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I’m 65 years of age. I have been taking acid reflux medication daily for at least 15 years and recently my doctor said my kidneys were declining. I’ve read that acid reflux medications taken over a long period of time, can cause kidney damage. By taking a probiotic, will it help reduce stomach acid, where I may be able to stop taking my acid reflux medication altogether?

There’s good and bad bacteria in there (fascinating fact: an estimated 100 trillion bacteria live inside your digestive tract): When the good outweighs the bad, your immune health soars; when the bad overpowers good, you get sick. You have diarrhea. Your immune system tanks. Your IBS, lactose intolerance, and other gut problems are exacerbated. It throws your entire system out of whack.
If you want to supercharge your probiotic friends, you may want to feed them with prebiotics. That’s P-R-E-biotics. They nourish the good bacteria in your gut in order to keep them healthy against the bad bacteria. They should go hand-in-hand with probiotics. Prebiotics are found in many foods, including bananas, whole grains, honey, garlic and onions. Try to get two to four servings of these prebiotic-rich foods a day.
The science on what probiotics do is still emerging. There is some hard evidence that suggests eating probiotic foods and supplements can have a beneficial effect on health. Other evidence suggests probiotics benefits are limited to those individuals in good health and should be avoided by those who suffer from certain serious health conditions. There is no research that demonstrates the risks or the benefits of probiotic supplements on children.
Best Probiotic says that Suprema Dophilus, manufactured and distributed by Vitabase, enjoys the highest customer rating in the market. Specially coated to help the bacteria spread through your entire digestive tract, its website claims over four billion viable cells per capsule, including five lactobacillus strains and three bifidobacteria cultures. Best Probiotic says that Suprema Dophilus also contains fructo-oligosaccarides to increase the life span of the bacteria.
Among their numerous health benefits, research shows these friendly microorganisms help prevent bowel diseases, improve your immune system, reduce traveler’s diarrhea, help you maintain a healthy weight, heal various skin conditions, improve bloating and other uncomfortable GI symptoms, and even boost your mood, helping to reduce the effects of anxiety and depression.
Probiotics have become buzzy in recent years: Celebrities including Lauren Conrad and Anna Paquin have been spotted carrying bottles of kombucha, a probiotic-containing fermented tea, and the probiotics market has been growing rapidly as more people pursue better health by taking probiotic supplements. Prebiotics are attracting notice too, but you may still be unsure of what exactly prebiotics and probiotics are. Here's what you need to know about them to decide whether taking supplements is right for you.

Since the bulk of your natural flora exists in your gut, it makes sense that this is the part of your body that feels it most when bacteria become imbalanced. Women, in particular, can experience all kinds of digestive problems, particularly during hormone fluctuations. These are just some of the digestive symptoms a high-quality probiotic can help reduce and even treat:

This mildly sour, chewy bread is made with a lactic acid starter that contains strains of lactobacillus, a friendly type of bacteria that adds good microbes into the bakery staple. Sourdough may be the healthiest bread choice if diabetes is a concern for you: one 2008 study found that people with pre-diabetes who ate sourdough bread had less of a blood sugar spike compared to when they ate bread made with baker's yeast. (Experts also say fiber-rich whole grain bread can also reduce a post-meal blood sugar spike.) The researchers credit the lactic acid for the favorable effect.
Some companies have been around for years, and you may know their names. Those that have made probiotics for a while likely have tested and studied them over and over. It's smarter to choose a product from them over one from a maker you don't know. Check a third-party certifier (like ConsumerLab or the USP) to see if they have tested the product and found that it’s safe and reliable. If you're in doubt, ask your doctor.
4. Ohnmacht C, Park JH, Cording S, Wing JB, Atarashi K, Obata Y, Gaboriau-Routhiau V, Marques R, Dulauroy S, Fedoseeva M, Busslinger M, Cerf-Bensussan N, Boneca IG, Voehringer D, Hase K, Honda K, Sakaguchi S, Eberl G. The microbiota regulates type 2 immunity through RORγt+ T cells. Science. 2015 Jul 9. pii: aac4263. [Epub ahead of print] PubMed PMID: 26160380.
The above line of probiotics is also a favorite of Engelman. "I like Nerium International's new Prolistic Pre & Probiotic Plus Vitamins ($45) because it combines prebiotics, probiotics, and vitamins," Engelman explains. "It supports overall health while targeting digestive function. It contains two types of prebiotics and two strains of probiotics to help enhance levels of beneficial microflora and balance levels of healthy bacteria in the digestive system. Additionally, it contains B vitamins, vitamin C, and vitamin D, which work to enhance the body's immune system and support natural energy production."

The discovery of the benefits of probiotics began with sour milk. Today we have many other options to get various bacteria from our foods, although it's not as simple as just adding them to the food. For there to be health benefits, the microorganism has to be able to survive the passage through the gastrointestinal tract, survive the food manufacturing process, and grow and survive during the ripening or storage period. Also, the bacteria must not negatively affect product quality and be included on the Generally Recognized as Safe (GRAS) list.
Eating more foods that are naturally rich in probiotics, like yogurt, kimchi and kefir, can help restore balance in your gut and create more “good” bacteria to fight off inflammation from “bad” bacteria. But what about food products that have probiotics infused into them? Indeed, manufacturers are banking on a new crop of gut-friendly products. From chocolates and granola bars to juices and tonics, nut butters, bottled water and even air sprays, you can’t escape the probiotic movement.
Previous studies have been contradictory, with some yielding more positive results about the benefits of probiotics, but most of them looked at probiotics in stool samples, not directly in the gut itself. In the new research, the scientists used more invasive methods to take samples of gut bacteria directly from different areas of the digestive system.

Dr. Vincent M. Pedre, medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. His philosophy and practices are a blend of both Western and Eastern medical traditions. He is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture. His unique methodology is best described as integrative or defined by a functional, systems-based approach to health. With his holistic understanding of both sides of the equation, he can help each patient choose the best course of action for their ailments to provide both immediate and long-term relief. His holistic approach incorporates positive, preventive health and wellness lifestyle choices. Dr. Pedre Wellness is a growing wellness platform offering health-enhancing programs along with informative social media and lifestyle products, such as dietary supplements, books, and weight-loss programs.
Some foods are made by adding bacteria — yogurt, pickles, cottage cheese, kombucha, and sauerkraut are good examples. Those foods work to provide the same probiotic benefits as supplements. However, most foods are so processed and pasteurized that it’s unlikely you’ll see the same benefits, let alone the right strains, as you would with a supplement. Regardless, it can’t hurt to get extra probiotics through your diet.
While past studies have investigated similar questions, they have all used patients' excrement as a proxy for microbe activity in the GI tract. Instead, Elinav, his colleague Eran Segal, (a computational biologist at the Weizmann Institute), and their teams spearheaded by Niv Zmora, Jotham Suez, Gili Zilberman Schapira, and Uria Mor of the Elinav lab collaborated with Zamir Halpern, Chief of Gastroenterology at the Tel Aviv Medical Center to measure gut colonization directly.

In the past, probiotics have been proposed as part of a weight loss diet. However, a 2015 meta-analysis looked at available randomized, controlled trials investigating this effect and determined that the studies did not seem to support this hypothesis, as body weight and BMI were not consistently reduced. The researchers did point out the need for better designed trials, because they were not convinced the results were based on well-designed science. 

The National Center for Complementary and Integrative Health (NCCIH) calls probiotics “live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut.” The NCCIH makes the point that we often think of bacteria as harmful “germs” — however, probiotic bacteria actually helps the body function properly.
Twenty-one volunteers were given a course of antibiotics and then split into three groups. The first group were left to let the microbiome recover without any interventions, the second group were given probiotics and the third were given a fecal transplant of their own gut bacteria which was collected before the antibiotic treatment. The study found that the probiotics easily colonized the gut of the second group, but worryingly, rather than aiding the return of the normal gut microbiome, the probiotics actually significantly delayed it for months compared to both the group that had no intervention and the people who received a transplant of their own gut bacteria.
"Many chronic health problems and inflammatory diseases are caused by a damaged microbiome where the good bacteria is overrun by the harmful bacteria and can't reinforce the gut walls, which results in increased intestinal permeability where bacteria and toxins leak through the intestines into the bloodstream triggering a system-wide immune response of inflammation that is a part of our body's natural healing cycle."
Other foods without substantial research: miso (fermented soybean paste); tempeh; sauerkraut; aged soft cheese; sourdough bread; sour pickles; gundruk (nonsalted, fermented, and acidic vegetable product); sinki (indigenous fermented radish tap root food); khalpi (fermented cucumber); inziangsang (traditional fermented leafy vegetable product prepared from mustard leaves); soidonis (widespread fermented product prepared from the tip of mature bamboo shoots)
If this ratio gets out of balance, the condition is known as dysbiosis, which means there’s an imbalance of too much of a certain type of fungus, yeast or bacteria that affects the body in a negative way. By consuming certain types of probiotics foods and dietary supplements (often in capsule form), you can help bring these ratios back into balance.
In October 2013, the International Scientific Association for Probiotics and Prebiotics (ISAPP) organized a meeting of clinical and scientific experts on probiotics (with specialties in gastroenterology, pediatrics, family medicine, gut microbiota, microbiology of probiotic bacteria, microbial genetics, immunology, and food science) to reexamine the concept of probiotics. They define probiotics as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host." They also differentiated between products containing probiotics and those containing live or active cultures and established the following criteria:

In these cases, IBS is essentially just TMI. “For the colon to be functioning properly, it needs to be contracting and relaxing in a way that is conducive to regular bowel movements that occur at predictable times and don’t occur too frequently or too rarely," Lebwohl says. "And the bowel needs to be giving infrequent feedback to the brain. People should not be getting updates from their bowel in terms of cramps or the feeling of having to have a bowel movement too often. Yet, people with IBS get very frequent unsolicited ‘progress reports’ from the bowel.”


Once GI experts realized there is more to the lower gut than first assumed, the push to understand the diverse roles these bacteria play became urgent. Many mysteries still need solving, but clinical evidence increasingly indicates that people in good health should optimize lower gut bacteria. You can accomplish this by eating prebiotics to encourage the growth of your existing gut microbes, and probiotics to add to the ones that are already there.


Caution needs to be taken by everyone who chooses to take these supplements, but this is especially true for children, pregnant women, elderly people, and people with compromised immune systems. For people with compromised immune systems due to disease or treatment for a disease (such as cancer chemotherapy), taking probiotics may actually increase one's chances of getting sick. It has been shown that the use of various probiotics for immunocompromised patients or patients with a leaky gut has resulted in infections and sepsis (infection of the bloodstream). One case of bacteremia (bacteria in the bloodstream) was recently found when someone with active severe inflammatory bowel diseases with mucosal disruption was given Lactobacillus GG. Always speak with a doctor before taking any supplement under these circumstances.
An imbalance in the gut microbiota is believed to contribute to a number of health problems, particularly gastrointestinal issues, as well as immune dysfunction and infections. The bacterial balance can be disrupted by medical conditions, emotional and physical stress, and, most notably, use of antibiotics, which destroy the good bacteria along with the bad.
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