Probiotics: Weighing the evidence

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Lyndsie Bourgon

Jeffrey Roberts, 49, of Toronto is convinced that taking probiotics has transformed his life. “Nothing was helping,” says Roberts of his irritable bowel syndrome (IBS), before he hopped on the probiotic bandwagon three years ago. Since then, Roberts has used probiotics “every single day.”

The outcome has been dramatic. “Now I want to stand on top of a mountain and scream about how good they are.”

Roberts runs the IBS Self Help and Support Group Canadian online community (www.ibsgroup.org). Although he’s only used probiotics for three years, he’s suffered from IBS for more than two decades. He says flare-ups often cause problems in his work and personal life, and had previously led to him becoming overwhelmed with illness and depression.

Bahar Nasirzadeh

For those who suffer from intestinal problems, probiotics have surfaced as a popular treatment for digestive disorders.

When There’s Gastrointestinal Distress

For people with stomach problems, probiotics can help fight the growth of harmful bacteria and support good bacteria in the stomach. As a result, studies have shown that taking probiotics can relieve symptoms such as diarrhea that are associated with stomach disorders.

While the cause is unknown, IBS is a common disorder for which taking probiotics has proven to be beneficial. The condition causes abdominal pain and bloating, paired with diarrhea and/or constipation. There is no infection, inflammation or lasting damage to the intestinal system. The symptoms may be active for some time and then recede, sometimes recurring later. It’s important to have an IBS diagnosis confirmed by a physician.

How Probiotics Work

Health Canada says that probiotics aid the digestive system by increasing the number of protective bacteria while decreasing the population of microorganisms that can cause disease. Probiotics may also suppress the activity of certain bacterial enzymes that have been associated with development of cancer in the intestinal system.

Probiotics are living microorganisms naturally present in the human gut. For the most part, they are beneficial, helping to break down foods and improve digestion — when consumed in adequate quantities. They may also boost the immune system. That’s why probiotics are considered “good” bacteria. The difficulty arises when “good” and “bad” bacteria get out of balance. That’s when people try to boost the number of probiotics at work in their gastrointestinal system. Specific probiotics have been credited with health benefits like improving mineral absorption, lowering cholesterol and managing lactose intolerance.

In food, probiotics are most often found in dairy products including yogurt and cheese. Probiotics are also available in supplement form, and are often added to prepared foods at health food stores.

Caveats

The amount of probiotics found in individual servings of popular foods like yogurt has recently been questioned. In the fall of 2009, yogurt giant Danone found itself in hot water over claims that the company exaggerated the healing effects of probiotics in its products. The case was settled out of court.

Experts say most yogurts do not contain enough bacteria to truly improve digestive health. “To increase the number [of probiotics in your stomach] you need to take a lot, and forever,” says Dr. Richard Fedorak, a professor of gastroenterology at the University of Alberta in Edmonton. “When you stop, these bacteria will disappear.”

Dietitian Doug Cook of Toronto says that there’s good science behind the yogurt claims, “…but to get the same quantity you’d have to have consumed five or six times [the serving size].”

He recommends Bio-K+ CL1285® — a food product similar to yogurt that contains a large number of probiotics. Fedorak recommends a few other probiotic products, including VSL #3 and TuZen®, which he says are particularly helpful for IBS.

Both Cook and Fedorak note that more research needs to be done to assess the effectiveness of probiotic products. “Probiotics are not really well regulated by Health Canada yet, and anyone can sell them online,” says Fedorak, adding that the federal health agency hopes to change that through the work of its Natural Health Products Directorate.

According to Cook, one of the biggest questions surrounding probiotic supplements is their ability to survive in the gut’s acid. “Most don’t [survive], actually,” he says. “They have to be proprietary formulas to ensure that happens, and not all have that.”

Some probiotic supplements have a coating to ensure they survive, but Cook emphasizes that these methods should have third-party testing to determine safety and efficacy.

“Basically it’s buyer beware,” says Cook. He adds that consumers should look for supplements that have a high count — “in the tens of billions, at least” — of probiotic content.