Probiotics and Prebiotics

Dr. Rekar in a ConsultationThe human gastrointestinal tract harbors ten times more bacterial cells than all the cells in the entire body. It's microflora benefits the human body by breaking down toxins, synthesizing vitamins, and defending against infections. In addition it is now believed that this microflora may play a role in such diseases as ulcers, diarrhea, colorectal cancer, and inflammatory bowel diseases. The collection of microbes is known as the microbiome which differs from one individual to another. There are approximately between 500 and 1000 different species that are established early in life. While the microbiome is thought to remain relatively stable throughout life, it is difficult to study since these bacteria are difficult to culture.

Probiotics are live commensal micro-organisms, which according to the World Health Organization, "when administered in adequate amounts confer a health benefit on the host", including the risk and duration of infections. Interestingly enough, the Talmud says that Abraham drank sour milk every day, most likely a form of yogurt, which possibly contributed to his long life.

According to the Internal Medicine World Report article of December 2007 ( there is good evidence for the use of probiotics in such conditions as infectious diarrhea, antibiotic-associated diarrhea, colic, travelers' diarrhea, cancer, allergy symptoms, and reducing the duration of colds and respiratory tract infections.

Lactobacillus strains were found to improve flu vaccine efficacy as noted in the Nutrition Journal of 2007 (Nutrition 2007; 23: 254-260). In fact Dr. Eamonn Quigley, MD, president of the World Gastroenterology Organization speculates that we will see designer probiotics designed for specific diseases. The field of gastroenterology is showing much greater enthusiasm for probiotics than in the past. Furthermore in the Mayo Clinic Proceedings Journal of 2008 (Mayo Clinic Proceedings 2008; 83 (4): 460-469) it was noted that microorganisms in the gut appear to have an important role in host energy homeostasis and nutrient acquisition, and that "the metabolic activities of the gut microbiota facilitates the extraction of calories from ingested dietary substances and help store these calories in host adipose tissue." The differences in caloric extraction may be due to the composition of the gut microbiota and there is now emerging evidence that the bacterial flora of obese mice and humans include fewer bacteroidetes and more firmicutes bacteria than their lean counterparts.

It is thought that probiotics reduce the inflammatory tone of the body. The best-studied of the probiotics are the bifidobacterium and lactobacillus. In an article of the Journal of the American Medical Association in September of 2000 it was noted that children with diarrhea given rehydration containing lactobacillus showed a significant reduction in their duration of disease and hospital stay. In another study it was shown that probiotics counteracted the episodes of diarrhea occuring with antibiotic use, resulting in a reduction of severity and incidence of diarrhea. Other conditions that may respond to probiotics are allergies, atopic dermatitis, eczema, respiratory tract infections, asthma, sinusitis, bronchitis, pneumonia, inflammatory bowel disease (Ulcerative colitis and Crohn's disease), and cancer prevention, where it is hypothesized that changes in the intestinal flora can decrease the concentration of potential carcinogens.

Finally in closing it should be noted that prebiotics are non-digestible food ingredients that stimulate the growth of specific bacteria and in so doing illicit a probiotic effect. One such substance, fructooligosaccharide (FOS), which is found in breast milk and some dietary foods, could modify the intestinal flora, boosting resident non-pathogenic bacteria.

Probiotics have in fact been used for centuries by people ingesting fermented milk products with apparently no ill effect, indicating that these agents are beneficial but safe. As noted above, it is speculated by the gastroenterology community that in the future we will see designer probiotics designed for specific diseases. (Inter-Medicine World Report Dec. 2007 []) We will keep you informed of these new exciting medical developments as they emerge.

Best in Health,

David M. Rekar, M.D.
Medical Director

 [Above Image Thanks To kaibara at]

Universal City Medical Wellness Group (UCMWG) is a Multidisciplinary & Complementary Alternative Medical Group near Universal Studios, Studio City, Hollywood, North Hollywood, Burbank & Toluca Lake, in L.A.

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