Each year in Canada alone multi-millions of antibiotic prescriptions are filled. Some are necessary and some are not. At the end of the day, these antibiotics do make their way down the GI tract to eliminate both the good and bad gut flora. We can help patients gain gut health back with probiotic recommendations. But how do we know what is best for them? 

A healthy gut has many benefits. Their immunity will be better for they aren't spending their resources on combating unnecessary inflammation and infections from unwanted bacteria over-growth. Less inflammation means better absorption. More nutrients are absorbed will lead to better tissue health (bone strength, quicker healing, better skin health).

Let's remove a couple of myths. The first common one is, "I eat yogurt and fermented foods so my gut flora should be ok." Yes, that would be ok if the patient wasn't on an antibiotic and had been eating it daily or weekly. Typically a daily serving of yogurt is about 750 million live cells. However, not all of the bacteria in your cup of yogurt will survive the journey through your gastric bubble. Also, the combination of these different good bacteria is what makes for a healthy gut. But most food-grade probiotics in yogurts are 2-3 different strains. In my clinical practice, patients are recommended to be on a general probiotic formula with a minimum of 10 billion CFU (colony-forming units). 

The second myth, "probiotic makes me bloated so it is bad." Yes, Not all probiotics are made equal. If it consistently gives you a problem after a few days of taking it, then it isn't right for you. Even a suitable product can make you a little bloated the first 1-2 days as the good flora tries to reclaim some real estate. What makes your probiotic not suitable for you? Some manufacturers might use bacteria cultured from plants (soil-based), or other mammals, or with dairy-based bacteria during cultivation (and you are dairy-free). So you've got to check the label. Professional brands will pay closer attention to these matters and use better-researched strains and/or fewer fillers.

Why use human strains? Our body temperature is 36.4C -37.2C degrees. When human-based strains are used, then the likely hood of having the bacteria colonizing in our gut is much higher. Also, the bacteria are more likely to be room temperature stable (still best to refrigerate to reduce moisture). Having said this, we don't need to worry if our probiotic has gone bad when it is in our carry-on for a few hours or when it was unintentionally left on the counter overnight.

A good probiotic should have gastric acid resistant capsules. You wouldn't want your probiotic to be released into the gastric bubble and killed off before they get a chance to colonize in the lower GI.

Healthy gut flora should have Saccharomyces boulardii, a specific species of healthy yeast. Clinically it has been shown to increase the production of secretory IgA to decrease GI inflammation and mild diarrhea. Sacro-B has been shown to support the growth of beneficiary flora as well. So this should not be an oversight when thinking of probiotics.

To recap a good manufacturer of probiotics will use human strains, live cells with 5 billion-plus (CFUs), attention to unnecessary additives and fillers, and gastric acid-resistant capsules. To keep a healthy gut every one should do a rotation of their probiotic at intervals of 1-3 months on and 1-3 months off.

 Years ago, I attended a gut health seminar by a researcher that had spent his entire life professional life understanding probiotics. And he ended the talk with, we only know about 1-2% about gut flora at best. So we have a lot to learn still.

If you have any questions regarding gut health and probiotics, you can reach Dr. Chi Hung La at our West Block location.