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clinical background

Gut Reaction #22: Probiotics and Prebiotics

Probiotics and prebiotics, both of which assist in maintaining a healthy gut, are often confused for one another. This blog will set out the definitions and differentiations between the two.

Probiotics are defined as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host.” A probiotic treatment can therefore be consumed to give a boost to the roughly 400 types friendly bacteria already in the gut, working to prevent digestive discomfort and other gastrointestinal problems.

Despite the definition there is a relative paucity of high quality evidence to support a health benefit. The one that I recommend in my patients with irritable bowel syndrome (IBS) is called Symprove. This is a water-based probiotic (each dose contains more than 10 billion live, active bacteria) that was shown in a high-quality trial to be significantly more effective than placebo in subjects with IBS. Individuals noted an improvement in abdominal pain and bowel function after 4 weeks treatment.

On the other hand, prebiotics are not ‘live microorganisms’, but “a non-digestible food ingredient that beneficially affects the host by selective stimulating the growth and/or activity of one or a limited number of bacteria in the colon and thus improves health”. While probiotics introduce good bacteria into the gut, prebiotics act as a fertilizer for the ‘friendly’ bacteria that are already there.

Once again there are few good studies to confirm the health benefits of prebiotic but one that caught my eye involved chicory-derived Orafti inulin. A well-conducted trial in healthy volunteers with constipation showed that taking 12g of chicory-derived Orafti inulin daily led to a significant improvement in stool frequency. This clinical improvement was associated with an increase in Bifidobacteria. This species of colonic bacteria is thought to promote health by producing antimicrobial substances including lactic acid that limits pathogen (“bad bacteria”) growth while stimulating growth of “good bacteria” that may be associated with health-promoting effects.

For more information on probiotics or prebiotics, please do not hesitate to contact Dr. Adam Harris.