Bacteria have a reputation for
causing disease, so the idea of tossing down a few billion a day for your
health might seem — literally and figuratively — hard to swallow. But a growing
body of scientific evidence suggests that you can treat and even prevent some
illnesses with foods and supplements containing certain kinds of live bacteria.
Northern Europeans consume a lot of these beneficial microorganisms, called
probiotics (from pro and biota, meaning “for life”), because of their tradition
of eating foods fermented with bacteria, such as yogurt. Probiotic-laced
beverages are also big business in Japan.
Enthusiasm for such foods has
lagged in the United States, but interest in probiotic supplements is on the
rise. Some digestive disease specialists are recommending them for disorders
that frustrate conventional medicine, such as irritable bowel syndrome. Since
the mid-1990s, clinical studies have established that probiotic therapy can
help treat several gastrointestinal ills, delay the development of allergies in
children, and treat and prevent vaginal and urinary infections in women.
Self-dosing with bacteria isn’t
as outlandish as it might seem. An estimated 100 trillion microorganisms
representing more than 500 different species inhabit every normal, healthy
bowel. These microorganisms (or microflora) generally don’t make us sick; most
are helpful. Gut-dwelling bacteria keep pathogens (harmful microorganisms) in
check, aid digestion and nutrient absorption, and contribute to immune function.
The best case for probiotic
therapy has been in the treatment of diarrhea. Controlled trials have shown
that Lactobacillus GG can shorten the course of infectious diarrhea in infants
and children (but not adults). Although studies are limited and data are
inconsistent, two large reviews, taken together, suggest that probiotics reduce
antibiotic-associated diarrhoea by 60%, when compared with a placebo.
Probiotic therapy may also help
people with Crohn’s disease and irritable bowel syndrome. Clinical trial
results are mixed, but several small studies suggest that certain probiotics
may help maintain remission of ulcerative colitis and prevent relapse of
Crohn’s disease and the recurrence of pouchitis (a complication of surgery to
treat ulcerative colitis). Because these disorders are so frustrating to treat,
many people are giving probiotics a try before all the evidence is in for the
particular strains they’re using. More research is needed to find out which
strains work best for what conditions.
Probiotics may also be of use in
maintaining urogenital health. Like the intestinal tract, the vagina is a
finely balanced ecosystem. The dominant Lactobacilli strains normally make it
too acidic for harmful microorganisms to survive. But the system can be thrown
out of balance by a number of factors, including antibiotics, spermicides, and
birth control pills. Probiotic treatment that restores the balance of micro
flora may be helpful for such common female urogenital problems as bacterial
vaginosis, yeast infection, and urinary tract infection.
Many women eat yogurt or insert
it into the vagina to treat recurring yeast infections, a “folk” remedy for
which medical science offers limited support. Oral and vaginal administration
of Lactobacilli may help in the treatment of bacterial vaginosis, although
there isn’t enough evidence yet to recommend it over conventional approaches.
(Vaginosis must be treated because it creates a risk for pregnancy-related
complications and pelvic inflammatory disease.) Probiotic treatment of urinary
tract infections is under study.
Probiotics are generally
considered safe — they’re already present in a normal digestive system —
although there’s a theoretical risk for people with impaired immune function.
Be sure the ingredients are clearly marked on the label and familiar to you or
your health provider. There’s no way to judge the safety of unidentified
mixtures.
In the United States, most
probiotics are sold as dietary supplements, which do not undergo the testing
and approval process that drugs do. Manufacturers are responsible for making
sure they’re safe before they’re marketed and that any claims made on the label
are true. But there’s no guarantee that the types of bacteria listed on a label
are effective for the condition you’re taking them for. Health benefits are
strain-specific, and not all strains are necessarily useful, so you may want to
consult a practitioner familiar with probiotics to discuss your options. As
always, let your primary care provider know what you’re doing.
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