Considering a probiotic? Go with your gut

Sick to the stomach. An expression so meaningful and evocative it’s common parlance. Nausea, bloating, churning, cramps, constipation, diarrhea — that’s nobody’s idea of fun — but it’s hardly a rare phenomenon. Recent studies have found that 75% of students1 and 50% of adults2, all of whom are otherwise healthy, suffer from one form of abdominal pain. Equally prevalent across varying geographic areas and age groups, it affects nearly all of us at some point, and accounts for innumerable sick days, missed appointments and panicked visits to the bathroom.

Irritable bowel syndrome, or IBS, is the most common functional gastrointestinal disorder, with a diagnosis rate of up to 15% in the United States. Functional is the key word here — it describes conditions with an absence of structural or biochemical abnormalities on standard diagnostic tests — which means it is tremendously difficult to treat, and also costly. IBS causes between 2.4 and 3.5 million annual trips to the doctor’s in the U.S. alone, accounting for up to 12% of visits to primary care givers, and is responsible for up to $21 billion in absenteeism and lost productivity every year3.

While it affects both men (35-40% of sufferers) and women (60 to 65%), IBS is becoming a major female health problem, with data revealing an increased risk of unnecessary and potentially dangerous extra-abdominal and abdominal surgeries occurring due to the disorder. Incidence of hysterectomy or ovarian surgery, for example, has been reported at rates of up to 55% in sufferers of IBS — much higher than in unaffected comparison groups3.

With IBS becoming an ever more prevalent issue, the race for an effective treatment, if not a cure, has never been more intense. While we might be used to thinking with our stomachs, it’s time we started to think, and care, about them.

What are probiotics?

It was more than a century ago that Russian scientist and Nobel laureate Elli Metchnikoff first discovered that gut flora could not only be modified, but harmful microbes replaced with beneficial straints to improve health and treat disease. Metchnikoff asserted that while there were many bacterial cultures found in the human gut that were integral to metabolic function, there were also putrefactive or proteolytic bacteria that were capable of generating toxins. If he could displace these damage cultures, Metchnikoff thought, he might be able to reverse their negative effects. To test his hypothesis, he began drinking milk fermented with bulgarian bacillus, not only introducing helpful cultures to his gut, but also lowering its pH, providing a favourable environment for their continued growth. Encouraging results led to his thinking being adopted throughout the world, and a new focus on the potential of probiotic bacteria as a serious field of medical research.

Since then, there has been an immense growth of public knowledge and interest in probiotics — you only need to look at supermarket shelves stocked with probiotic yoghurts and drinks to see— but are they actually doing us any good?

Where’s the evidence?

Since their rise to popularity, many probiotics have been extensively tested in clinical settings and a wide range of applications have been found.

Acute infectious diarrhea

A 2010 review of research by SJ Allens et al found that probiotics, taken alongside rehydration therapy, were safe and had clear benefits in reducing the frequency of stools and the duration of illness4.

Antibiotic-associated diarrhea

A 2006 review of research by LV Macfarland found that probiotics have beneficial effects for the prevention and treatment of diarrhea brought on by antibiotics5.

Traveler’s diarrhea

A 2007 review of research by LV Macfarland found that probiotics are a safe and effective way to prevent traveler’s diarrhea6.

Crohn’s disease

While there has yet to be a medical consensus on the efficacy of probiotics in the treatment and management of Crohn’s disease, there have been a number of promising studies and research continues.

Ulcerative colitis

A 2010 review of research by VT Do et al found probiotics were potentially beneficial in maintaining remission in sufferers of ulcerative colitis7.

Pouchitis

A 2010 review of research by SD Holubar et al found probiotics were effective for both the treatment and prevention of pouchitis8.

Irritable bowel syndrome

A 2014 review of research by BD Cash found that probiotics were potentially beneficial in the management of IBS and further research continues to determine optimal dosage, cultures and length of treatment9.

The problem with probiotics

While the science for the efficacy of probiotics is certainly solid, particularly in clinical conditions, is there evidence to indicate that commercial probiotics actually do what they advertise?

Scientists headed by Dr. Simon Gaisford from the School of Pharmacy at University College London (UCL) recently undertook a study to test the effectiveness of eight commercially available probiotic supplements using pig digestive fluid to simulate the human stomach. This test was based on three criteria: whether the number of viable bacteria matched the producer’s claims; how many viable bacteria made it into the gut; and how successful the probiotic was at establishing a successfully reproducing culture in the gut.

Of the eight products tested, only one passed all three trials, delivering 100% or more of advertised viable bacteria, surviving the 120 minute journey through the stomach, and producing strong culture growth within 10 hours. But why? What makes this particular Aprobiotic, called Symprove, special?10

Dairy and tablets are thicker than water

While most probiotics come in tablet, capsule or dairy form, none of these methods are the most effective at delivering viable amounts of bacteria that can then reproduce successfully within the gut. Tablets and capsules rely on freeze-dried bacteria which must then be rehydrated, an imperfect process in which many cultures fail to reactivate; dairy drinks and yoghurts, because of their fat and protein content, trigger digestion, meaning many bacteria are destroyed by stomach acids.

Symprove, on the other hand, is a water-based, barley solution containing multiple strains of live bacterial cultures. Because the cultures are live, there’s no danger that they won’t be viable as with tablets and capsules, and because it’s water- and not dairy-based, it doesn’t trigger digestion either, avoiding interfering stomach acids. Symprove isn’t just packed with beneficial bacteria; it makes sure they get where they’re needed most too.

IBS success with Symprove

Though scientists have had little concrete success with probiotics as a treatment for IBS, all that may be about to change. Researchers at King’s College Hospital in London have recently published a study on Symprove’s application for treatment of IBS, with promising news for those suffering from this notoriously difficult-to-manage illness.

The study involved 186 patients with moderate to severe IBS which had not responded to conventional treatments, who for three months were either given a daily dosage of Symprove or a placebo. Participants who received Symprove reported improvements across all symptoms, particularly pain, and across all sub-types of IBS11. While this is only a small-scale trial, its importance cannot be overstated and it represents a promising start for further research.

Discover Symprove

Symprove is a clinically proven, scientifically developed probiotic, made from organic, cold-pressed seeds and designed to deliver beneficial bacterial cultures to where they’re needed most. If you suffer from IBS or other gastrointestinal problems, Symprove may be the answer. Check out our product page to learn more.

References

1. Hyams JS, Burke G, Davis PM, et al. Abdominal pain and irritable bowel syndrome in adolescents: a community-based study. J Pediatr 1996; 129:220.

2. Heading RC. Prevalence of upper gastrointestinal symptoms in the general population: a systematic review. Scand J Gastroenterol Suppl 1999; 231:3.

3. About IBS. The International Foundation for Functional Gastrointestinal Disorders. 2014. http://www.aboutibs.org/site/what-is-ibs/facts/statistics

4. Allen SJ, Martinez EG, Gregorio GV, et al; Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010 Nov 10;(11):CD003048. doi: 10.1002/14651858.CD003048.pub3.