Probiotics, Prebiotics — Keeping Your Gut Healthy

Probiotics are among the most commonly used dietary supplements. They’re typically marketed to improve “digestive health”. But what are they? How do probiotics compare to prebiotics? And what are their health benefits? Let’s talk about “digestive health”, and how pro- and prebiotics fit into the picture.

 Digestion

Digestion starts as soon as we put food in our mouth. From chewing and saliva production all the way into the stomach and intestines, food is progressively broken down into smaller and smaller pieces. Finally, the pieces are tiny enough that they can cross from inside the intestines to the blood, where they provide nutrition for the body.

The fuel for much of that process comes from the bacteria and other microorganisms living in the digestive system. Yes, bacteria, viruses and fungi in the digestive tract are our friends! This friendly environment is called the gut “microbiome”, and each person's is unique. Though there are lots of common bacteria among humans, the exact combination is different from one person to the next. Our microbiome is made up of microorganisms on our skin, in our digestive and genital tracts, and in many other areas of the body. And it helps to keep us healthy.

The gut microbiome helps break down food into microscopic particles that can be absorbed into the bloodstream. And the parts of food that don’t contain nutrients are ferried through the intestines and turned into waste that's easy to get rid of. That part, regular and comfortable bowel movements, is one of the first things many of us think of when we think about digestive health.

But “digestive health” isn’t only about digestion. The gut microbiome also strengthens the intestinal barrier. The intestines do an amazing job of allowing necessary nutrients to get into the bloodstream while keeping all the nasty stuff out. And the microbiome helps to keep that barrier intact. Another role of the gut microbiome is to support the immune system, so that unfriendly microorganisms don’t cause trouble, either in the digestive tract or elsewhere.

Somewhat surprisingly, the gut microbiome also affects the brain and nervous system. Some neurotransmitters, like serotonin and dopamine that regulate mood, are produced in the gut. The gut also supports the body’s production of other hormones like cortisol. Overall, the gut microbiome helps to regulate our mood, our cognition, even our risk of disease.

Keeping the gut microbiome healthy

The friendly and helpful gut microbiome needs your help to stay healthy, so in turn it can keep you healthy. And research shows that the best way to do that is to eat a healthy, balanced diet. Fruits, vegetables, whole grains, and fermented foods (like yogurt, sauerkraut and kimchi) can keep your microbiome running smoothly. In the ideal world, that’d be all we need. Treat your gut microbiome to a healthy, balanced, and colorful diet if you can!

But what if you can’t, for one reason or another? Prepared/processed foods are quick and easy, but may lack the nutrients in freshly prepared, homemade meals. Not everyone enjoys a variety of fruits and vegetables. Allergies, weight-loss diets -- there are any number of reasons we end up not treating our gut microbiome as well as we could.

And our bodies sometimes “turn” on us, too. For no apparent reason we find we’re having digestive discomfort despite our best efforts. Maybe there’s a new diagnosis of a digestive disorder. Whatever the reason, the advertisements begin making us wonder, “Can pro- or prebiotics help me?”

Where do Pro- and Prebiotic Supplements fit in?

Probiotics are dietary supplements that contain microorganisms. They’re intended to help replenish your microbiome with healthy bacteria and/or fungi. The goal is to help your microbiome get back to its job of keeping you healthy. Probiotic supplements may contain bacteria or fungi of varying types and amounts. The most common bacteria are Bifidobacterium and Lactobacillus. Saccharomyces is a fungus that’s also commonly found in probiotic supplements. Probiotics also exist in those fermented foods we talked about earlier, like yogurt, kimchi, sauerkraut, and others.

Prebiotics are dietary supplements that contain nutrients for the microbiome. In other words, prebiotics “feed” the bacteria and other microorganisms that live in your digestive system. Many prebiotic supplements contain inulin, a form of fiber. There are also plenty of prebiotic foods -- just about anything containing fiber will make that microbiome happy.

So far, the evidence suggests that probiotics may be effective for specific problems like diarrhea in youngsters, constipation, traveler’s diarrhea, antibiotic-associated diarrhea, and irritable bowel syndrome (IBS). But other research looking at their efficacy in urinary tract infections, vaginal infections, obesity, diabetes, allergies, Crohn’s disease, and a number of other health problems was inconclusive.

Keep in mind that the lack of research doesn’t necessarily mean probiotics don’t have a health benefit. We just don’t always know what they’re best for, or what dose to use. And the FDA’s loose regulations around dietary supplements make it even harder. 

Is a Pro/Prebiotic Supplement right for you?

Now that you know the potential (but unproven) benefits as well as the risks, you can make the decision that’s right for you. I suggest the following steps for trying this (or any) supplement:

1. 1. Make sure it’s safe. Purchase a product that's pure and potent. And always check first for side effects and drug interactions. (Prebiotics, being mostly fiber, can cause bloating and cramping in some people. Probiotics tend to be well tolerated. Neither cause major drug interactions.)

   2. Know what you’re taking it for

   3. Consider how you’ll know if it’s working

   4. Then see how you do over the course of a month or two

Digestive health is important

In whatever way works best for you, try to keep your gut microbiome working its best. If you have good recipes to share, or have had experiences with supplements, please leave your comments and questions in the space below. Or contact us directly at Better My Meds – we love hearing from you!

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