Probiotics

Question 0

Foods containing Probiotics

Answer 0

• yogurt - lactobacillus bifidobacteria
• kefir
• buttermilk
• acidophilus milk
• fermented vegetables (sauerkraut)
• need large amounts and must be viable

Question 1

What are Probiotics?

Answer 1

• Probiotics is a term derived from Greek meaning “for life”
• often thought of as good bacteria
• strains of lactobacillus and bifidobacterium
• live organisms that when administered in adequate amounts, confer a health benefit to the host

Question 2

What are Prebiotics?

Answer 2

• act as substrates to promote bacterial growth
• typically are dietary carbohydrates that do not get digested in the upper GI tract
• a non-digestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacterium in the colon

Question 3

Examples of prebiotics

Answer 3

• fructooligosaccharides (FOS) - naturally occurring in plants such as chocory, onions, asparagus, bananas and wheat
• inulin
• lactulose (medication for ppl with liver disease)
• Raffinose
• Xylitol
• cookies/granola bars
• breads
• smart pasta
  non-dairy milk; Dream Products
• some enteral formula

Question 4

What is Synbiotic?

Answer 4

• when a product contains both probiotics and prebiotics

- act synergistically to enhance the growth of probiotics, conferring a health benefit to the host

Question 5

Influence of Disease on the Intestine

Answer 5

• mucosal barrier becomes compromised
• possibly due to inflammation, infection, neoplasia or trauma
• increased intestinal permeability
• enhanced transmural migration of enteric bacteria and toxic products to the systemic circulation
• leaky gut syndrome: good flora can leak out or bad flora can leak in; toxic products

Question 6

Risk factors for increased intestinal permeability

Answer 6

• altered luminal micro-environment
• ischemia (peripheral vascular disease, tumor or thrombus)
• malnutrition

Question 7

impact of probiotics

Answer 7

• is transient (you have to keep taking them)
• effect is greatest in the colon
• immune effect is greatest in the distal small intestine (ielum)

Question 8

Probiotic Bacteria

2 types

Answer 8

• lactobacillus and bifidobacterium are found naturally in the gut
• maintain gut barrier
• protect against pathogenic bacterial invasion
• species along the gut barrier can block out the toxins from coming in (e coli or salmonella)

Question 9

Proposed Mechanisms for Beneficial Activity

Answer 9

• competitive exclusion of pathogenic bacteria
• release of chemical products or biologically active products to inhibit pathogens (release secretin)
• product of butyric acid to enhance turnover of enterocytes
• stimulation of mucin and slgA production to enhance barrier function
• modulate the inflammatory and immune response
• secretion of a soluble factor to enhance barrier function
• reduction of gram negative bacteria by displacement

Question 10

Bacteria used as probiotics should…

Answer 10

• be a strain present in humans
• demonstrate non-pathogenic behavior
• be resistant to gastric secretions and bile
• adhere to gut epithelium
• persist in the GI tract
• modulate immune response

Question 11

General Health Effects

-strong evidence-

Answer 11

• decreased frequency and duration of diarrhea; 1-3 days improvement, bifidobacterium bifidum, S. thermophilus and lactobacillus GG
• management of GI diseases
• stimulation of humoral and cellular immunity

Question 12

General Health Effects

-Weaker Evidence-

Answer 12

• decreased Helicobacter Pylori infection
• decreased allergies
• improvement in constipation
• positive effects in mineral metabolism
• cancer prevention
• decreased serum cholesterol and triglycerides

Question 13

Gi disease management

Answer 13

• maintain remission in patients with UC and poutitis (with VSL#3)
• unable to show benefit in patients with Crohn’s disease *

Question 14

Probiotics and Immunity

Answer 14

milk and lactobacillus GG vs milk

• reduction in respiratory infections
• reduction in those requiring antibiotics

Question 15

Improvement in Irritable Bowel Syndrome and Constipation

Answer 15

• IBS symptoms (bloating, flatulence, constipation) decreased
• abdominal pain and distention decreased with bifidobacteria dose 10^8
• Bifidobacteria most promising with IBS (other probiotics have no effect)

Question 16

VSL#3

Answer 16

• combination of 7 strains of bifidobacteria and lactobacilli and one strain of streptococcus salivarius ssp thermophilus