacterial community that lives within all of us,” says Wolff.  “What has been noted is that many of the symptoms of IBS — particularly bloat and irregular bowel movements — are due to bacterial metabolism of small chain carbohydrate molecules, also known as ‘FODMAPS.’”

“When bacteria ingest FODMAPs like wheat, barley, rye, onion, garlic, lactose, to name a few, water is drawn into the gut, and gas is produced. This leads to abdominal distention and alterations in gut permeability that can cause irregular stools.”

The concept of the low FODMAP diet is to reduce the intake of these inflammatory foods, which essentially “starve bacteria of some of the substrate that leads to gaseous waste” and “reset the microbiome for a more favorable bacterial community within ourselves.”

But don’t think of low FODMAP as a permanent elimination diet. “It’s not a long-term commitment,” says Wolff. “After a few weeks of FODMAP reduction, the concept is to gradually reintroduce foods slowly so that one can identify the main triggers in the diet that are contributing to symptoms.”

In other words, while something as simple as garlic may have detrimental effects on one person, it may be completely fine for another.


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Final Thoughts on Gut Health


As with all burgeoning health trends, it’s important to ultimately seek the advice of a medical professional before incorporating new products, supplements, or ingredients into your diet. But never underestimate the power and complexities of your own body in pinpointing what causes IBS symptoms in the first place and how to treat them.

“The human body is a pretty amazing machine,“ says Wolff.  “I usually advise my patients to save their money and take a ‘less is more’ approach when it comes to supplements and probiotic use.”

Frankly, “less is more” is an approach we should probably take to nearly every aspect of our life, which will prevent some of the GI issues we have in the first place.


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Due Credit: Askmen.com

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