Probiotics are live, “friendly” organisms that live in the intestine. They help decrease “unfriendly” bacteria and viruses that cause diseases such as diarrhea. They act as a barrier against bacteria or toxins in the intestinal wall. Examples of probiotics are Lactobacillus, Bifidobacteria, and Saccharomyces boulardii. They are available in a range of dosage forms, such as capsules, tablets, and powders.
For what conditions are probiotics effective?
Certain probiotics have been shown to be beneficial for preventing and treating some types of diarrhea, including diarrhea caused by antibiotics/ Clostridium difficile- associated diarrhea. Recent studies have shown that patients at risk for getting C. Diff- diarrhea lowered their infection rate by 66% when they took prophylactic probiotics. They are also used to prevent Traveler’s diarrhea. Probiotics also seem to help some bowel diseases such as ulcerative colitis and irritable bowel syndrome.
What probiotic products are available, and how do you choose one?
Not all probiotics are the same. Some work better for certain conditions than others. To prevent diarrhea caused by antibiotics, choose Culturelle, Align, and Acidophilus (Lactobacillus) or Florastor ( Saccharomyces boulardi). There is powder form of Florastor made for kids and breaking open the contents of Culturelle and mixing it onto cool food is another option for children on antibiotics or adults having trouble swallowing capsules or tablets. These products are also beneficial for protection against traveler’s diarrhea. Start taking them a few days before travel, and continue them for the duration of your trip.
Yogurt is a source of probiotics, but not all yogurts contain the right kinds of organisms. Choose a product with the National Yogurt Association’s "Live and Active Cultures" seal on the label (ex DANONE, Yoplait). You will need to eat about 8 ounces twice daily to prevent antibiotic- associated diarrhea. However, eating yogurt doesn’t seem useful for preventing vaginal yeast infections caused by antibiotics.
What are the side effects and drug interactions with probiotics?
Probiotics can cause stomach and intestinal upset, including gas and bloating. These usually improve with time. Antibiotics are used to reduce harmful bacteria in the body. They can also reduce friendly bacteria like Lactobacillus and Bifidobacteria. If you are using these probiotics, you should take them at least 2 hours before or after the antibiotic. The calcium in yogurt can also decrease the effectiveness of certain antibiotics like Cipro or Avelox, so allow for several hours after eating yogurt to take your antibiotic.
Who should not take probiotics?
For healthy people, routine use of probiotics to maintain bowel health is unnecessary. There is a small risk of infection with probiotics so if you a weakened immune system, you should avoid taking them. Pregnant women should check with their doctor before taking probiotics.
- Vanessa Andricola, Pharm. D.