In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.


Even if some of the bacteria in a probiotic managed to survive and propagate in the intestine, there would likely be far too few of them to dramatically alter the overall composition of one's internal ecosystem. Whereas the human gut contains tens of trillions of bacteria, there are only between 100 million and a few hundred billion bacteria in a typical serving of yogurt or a microbe-filled pill. Last year a team of scientists at the University of Copenhagen published a review of seven randomized, placebo-controlled trials (the most scientifically rigorous types of studies researchers know how to conduct) investigating whether probiotic supplements—including biscuits, milk-based drinks and capsules—change the diversity of bacteria in fecal samples. Only one study—of 34 healthy volunteers—found a statistically significant change, and there was no indication that it provided a clinical benefit. “A probiotic is still just a drop in a bucket,” says Shira Doron, an infectious disease expert at Tufts Medical Center. “The gut always has orders of magnitude more microbes.”
The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.
Next the researchers measured what happens to the microbiome of people who take probiotics in the hope of restoring their microbiome after antibiotics. Twenty-one volunteers took an identical course of antibiotics and were then assigned to one of three groups. The microbiome of the first group was allowed to recover by itself, whereas the second group was given probiotics. The third group was treated with a dose of their own original pre-antibiotic microbiome by a faecal microbiota transplant (FMT).

Walk into any grocery store, and you will likely find more than a few “probiotic” products brimming with so-called beneficial bacteria that are supposed to treat everything from constipation to obesity to depression. In addition to foods traditionally prepared with live bacterial cultures (such as yogurt and other fermented dairy products), consumers can now purchase probiotic capsules and pills, fruit juices, cereals, sausages, cookies, candy, granola bars and pet food. Indeed, the popularity of probiotics has grown so much in recent years that manufacturers have even added the microorganisms to cosmetics and mattresses.


Certain brands, like Attune (attunefoods.com; available at Whole Foods), have pumped up the dessert by adding probiotics. (Attune boasts 6.1 billion CFUs, or "colony forming units," a measure of live, active microorganisms per serving. As a comparison, some probiotic supplements may contain 1 to 50+ billion CFUs.) Sounds crazy, but it's backed by science. One study in the International Journal of Food Microbiology found that probiotics added to chocolate were able to reach the GI tract where they could get to work colonizing the gut with healthy bacteria.
In a food sensitivity, the immune reaction is delayed, usually several hours to days after the exposure. Food sensitivities are the most difficult to determine since there is not an immediate reaction. These kinds of issues with foods can cause a wide range of physical and mental problems. An elimination diet followed by reintroduction is one of the best ways to determine a food sensitivity.
Known as the most clinically proven effective probiotic strain, Lactobacillus rhamnosus GG (otherwise known as “LGG”) has been clinically proven to maintain healthy numbers of bacteria and yeast for optimal digestive health. This powerful probiotic is also paired with some of the best probiotic strains for feminine health, making it an ideal choice for any woman that is looking for complete care from her probiotic.

More than 80 years later, probiotics have become wildly popular and incredibly profitable. A 2012 survey by the National Institutes of Health showed that 3.9 million Americans stated they had used some form of probiotics or prebiotics (a type of dietary fiber thought to feed the friendly bacteria in your gut) in the last 30 days—3 million more people than in the previous study in 2007. Probiotics are now available for consumption in almost every imaginable form—pills, tablets, yogurts, juices, cereals, and energy bars. They have been touted as having benefits not only for digestive health, but also mood disorders, cancer, cold and flu prevention, and reproductive health issues.


It’s great to get some healthy sour foods. I often add one tablespoon of apple cider vinegar to a drink, twice a day. Before breakfast and lunch or breakfast and dinner, add one tablespoon of apple cider vinegar in your meal, and then start consuming more fermented vegetables like sauerkraut and kimchi, or drinking kvass. Is apple cider vinegar a probiotic itself? No, but apple cider vinegar probiotic content makes it an excellent source of probiotics benefits.
Probiotics stick around for a while, though for how long isn’t precisely clear. You have to keep taking them to continue to reap the benefits. Further, getting a wide variety of strains into your system is beneficial. “Periodically mixing up your probiotic supplement is also a good way to ensure that you get different health-building strains in your health regime,” says Dr. Cook.

"I usually recommend Garden of Life, BioK or Megafoods brand," says Shapiro. "I also recommend starting with about 30 billion CFU and making sure your supplement has at least 12 different strains. And if you don't eat a diet high in fruits, vegetables, nuts, seeds, and whole grains that provide fiber for the probiotics to live off of, make sure you're the one you are taking contains prebiotics as well.
If your child has a history of stomach problems that medicine doesn’t seem to help, adding a probiotic to his or her diet can help. We love the OLLY Kids Happy Tummy Gummy Supplements because they offer complete probiotic support in a kid-friendly gummy form. Each gummy has a blend of prebiotic, probiotic, and peppermint to help soothe upset stomachs. They contain 500 million CFU of Bacillus coagulans. This container comes with 30 gummies (to be taken once a day) and is recommended for children 2 years and older.

Probiotics and raw fermented foods and drinks, such as sauerkraut and kefir that contain probiotic-like microbes, are very helpful for digestion. They help to keep your gastrointestinal tract at the proper pH for optimal digestion and help to break down foods. They also regulate the motion of your intestines so that food moves through at the proper pace.


Taking relatively high doses of these probiotic strains before, during, and after antibiotic treatment can help your microbiome get back on its feet: B. Lactis, B. Infantis, L. Acidophilus, L. Casei, L. Bulgaricus, L. Paracasei, L. Rhamnosus GG, and S. Boulardii. Our antibiotic combatant MegaFood MegaFlora has six of these strains, as well as eight others. One serving contains 20 billion CFUs to replenish the good bacteria.
Don't assume that the only way you can get your probiotic yogurt fix is through dairy. Cultured soymilk, or soy yogurt, is a non-dairy alternative that also boasts live active cultures. Most of these products are fortified with calcium and vitamin D to make them comparable to dairy yogurts. It makes a great option if you're vegan or lactose intolerant. (And if you're looking for more variety, almond milk and coconut milk yogurts are also rich in probiotics.)

"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."
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.
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.
What's more, people who have serious heart issues commonly have S. mutans in their heart valves—this is an undesirable type of bacteria that’s actually more often found in the mouth. If your oral microbiome is in balance, S. mutans are normally kept in control by more beneficial species, but if things get out of balance, they can reproduce and make their way into your bloodstream via openings in your gums, compromising your cardiovascular function.3

When the digestive tract is healthy, it filters out and eliminates things that can damage it, such as harmful bacteria, toxins, chemicals, and other waste products. The healthy balance of bacteria assists with the regulation of gastrointestinal motility and maintenance of gut barrier function. Research has shown some benefits for the use of probiotics for infectious diarrhea, antibiotic-associated diarrhea, gut transit, IBS, abdominal pain and bloating, ulcerative colitis, Helicobacter pylori infection, nonalcoholic fatty liver disease (NAFLD), and necrotizing enterocolitis.
Many factors influence the proportion of each family; from the early years of your life (the type of birth you had, breastfed vs. formula-fed, exposed to antibiotics prenatally) to the later years, where more lifestyle factors like diet, smoking, alcohol consumption, stress, and sleep come into play. The bacteria species found in the digestive tract have a significant influence on overall health, both physical and mental, which is why it’s important to take care of them every day.
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and
Scientists are investigating probiotics, and their combined effects, by trying to classify the probiotic benefits of ingesting specific probiotic strains and understanding their role in the digestive tract. At present, the methodological and ethical limitations of human studies still make it difficult to fully understand the mechanisms of action of probiotics, but some explanations are available. Nevertheless, benefits linked to the consumption of probiotic strains have already been suggested (e.g. helping to support the immune system, help support digestive health), and others are still being investigated.
Some yogurts contain the aforementioned bacteria; however, because they are sensitive to oxygen, light, and dramatic temperature changes, make sure to look for yogurts with “live and active cultures.” Many commercial yogurts are heat-treated or pasteurized, resulting in the loss of these valuable cultures. Learn more about the smart way to shop for probiotics.
The two main species you want to look for are: Lactobacillus and Bifidobacterium. Within these two species, there are a lot of different strains. The strains we chose for our probiotic—Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium longum—have been shown to help modulate the immune system, help with autoimmunity conditions (which affect most of my patients), and counter infections in the gut.
The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.
Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems. 

Probiotic supplements are not drugs (in the United States), although super potent forms may be obtained through prescription. As such, they are not intended to treat or cure any diseases, mental or physical. Probiotics benefit and complement a healthy way of life filled with nutritious food, adequate exercise, restorative sleep, beneficial social engagements, reduced exposure to toxins, and hydration with clean water.
“Microbiome” refers to the trillions of bacteria and microorganisms that live on and in our individual bodies. “There’s increased recognition of the various ways that the microbiome affects our health,” Lebwohl tells me. “And with that recognition comes the true observation that many bacteria are good for us. This goes against the old idea that bacteria equal germs, which equal harm. It turns out that many bacteria keep us healthy and probiotics could potentially support that notion.”
A 2017 survey of cancer patients showed that more than 80 percent were taking some sort of dietary supplement, vitamin, mineral, or herb to treat digestive issues they were experiencing due to chemotherapy. Researchers noted that while supplements can be beneficial in some cases, they can also change the metabolism of anti-cancer drugs, or lead to life-threatening conditions like sepsis because of the patient’s compromised immune system. 

Made by fermenting the juice of young coconuts with kefir grains, this dairy-free option for kefir has some of the same probiotics as traditional dairy kefir but is typically not as high in probiotics. Still, it has several strains that are great for your health. Coconut kefir has a great flavor, and you can add a bit of stevia, water and lime juice to it to make a great-tasting drink.
Made by fermenting the juice of young coconuts with kefir grains, this dairy-free option for kefir has some of the same probiotics as traditional dairy kefir but is typically not as high in probiotics. Still, it has several strains that are great for your health. Coconut kefir has a great flavor, and you can add a bit of stevia, water and lime juice to it to make a great-tasting drink.

If that's not enough, your doctor may also suggest a probiotic supplement. But don't go and grab just anything off the pharmacy shelf. Probiotic supplements are not all the same, and they often contain different strains to serve different needs, says naturopathic physician Amy Fasig. Example: What one person gets to battle strep throat is different from what would be prescribed for someone suffering from Irritable Bowel Syndrome, she says.
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT." Cell (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047
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