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Q&A: Are Prebiotic and Probiotic Supplements Necessary for Good Gut Health?

Man shopping for supplements in the drugstore
Probiotics are popular digestive supplements. However, these products are not regulated. So before buying, talk to your doctor about which is right for you.

Probiotic supplements are a relatively new addition to drugstore shelves. Yet they’re now in high demand, with consumers spending approximately $2 billion on these digestive supplements in 2017.

Probiotics become part of a daily routine for many because of the purported benefits, which range from improved digestion to disease prevention and weight loss. But are they truly necessary for a healthy gut?

Gastroenterologist Stephen Borowitz, MD, answers this and more in the Q&A below.

An Expert Weighs In On Digestive Supplements

What are probiotics?

Probiotics are live organisms that we put in our bodies with the goal of benefiting our health. The best probiotics have a large number of viable bacteria that can survive prolonged storage and, since we eat them, they must also survive in the intestinal tract.

Why do we need live bacteria in our bodies?

There are more than 100 times as many bacteria living in our gut than there are cells in our body. These microbes do many things for us. They harvest energy from foods we are unable to digest, they synthesize vitamins, and they influence the development and function of our immune system.

How does diet impact the bacteria in our gut?

When we eat a healthy diet, the “good” bacteria in our gut, which help with digestion and boost our immune system, thrive. When we limit our intake of fruits and vegetables and eat lots of processed foods and lots of refined sugars, our intestinal flora may become less diverse, and this may increase our risk of developing infections and chronic inflammatory conditions.

What are probiotic foods?

Foods naturally high in probiotics include foods that naturally contain live cultures, such as yogurt, fermented foods like sauerkraut and pickles, as well as tempeh and some cheeses like cheddar.

The sooner we introduce these foods into our diet, the better. Feeding babies a variety of foods with lots of fiber is one of the single most important things we can do early in life to promote a healthy gut. That may help to lower their risk for disease later in life, including allergies, diabetes and inflammatory bowel disease.

What are prebiotics?

Prebiotics are non-digestible sugars that stimulate the growth of the good bacteria already residing in our intestines. In other words, they feed the bacteria in your gut. Many of the probiotic foods listed above are actually symbiotic, meaning they contain both prebiotics and probiotics.

Some examples of prebiotic-rich foods include:

  • Barley
  • Garlic
  • Onion
  • Asparagus

Together, probiotics and prebiotics may maximize gut health.

Are probiotic supplements necessary?

For people who are healthy and eat a diverse diet, there is not a lot of evidence that probiotic supplements are necessary or make a significant difference in their health or sense of well-being. However, there are some instances in which probiotics have proven to be beneficial.

Probiotics to Prevent Disease

Probiotics can help prevent or limit the extent of antibiotic-associated diarrhea. Studies show that taking a probiotic during a course of antibiotics reduces your risk of getting diarrhea from 30 to 10%.

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There is also evidence that probiotics decrease your risk of getting norovirus or may decrease the severity and duration of symptoms if you’re infected. Two of the best-studied, over-the-counter probiotics for these uses are Culturelle (Lactobacillus rhamnos GG) or Florastor (Saccharomyces boulardii).

Probiotics to Treat Disease

There have been a number of studies showing that probiotics lessen irritable bowel syndrome (IBS) symptoms. A combination of probiotics and prebiotics also may reduce the symptoms of mild ulcerative colitis. The probiotic doctors most recommend in this circumstance is VSL#3.

Note that the U.S. Food and Drug Administration doesn’t regulate probiotic supplements, so there is some variability out there. However, we have good scientific evidence that the supplements mentioned above are effective. Before taking a supplement, talk to your doctor about the one that is right for you.

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