Acidophilus and Other Probiotics
• B. bifidus, Bifidobacterium, L. acidophilus, L. bulgaricus, L. casei, L. gasseri, L. reuteri, L. plantarum, Lactobacillus, Lactobacillus GG, Lactobacillus LB, Probiotics, S. salivarius, S. thermophilus, Saccharomyces boulardii
• Various Forms of
Lactobacillus acidophilus is a "friendly" strain of bacteria used to make yogurt and cheese. Although we are born without it, acidophilus soon establishes itself in our intestines and helps prevent intestinal infections. Acidophilus also flourishes in the vagina, where it protects women against yeast infections.
Acidophilus is one of several microbes known collectively as probiotics (literally, "pro life," indicating that they are bacteria and yeasts that help rather than harm). Others include the bacteria L. bulgaricus , L. reuteri , L. plantarum , L. casei , B. bifidus , S. salivarius , and S. thermophilus and the yeast Saccharomyces boulardii . Your digestive tract is like a rain forest ecosystem with billions of bacteria and yeasts rather than trees, frogs, and leopards. Some of these internal inhabitants are more helpful to your body than others. Acidophilus and related probiotics not only help the digestive tract function, they also reduce the presence of less healthful organisms by competing with them for the limited space available. For this reason, use of probiotics can help prevent infectious diarrhea.
Antibiotics can disturb the balance of your "inner rain forest" by killing friendly bacteria. When this happens, harmful bacteria and yeasts can move in and flourish. This can lead to vaginal yeast infections. Conversely, it appears that the regular use of probiotics can help prevent vaginal infections and generally improve the health of the gastrointestinal system. Whenever you take antibiotics, you should probably take probiotics as well and continue them for some time after you are done with the course of treatment.
Although we believe that they are helpful and perhaps even necessary for human health, we don't have a daily requirement for probiotic bacteria. They are living creatures, not chemicals, so they can sustain themselves in your body unless something comes along to damage them, such as antibiotics.
Cultured dairy products such as yogurt and kefir are good sources of acidophilus and other probiotic bacteria. Supplements are widely available in powder, liquid, capsule, or tablet form. Grocery stores and natural food stores both carry milk that contains live acidophilus. Substances known as prebiotics
Dosages of acidophilus are expressed not in grams or milligrams, but in billions of organisms. A typical daily dose should supply about 3 to 5 billion live organisms. Other probiotic bacteria are used similarly. The typical dose of S. boulardii yeast is 500 mg twice daily (standardized to provide 3 x 10 10 -colony-forming units per gram), to be taken while traveling or at the start of using antibiotics, and continued for a few days after antibiotics are stopped.
Because probiotics are not drugs, but rather living organisms that you are trying to transplant to your digestive tract, it is necessary to take the treatment regularly. Each time you do, you reinforce the beneficial bacterial colonies in your body, which may gradually push out harmful bacteria and yeasts growing there.
The downside of using a living organism is that probiotics may die on the shelf. In fact, a study reported in 1990 found that most acidophilus capsules on the market contained no living acidophilus. 1
To treat or prevent vaginal infections, mix 2 tablespoons of yogurt or the contents of a couple of capsules of acidophilus with warm water and use as a douche.
Finally, in addition to increasing your intake of probiotics, you can take fructo-oligosaccharides, supplements that can promote thriving colonies of helpful bacteria in the digestive tract. (Fructo-oligosaccharides are carbohydrates found in fruit. Fructo means "fruit," and an oligosaccharide is a type of carbohydrate.) Taking this supplement is like putting manure in a garden; it is thought to foster a healthy environment for the bacteria you want to have inside you. The typical daily dose of fructo-oligosaccharides is between 2 g and 8 g.
Evidence from many but not all double-blind, placebo-controlled
Probiotics may be helpful for controlling symptoms and maintaining remission in
Probiotics might help prevent
Although probiotics are widely used to prevent or treat
can cause a different type of vaginal infection; as with vaginal yeast infections, probiotics have shown some promise for this condition, but evidence remains inconclusive.
is the main cause of
Some, but not, all preliminary double-blind trials suggest that probiotics might improve
Various probiotics might be helpful for
One double-blind, placebo-controlled study of 70 people with
A preliminary double-blind, placebo-controlled study found evidence that
might potentially be helpful for treating antibiotic-resistant bacteria.
On a related note, preventive use of probiotics does not appear to help prevent the development of resistant bacterial strains that may arise during antibiotic treatment.
One study found that giving probiotics to certain critically ill people could help prevent multiple organ failure.
One small, placebo-controlled study found that use of
might improve sleep quality in seniors, for reasons that are not at all clear.
An open study found hints that probiotics might be helpful for mouth sores caused by Behcet’s syndrome.
As noted above, probiotics have shown some promise in the treatment of infections with the yeast
. Probiotics are also proposed for the treatment of a theoretically related, but markedly controversial condition, known as
yeast hypersensitivity syndrome
(also known as chronic candidiasis, chronic candida, systemic candidiasis, or just
In one small, 12-week study,
failed to prove more effective than placebo for the treatment of
A year-long open trial of 150 women failed to find
probiotics effective for preventing
What Is the Scientific Evidence for Acidophilus and Other Probiotics?
According to several studies, it appears that regular use of acidophilus and other probiotics can help prevent "traveler's diarrhea" (an illness caused by eating contaminated food, usually in developing countries).
One double-blind, placebo-controlled study followed 820 people traveling to southern Turkey, and found that use of
significantly protected against intestinal infection.
Other studies using
have found similar benefits,
Probiotics may also help prevent or treat acute infectious diarrhea in children and adults.
A review of the literature published in 2001 found 13 double-blind, placebo-controlled trials on the use of probiotics for acute infectious diarrhea in infants and children; 10 of these trials involved treatment and 3 involved prevention.
For example, one double-blind, placebo-controlled trial of 269 children (ages 1 month to 3 years) with acute diarrhea found that those treated with
recovered more quickly than those given placebo.
In addition, a double-blind study evaluated the possible benefits of the probiotic
in 66 children with rotavirus diarrhea.
A double-blind, placebo-controlled study of 81 hospitalized children found that treatment with
reduced the risk of developing diarrhea, particularly rotavirus infection.
Other studies, though not entirely consistent, generally indicate that the probiotics
—both individually and combined with
—may also help prevent or treat diarrhea in infants and children.
Keep in mind that diarrhea in young children can be serious. If it persists for more than a day, consult a physician.
A large (211-participant), double-blind, placebo-controlled study found that adults with diarrhea can benefit from probiotic treatment as well.
The results of many, but not all, double-blind and open trials suggest that probiotics, especially
may help prevent or treat antibiotic-related diarrhea.
However, a study of 302 people found no benefit with
Although taking probiotic organisms in the proper concentration may be beneficial for antibiotic-induced diarrhea, at least one study found that consuming fresh yogurt during antibiotic treatments had no significant effect on the incidence of diarrhea.
Note: Diarrhea that occurs in the context of antibiotics may be dangerous; for this reason, physician consultation is essential.
Other Forms of Diarrhea
Two double-blind, placebo-controlled studies enrolling a total of almost 700 people undergoing
Small double-blind studies suggest
might be helpful for treating chronic diarrhea in people with HIV, hospitalized patients being tube-fed, and people with Crohn's disease.
Premature infants weighing less than 2,500 grams (5.5 pounds) are at risk for a life-threatening intestinal condition called necrotizing enterocolitis (NEC). In a study that pooled the results of 9 randomized, placebo-controlled trials involving 1,425 infants, probiotic supplementation significantly reduced the occurrence of NEC and death associated with it.
Inflammatory Bowel Disease (Ulcerative Colitis and Crohn’s Disease)
A double-blind trial of 116 people with ulcerative colitis compared probiotic treatment against a relatively low dose of the standard drug mesalazine.
One preliminary study found
helpful for mild diarrhea in stable Crohn’s disease.
Probiotics might be useful for people with ulcerative colitis who have had part or all of the colon removed. Such people frequently develop a complication called pouchitis, inflammation of part of the remaining intestine. A 9-month, double-blind trial of 40 people found that a combination of three probiotic bacteria could significantly reduce the risk of a pouchitis flare-up in people with chronic pouchitis.
Finally, some evidence hints that probiotics might reduce the joint pain that commonly occurs in people with either kind of inflammatory bowel disease.
Irritable Bowel Syndrome
For example, in a 6-week double-blind, placebo-controlled trial of 274 people with constipation-predominant irritable bowel syndrome, use of a probiotic formula containing
significantly reduced discomfort and increased stool frequency.
Another study examined the effects of 4 weeks treatment with
on intestinal gas in 60 people with IBS, and found benefits as compared to treatment with placebo; furthermore, these benefits apparently persisted for an entire year after treatment was concluded.
Benefits were seen in 8 other small, double-blind trials as well, using
Two studies that pooled previous randomized trials on the use of probiotics for IBS came to similar conclusions: probiotics appear to offer some benefit, most notably for global symptoms and abdominal discomfort. However, these two studies were unable to determine which probiotic species were most effective.
Use of probiotics during pregnancy and after childbirth may reduce risk of childhood
According to some but not all studies, infants who already have eczema may benefit from probiotics.
If probiotics are beneficial for childhood eczema, they are probably more effective at preventing the condition rather than treating it. A carefully conducted review of numerous studies cautiously concluded that probiotics may help reduce the risk of eczema in infants and children, particularly those at high risk.
A number of studies suggest that various probiotics can enhance
A 7-month, double-blind, placebo-controlled study of 571 children in daycare centers in Finland found that use of milk fortified with
reduced the number and severity of respiratory infections.
Benefits were seen in three other large studies, in which probiotics combined with multivitamins and minerals helped prevent colds (or reduce their duration and severity) in adults.
One study found that
may improve the immune response to vaccinations.
An 8-week, double-blind, placebo-controlled trial of 70 overweight people found that a probiotic treatment containing
could reduce LDL ("bad") cholesterol by about 8%.
Probiotics may occasionally cause a temporary increase in digestive gas. But, beyond that, they do not present any known risks for most people. However, individuals who are immunosuppressed could conceivably be at risk for developing a dangerous infection with the probiotic organism itself; at least one person taking immunosuppressive medications has died in this manner. 31
In a detailed review of four studies, researchers concluded that the use probiotics did not benefit patients with severe acute pancreatitis.
Interactions You Should Know About
- If you are taking antibiotics
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Last reviewed April 2009 by EBSCO CAM Review Board
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