Probiotics & Prebiotics by Puglisi

Probiotics & Prebiotics for Healthy Digestion

Jennifer Puglisi, writer for Whole Foods Monthly Magazine discusses probiotics in her article, “Alive & Well in the Digestive Tract”. She says that it is estimated that 20 million Americans experience stomach problems from time to time, with problems varying from ulcers to diarrhea to constipation and beyond. She says that they probably don’t realize that an underlying cause may have a lot to do with bacteria, not the bacteria that causes illness and disease, but probiotics, the friendly, good bacteria.

She explains how each human being has millions of bacteria in his or her body at any given time. In fact, “there are more bacteria in one human body than there are people in the world,” says Khem Shahani, PhD, in ‘Cultivate Health from Within‘, “These bacteria are essential to the manual function of both our gastrointestinal and immune system.”

She quotes Brenda Watson, ND. and Susan Stockton, MA., in ‘Renew Your Life: Improved Digestion and Detoxification‘, who explain that these bacteria fall into 2 categories: probiotics, which are a live microbial food supplement that beneficially affects the host animal by improving its intestinal microbial balance;” and the “bad” bacteria, which are potentially disease-causing pathogens.

Watson and Stockton, as well as Leonard Smith, M.D., as he writes in, ‘Gut Solutions: Natural Solutions to Your Digestive Problems‘ explain how the correct ratio in the gastrointestinal tract should be 80% good probiotics to 20% bad pathogens. The benefits of probiotics become especially important when this ratio is upset, creating an imbalance of the body, which is referred to as dysbiosis.

Many factors -some surprising, others less so, can contribute to dysbiosis. “Most shocking seems to be the use of antibiotics”, says Natasha Trenev in ‘Probiotics: Nature’s Internal Healers‘. Antibiotics, a revolutionary medical break-through, “were designed to destroy a wide range of the dangerous infectious organisms that make you sick. When antibiotics were ingested or injected, the bad bacteria were destroyed and the patient recovered.”

The problem? According to George Weber, Ph.D., in ‘Protecting Your Health with Probiotics‘, it is now widely understood that antibiotics are indiscriminate in the type of bacteria they kill-both good and bad, so while the antibiotics are fighting off the bacteria making one sick, they are also fighting off the bacteria that can help ward off other ailments and diseases.

Earl Mindell R.Ph., Ph.D., in the ‘Basic Health Publications User’s Guide to Probiotics‘ talks about another factor contributing to the problem i.e. our modern American diet. Contemporary, overly processed food can be produced and served quickly and cheaply, but often at the expense of our nutritional health. “Diets rich in refined carbohydrates and sugars-all too common in children and adults-enhance the growth of ‘bad’ bacteria and yeasts, to the detriment of the friendly bacteria.” Our love of meat also contributes to the problem. “Diets that are heavy on the meat and light on the vegetables and fruits alter the activity of friendly probiotic bacteria,” Mindell continues.

Mindell writes about other modern factors like chlorinated water and C-section births that may be problematic. Chlorinated water has damaging effects on probiotics, while children born by C-section have damaged initial development of probiotic populations.

Mindell also warns about synthetic estrogen, in the form of birth control pills, that also decreases populations of probiotics, as well as the frequent use of antacids and other acid-reducing drugs that lower the acidity of the gastrointestinal tract and in turn creates a hostile environment for probiotics.

This is distressing news, according to Anil Minocha. MD and David Carroll in ‘Natural Stomach Care‘, considering all the health benefits probiotics can provide. Probiotics aid digestion by “secreting an enzyme that helps break down food into essential components, a process that expedites the movement of wastes along the gastrointestinal tract,” In addition, probiotics friendly bacteria can help relieve pesky and embarrassing digestion problems, like constipation and diarrhea, by speeding the time in which wastes are eliminated, helping to restore regularity.

Khem Shahani writes how a proper balance of probiotics in the body can help ward off candidiasis, a parasitic infection whereby levels of yeasts increase dramatically, well beyond acceptable, ecologically balanced levels. This can happen in multiple places on and in the body, including the mouth, skin, or vagina-it could even spread through the entire body. He says that probiotics good bacteria produce metabolites that inhibit the spread of yeasts.

Donald R Goldberg, R.Ph., Arnold Gitomer, R.Ph., and Robert Abel, Jr., MD. in ‘The Best Supplements for Your Health‘ explain that the lining of the intestines should serve as a barrier, preventing the absorption of food protein antigens. Antigens are protein fragments that can trigger an allergic reaction. “Probiotics enhance the integrity of the intestinal mucosa preventing the absorption of these allergens,” they say.

Fuglisi goes on to say that according to The Natural Pharmacy, distributed by Prima Health Publishing, probiotics friendly bacteria and related substances have several other helpful functions as well. Fructooligosaccharides (FOS), for example, are naturally occurring carbohydrates that have been reported to not only lower cholesterol, but also reduce blood sugar levels and increase absorption of calcium. FOS is not strictly speaking a probiotic but might rather be called a prebiotic, since it cannot be digested or absorbed by humans. It does, however, support the growth of bifidobacteria, one of the beneficial probiotics.

On an even more serious note, several studies have shown that probiotics friendly intestinal bacteria like Lactobacillus acidophilus can significantly lower the degree of activity of by-products of enzymes produced when one’s diet is rich in meat and fat.

Leon Chaitow, N.D., D.O., and Natasha Trenev explain in ‘Probiotics: the Revolutionary ‘Friendly Bacteria’ Way to Vital Health and Well-Being,‘ that these enzymes have the potential to be converted by hostile bacteria into “extremely harmful carcinogens. They add, “In general, the more of these enzymes there are, the greater the risk of cancer-forming substances being created. The ability of the lactobacilli to deactivate the production of (or the action of) these enzymes is the most important contribution to cancer prevention.”

A more balanced diet in general will help one’s overall balance of bacteria. Chaitow and Trenev suggest a diet rich in complex carbohydrates such as fresh vegetables, nuts, and whole grains as well as a reasonable amount of fermented milk (or soy) products.

Yogurt is a food source of beneficial good bacteria, and the positive results are not only the digestive tract. Steven Pratt, M.D., and Kathy Matthews in ‘SuperFoods: Fourteen Foods That Will Change Your Life’ write that those that have attracted the most attention include yogurt’s anti-cancer abilities, yogurt’s ability to lower cholesterol, and its ability to inhibit unfriendly bacteria.”

They urge awareness with regard to the “LAC” seal on the yogurt package. The “LAC” (live active cultures) seal ensures that the yogurt contains at least 100 million live organisms- i.e. friendly probiotic bacteria -at the time of production. Pratt and Matthews also encourage shoppers should look for yogurts that are very fresh, with an expiration date that indicates a relatively short shelf life. Low-fat or non-fat varieties are helpful, but they warn against yogurt with fruit on the bottom, which adds artificial sugar that can potentially destroy the “LAC”.

They suggest adding fresh fruit, wheat germ, ground flaxseed or berries for added taste and nutritional benefits.

A balanced diet, however, is ineffective if the gastrointestinal system is unhealthy, forming a sort of double-edged sword. Deepak Chopra, MD, writes in ‘Perfect Digestion‘ that “for a balanced diet to have its proper effect, digestion must be strong enough and balanced enough to properly assimilate the nutrients contained in that diet.” For this reason probiotics friendlsy bacteria become especially important for maintaining good overall health.

Puglisi quotes William H. Lee, R.Ph., Ph.D., author of ‘The Friendly Bacteria‘, saying that different types of probiotic should be taken at different times and in different manners. Lee recommends that probiotic lactobacillus and bifidobacterium i.e. bifidus, supplements, “be taken well before a meal, and with water only.

The gastrointestinal activity of digestion will kill the bacteria if they are ingested while the process is going on; they need time to pass through the stomach and become implanted in the intestinal tract.”

He recommends that probiotic Lactobacillus bulgaricus be taken with, and not before, meals. This is because, according to Lee, probiotic “Lactobacillus bulgaricus operates via the lymph system. It must be digested into order to release the cell wall components which interact with that system.

Can you overindulge in probiotics? Drs. S.K. Dash, Allan N. Spreen, and Beth M. Ley in ‘The Health Benefits of Probiotics‘ state that probiotics friendly intestinal bacteria don’t seem to cause any significant health problems. “Aggressive efforts to overdo it may only produce mild gastrointestinal disturbances, and true safety issues seem to be non-existent.” Taking probiotic and prebiotic supplements or increasing intake of foods rich in these supplements only stands to improve quality of life.


    • Probiotics: the Revolutionary ‘Friendly Bacteria’ Way to Vital Health and Well-Being by Leon Chaitow, N.D., D.O., and Natasha Trenev.
    • Perfect Digestion: the Key to Balanced Living by Deepak Chopra, M.D.
    • Health Benefits of Probiotics by Dr. S.K. C Dash, Dr. Allan N. Spreen, and Dr. Beth M.Ley.
    • The Best Supplements for Your Health by Donald P. Goldberg, R.Ph, Arnold Gitomer, R.Ph., and Robert Abel, Jr M.D.
    • The Friendly Bacteria, by William H. Lee, R.Ph.D.
    • Basic Health Publications User’s Guide to Probiotics, by Earl Mindell, R.Ph.,Ph.D.
    • Cultivate Health from Within, by Khem Shahani, PhD
    • Probiotics: Nature’s Internal Healers, by Natasha Trenev.
    • Gut Solutions: Natural Solutions to Your Digestive Problems, by Brenda Watson, N.D. and Leonard Smith, M D., with Susan Stockton.
    • Renew Your life: Improved Digestion and Detoxification, by Brenda Watson, C.T. with Susan Stockton, MA.
    • Protecting Your Health with Probiotics: the ‘Friendly’ Bacteria, by George Weber, Ph.D.

Read More about Probiotics

Probiotic Abstract – protection from GI Disease

Protection from Gastro-intestinal Diseases with the use of Probiotics.

Presented at the symposium Probiotics and Prebiotics held in Kiel, Germany June 11―12, 1998.

Probiotics are nonpathogenic microorganisms that, when ingested, exert a positive influence on the health or physiology of the host. They can influence intestinal physiology either directly or indirectly through modulation of the endogenous ecosystem or immune system.

The results that have been shown with a sufficient level of proof to enable probiotics to be used as treatments for gastrointestinal disturbances are:

  1. the good tolerance of yogurt compared with milk in subjects with primary or secondary lactose maldigestion,
  2. the use of Saccharomyces boulardii and Enterococcus faecium SF 68 to prevent or shorten the duration of antibiotic-associated diarrhea,
  3. the use of S. boulardii to prevent further recurrence of Clostridium difficile―associated diarrhea, and
  4. the use of fermented milks containing Lactobacillus Rhamnosus GG to shorten the duration of diarrhea in infants with rotavirus enteritis (and probably also in gastroenteritis of other causes).

Effects that are otherwise suggested for diverse probiotics include alleviation of diarrhea of miscellaneous causes; prophylaxis of gastrointestinal infections, which includes traveler’s diarrhea; and immunomodulation. Trials of gastrointestinal diseases that involve the ecosystem are currently being performed, eg, Helicobacter pylori infections, inflammatory bowel disease, and colon cancer.

    • Probiotics can be defined as nonpathogenic microorganisms that, when ingested, exert a positive influence on the health or physiology of the host.
    • They consist of either yeast or bacteria, especially lactic acid bacteria.
    • Their fate in the gastrointestinal tract and their effects differ among strains
    • The effects of probiotics can be direct or indirect through modulation of the endogenous flora or of the immune system


Probiotics improve lactose digestion and have other enzymatic effects.

Lactose maldigestion occurs frequently, especially in adults (primary lactose maldigestion) and in persons with bowel resection or enteritis (secondary lactose maldigestion). It is well established that persons with lactose maldigestion experience better digestion and tolerance of the lactose contained in yogurt than of that contained in milk3.

The mechanisms involved have been extensively investigated. The importance of the viability of lactic acid bacteria was speculated as pasteurization reduced the observed digestibility. At least 2 mechanisms, which do not exclude each other, have been shown: digestion of lactose in the gut lumen by the lactase contained in the yogurt bacteria (the yogurt bacteria deliver lactase when lyzed by bile acids) and slower intestinal delivery or transit time of yogurt compared with milk 3-6.

In clinical practice, the replacement of milk with yogurt or fermented dairy products allows for better digestion and decreases diarrhea and other symptoms of intolerance in subjects with lactose intolerance, in children with diarrhea, and in subjects with short-bowel syndrome 3,4,7,8.

An enhanced digestion of a sucrose load was shown in infants with sucrase deficiency when they consumed Saccharomyces cerevisiae, ie, a yeast that contains the enzyme sucrase9. This is yet another example of a direct effect of a probiotic; however, its relevance in the treatment of sucrase deficient subjects is not established.

Antibiotic-Associated Diarrhea.

Diarrhea occurs in 20% of patients who receive antibiotics. Antibiotic-associated diarrhea (AAD) results from a microbial imbalance that leads to a decrease in the endogenous flora that is usually responsible for colonization resistance and to a decrease in the fermentation capacity of the colon. Clostridium difficile and Klebsiella oxytoca contribute to the occurrence of AAD in some cases and play a role in the pathogenesis of colonic lesions.

Several attempts have been made to determine whether the administration of probiotics would prevent antibiotic-associated intestinal symptoms (mainly AAD). Randomized controlled trials have showed a significant therapeutic effect of probiotics;

Three randomized, double-blind, placebo-controlled studies showed that oral administration of Saccharomyces boulardii (Ultralevure, Biocodex, France) can decrease the risk of AAD. Another study showed that S. boulardii significantly shortened the duration of AAD 22. The mechanism involved is unclear because multiple biological effects of the yeast in the gastrointestinal tract have been shown, which may contribute to the clinical efficacy of S. boulardii (ie, effects against the population levels of C. difficile, toxins, and intestinal secretion) 23, 24.


Gastroenteritis is the main cause of acute diarrhea and is a frequent disorder that usually heals spontaneously within a few days. Gastroenteritis can be due to several viral or bacterial pathogens or to parasites, but the most frequent cause in children is rotavirus infection. The use of oral rehydration solutions is the main treatment, but it does not shorten the duration of diarrhea.

Several controlled randomized trials showed a beneficial effect of probiotics and fermented dairy products in infantile or, less often, adult gastroenteritis; however, this is not a general property of all probiotics. Lactobacillus rhamnosus GG (L. GG, Valio, Finland) has been shown to be effective in the treatment of infant rotavirus diarrhea.

L. rhamnosus GG repeatedly reduced the duration of diarrhea by about half in randomized controlled trials. It also proved effective in the treatment of acute diarrhea in children in Asia 34, 35.

Abstract presented by:
Philippe R Marteau, Michael de Vrese, Christophe J Cellier and Jurgen Schrezenmeir
From the Gastroenterology Department, Hôpital Europèen Georges Lompidou, Assistance Publique des Hôpitaux de Paris and Paris V University, Paris, and the Institute of Physiology and Biochemistry of Nutrition, Federal Dairy Research Center, Kiel, Germany.

Read other information on Probiotics