Can Pre- and Probiotics supplements actually improve gut health? Research and my clinic experience say yes. Probiotics have been proven to be helpful in several conditions, such as irritable bowel, yeast infections, weaken immune function, and even weight loss. There is no ‘one-size-fits-all', so choosing the right probiotic can be a tricky task. You have to first ask yourself ‘what are you looking to achieve?’. If you’re looking to improve digestive health, such as gas, bloating and irregular stools, look for a probiotic that's rich in bifidobacteria, such as b. animalis and b. infantis. For repeat yeast infections and urogenital health, you’re better off with lactobacillus species, such as l. acidophilus, l. rhamnosus and l. reuteri. Furthermore, some probiotic strains are not seen in the human microbiome but have been shown to prevent traveller's diarrhea or antibiotic-associated diarrhea, such as s. boulardii.
That being said, unfortunately, most of the literature suggests probiotics provide benefits during use but don’t culture the gut long term. This is where prebiotics become helpful, promoting the development and strengthening of the colonies of your endogenous flora, as well as increasing the output of butyrate (a short-chain fatty acid showing wide spectrum positive effects in everything from cardiovascular disease to colon cancer prevention) One thing to note - certain probiotics can also worsen certain conditions like SIBO or histamine intolerances, so it's always best to check with a professional to ensure the probiotic you’re taking is right for you. What's the difference between pre- and probiotics? Probiotics are supplementation of exogenous (or ‘outside’) sources of bacteria that did not originate in your digestive tract. They prove to be helpful when there’s an intended outcome in mind, such as reducing gas or bloating or preventing travellers' diarrhea. The biggest downfall to probiotics is that most research concludes that lab-grown probiotics don’t successfully culture human guts. This is where prebiotics are beneficial, as they help strengthen the strains that are native to your digestive tract. You can certainly take both, depending on your desired outcome. The easiest way to compare the difference is to envision your digestive tract as a garden that needs some tending. Prebiotics are like fertilizing the flowers that already exist, and probiotics are like planting some new ones (quick results - but they may not last long term). I generally recommend probiotics for more acute concerns, symptom management, or prevention of illness (such as in travel or alongside antibiotics) and prebiotics for general health and long-term microbiome recovery. Can I get pre- and probiotics through my diet? Consuming foods rich in soluble fibre provides a natural source of prebiotics for your gut bacteria, such as flax, hemp and chia seeds, oats, bananas, kiwis, artichokes and legumes. Natural sources of prebiotics include cultures of dairy products like yogurt and kefir, sauerkraut, kimchi and other fermented foods like miso and tempeh. However, not everyone tolerates high-fibre foods well so speak to your naturopath before changing your diet. Preliminary research suggests artificial sweeteners like aspartame may have the most negative impacts on our gut microbiome, but more human-based research is required. Are some prebiotic fibres better than others? Each person is unique. Generally speaking, fibre doesn’t have favourable outcomes in IBS studies. However, someone who’s recently undergone gallbladder surgery and/or experienced diarrhea can benefit from a soluble fibre like psyllium. Soluble fibres can also help lower cholesterols and irregular blood sugar levels, as well as assist in the elimination of sex steroid hormones, like estrogen. Soluble fibre is also rich in foods like oats, beans, apples, carrots, barley and psyllium. Are there downsides to taking a prebiotic supplement? Unfortunately, fibres can often increase bloating. Since they’re fermentable, they can often be consumed by gut bacteria and increase gas formation and distension in the abdomen. They also interact with several medications, such as birth control pills, and statin medications. If you’re planning to add fibre to your diet, look for ones that are FODMAP approved, such as partially hydrolyzed guar gum, or acacia gum. Furthermore, increase them gradually and take them with a large volume of water. Lastly, make sure they’re taken 2-4 hours away from all oral medications. Can "cleanses" help improve gut health? Cutting out certain foods that induce inflammation like sugar, dairy, or high FODMAP foods can help alleviate symptoms, reduce inflammation and help the gut recover from certain acute stressors like antibiotics, diarrhea or illness. However, most ‘box’ prepared cleanses generally contain mostly laxatives and diuretics, and give a false sense of improvement by forcing bowel emptying and reducing water retention, and show no long-term benefits. Lastly, let me say this. Colonics are not an effective means of ‘cleansing’ the gut. The microbiota is a very delicate ecosystem, so I would not advise disrupting it with measures that have resulted in rectal perforation, where little to no proven benefit exists. To find out more about the right supplements, dietary approaches, and testing for your gut and microbiome, please feel free to contact Toronto naturopathic doctor, Dr. Courtney Homberg at 647-351-7282 to schedule your appointment today.