Dr. Melody Khorrami, PharmD, RPh, INHC
The human body isn’t just made up of our own cells. We host around 100 trillion microbes. Over 500 species of bacteria reside in the gut. The bacterial composition of each human is unique. Various factors can affect the composition of the gut, including lifestyle, diet, antibiotic use, exposure to toxins, and the initial colonization that occurs at birth. All these components affect the intestinal bacterial composition.
Probiotics can help you get a healthy gut microbiome. There are many proven ways to support a healthy gut microbiome. Lifestyle methods include:
- eating a balanced diet
- increasing fiber consumption
- reducing stress
- managing emotional health
- getting enough sleep
- minimizing unnecessary exposure to antibiotics
- using certain probiotics.
Probiotics are microscopic live organisms. When used correctly, they give their host health benefits. Probiotics work by competing with pathogens that try to enter the body. They produce anti-bacterial effects by making bacteriocins. Bacteriocins are antibiotics that are produced by certain bacterial species. Once produced for a particular strain of bacteria, bacteriocins can work on similar or related species. By producing bacteriocins, probiotics can:
- destroy some toxins entering the body
- strengthen your gut’s barrier
- control muscle movements and sensations in the gut
- enhance immunity
- play a role in immune and cytokine modulation
- help the metabolism function, including the drug metabolism
- control the microbiota-gut-brain axis
- break down food
- produce usable nutrients in the form of vitamins and minerals for the body to use
What makes a good probiotic?
There are a couple of essential criteria to consider when choosing good probiotic products. They include:
- showing a proven benefit—requesting clinical studies for the intended use(s)
- proof that they survive the intestines after ingestion
- no pathogenicity
- no transmissible drug resistance
- acid and bile resistance
- defined antibiotic sensitivity
Additionally, there should always be 2 to 4 hours between administering antibiotics and ingestion of probiotics.
Generally, probiotics will not take up permanent residence in the gut after they are administered. Requesting clinical studies related to the exact probiotic product being used is important. Some observational studies have shown that within one to two weeks of stopping probiotics, they can no longer be found in the stool. Another study showed that after one month of discontinuing probiotics, fecal concentrations of lactobacilli, Bifidobacterium, and Streptococcus reached their original levels before probiotic consumption. However, this does not mean they are not beneficial to the host. As probiotics travel down the gastrointestinal tract they interact with the immune system. Probiotics also react with the variety of microbes that reside in the different parts of the body. Colonization is not required for health benefits to occur.
How do I know if I need probiotics?
As with all therapies, everyone may react differently when starting probiotics. It can take a few days up to a full month to notice the health benefits of probiotics. Each person is unique and listening to your body and its responses is important.
You can take some steps to determine whether probiotics are helping you. First, you should understand what symptoms you have and whether you want to see improvement in those symptoms with the probiotic you are using.
- Do you have digestive issues?
- Are you experiencing diarrhea with your IBS symptoms?
- Do you have bloating and gas?
- How severe are your symptoms?
- Are you currently on antibiotics or have you just finished a course of antibiotics?
- When did your symptoms start?
- Do you want a daily use probiotic for general gut support?
It is important to notify your healthcare provider of unusual symptoms you may be experiencing. Pay attention once you start a probiotic. Only use the recommended amount. Notice how you are improving during the first couple of weeks. Some people may need to start at a lower dose due to side effects like bloating until the body adjusts. Listen to your body and its needs. Within about four weeks you should start seeing improvements. Although, it may take 12 weeks or longer to see to full benefits.
Which probiotic is right for me?
When choosing a probiotic, it is important to look carefully at the product label. Probiotic labels should contain the genus, species, and strain designation, the number of CFUs (colony forming units), expiration date, recommended dosage, and storage requirements, according to guidelines issued by the Joint Food and Agriculture Organization of the United Nations and World Health Organization (2002) and the International Probiotics Association in its partnership with the Council for Responsible Nutrition (2017).
The side effects of probiotics are generally mild. Some of the common side effects associated with probiotic use include bloating and gas, but they typically disappear in the first couple of days. Adverse effects from probiotics are rare and typically limited to people with underlying diseases. If you have any underlying diseases, you should discuss whether probiotics are appropriate for you, with your licensed healthcare provider.
Please note: This article is for educational purposes only. Always check with your licensed healthcare provider before starting any new therapies or changing your health plan.
There has been a lot of attention in the last couple of years over the concept of gluten-free. It is hard to differentiate between fads and necessary health practices around certain nutritional advice.
The gluten-free diet has been promoted for various health goals. Some supporters of the diet believe that gluten triggers inflammation in the body and can contribute to certain health conditions.
While many people can tolerate gluten and have no problems consuming it, some people should consider avoiding it.
As consumer use of probiotics increases, the need for education around choosing the right probiotic combination and which strains are most valuable for specific health conditions is also expanding. When choosing the right probiotic, two important factors to consider are strain specificity and disease specificity as they relate to the usefulness for a particular medical condition. There is evidence to suggest that the practicality of probiotic use is related to both strain and disease specificity.
Stress management is an important area that is discussed during GI visits for patients who are dealing with irritable bowel syndrome. The relationship between the brain and the digestive system is important to consider when developing a plan for managing irritable bowel syndrome (IBS). Certain emotions such as stress, depression and anxiety can activate signals in the gut (the stomach and intestines) which cause gastrointestinal distress. Improving psychological and emotional health can also help to improve digestive conditions such as IBS. This may require that you work with not just your doctor but also a nutritionist and a therapist.
Experiencing stress and negative emotions are a part of the human experience, but if they are not processed in a healthy manner they can lead to manifestations of physical health problems. The gut-brain connection is revolutionizing our understanding of what the trillions of bacteria, are doing in the gut.
By Melody Khorrami, PharmD, RPh
As we enter a new year, it is always helpful to take a moment to reflect on the past year. Journaling about your personal progress, both professionally and socially, and re-examining your life vision can help you set new goals. As you assess the past, try to practice grace and gratitude for all the twists and turns of life. Many of us will use this time of renewal to focus on health and wellness goals. Here’s a thought: start with your gut!
Research in the gut microbiome space has erupted in the last couple years. Our gut is home to trillions of microbes that create a dynamic environment which influences so much of our health and well-being. These microbes are responsible for the digestion process, metabolism, and immune function. There are a variety of factors that can affect the gut microbiome which include your diet and lifestyle, environmental changes, the aging process, stress, and the use of unnecessary antibiotics.
Individual variations in the human microbiota are always present, that is why bio-individuality is important in this space. Research has suggested a link to an imbalance of gut bacteria and some common health conditions. These include, irritable bowel syndrome, inflammatory bowel disease, obesity, diabetes, as well as possible links to mental health conditions through the gut-brain axis.
So now you might ask yourself: How can I support my gut health in the new year? Starting slowly and sustainably is key, and as always, be patient with yourself as you make these changes!
Tip 1: Manage your stress
The gut-brain axis has been an important area of research the last couple years. There is increasing evidence that dysbiosis, or an imbalance of gut microbiota, can contribute to anxiety, and depression. Excess stress can also be a trigger for negative digestive symptoms. Research has shown that using mind-body techniques such as mindfulness-based stress reduction practices can assist with managing stress that could be contributing to digestive issues and other conditions.
Incorporating movement in your everyday life can help reduce stress, this includes practices like yoga, which has been shown to lower cortisol, the primary stress hormone. As always, if you feel like your stress and anxiety have gotten to unmanageable levels seeking professional counseling or psychotherapy is an important measure to take. In fact, therapy can be a wonderful way to explore and reflect on the root cause of your emotions and stress and find the tools to learn more about yourself.
Tip 2: Adjust your diet
Have you heard the term you are what you eat? Our gut microbiome is heavily influenced by the foods that we eat. Eliminating processed and high sugar content foods and incorporating more nutrient dense foods are a great first step that will help your beneficial gut bacteria thrive. Some studies have shown that altering your diet can create temporary microbial shifts within just 24 hours. Incorporating prebiotic foods such as garlic, artichoke, onions, asparagus, leeks, bananas, flaxseeds and oats and more fiber into the diet can help modulate the gut microbiota. Some examples of high fiber foods include, pears, berries, chia seeds, avocados, brussels sprouts, lentils and chickpeas.
Working with a nutritionist or dietician can be a great way to figure out food sensitivities, and to find sustainable ways to include more nutrient dense foods into your diet and find a plan that works for your lifestyle.
Tip 3: Consider a probiotic
As research increases around the relationship between the gut microbiome and different diseases the interest around probiotics has also increased.
While you should always start with lifestyle and diet when approaching gut health, incorporating a well-studied probiotic can also be beneficial in certain circumstances. The most used strains are from the Lactobacillus and Bifidobacterium genera. Other strains such as the Enterococcus and Streptococcus genera are also used in probiotic products.
With so many probiotics on the market it can be challenging to find a product that has its own clinical studies and is a multi-strain product. Probiotics can help your body maintain a healthy community of microbes and can have an influence on your body’s immune response and digestive process. Here are a couple questions to consider when choosing a probiotic:
- Does this specific product have clinical trials to show a health benefit?
- How does this probiotic brand ensure potency of product?
- Does this product contain an appropriate CFU count? (CFU is the unit used to estimate the concentration of microorganisms in the product)
- Does the product have diversity in strains that are used?
Asking the right questions can help you and your healthcare provider make informed choices related to choosing the right probiotic for your needs.
Please note: This article has been written for informational use only. Please consult your doctor before making any changes to your health and diet regimen.
By Melody Khorrami, PharmD, RPh
As the holidays approach, many of us look forward to gathering with family and friends to celebrate and enjoy delicious meals. We are eager to feast on seasonal treats like turkey, stuffing, potatoes, and rolls; not to mention all the desserts! While all this food and company is wonderful, it can be overwhelming to our digestive systems. Fear not! There are steps you can take to help ease the digestive process. This is supposed to be a fun day and you shouldn’t feel any stress or shame about indulging and enjoying the festivities!
Starting your morning off with fiber rich foods can help keep your bowels moving regularly and feed the good bacteria in your gut to help keep your microbiome healthy. Having regular bowel movements is important in eliminating toxins, keeping your hormones balanced, and reducing constipation. The last thing you want is to be constipated on the holidays, right before enjoying your meal. Fiber is naturally found in most fruits and vegetables. So, make sure to include a variety of these in your meals!
Drinking enough filtered water throughout the day is an important step in preventing dehydration, keeping your bowels moving, and digestion. According to studies
inadequate hydration has also been linked to elevated BMI and obesity. Starting your morning with a glass of filtered water or lemon water upon waking is one of the best things you can do you start your day. This is because your body is in a fasted state while sleeping and can be dehydrated upon waking. Lemon water can help with digestion by increasing the production of HCL, also known as hydrochloric acid. Our stomach secretions are made up of hydrochloric acid
, and digestive enzymes that help us digest and absorb nutrients such as proteins in our foods.
Need I say more? Finding the right movement for your body is important to many aspects of your overall health and wellness. Improved digestion is just one!
Take a walk the morning of your dinner plans and perhaps a second one with family and friends about 15 minutes after eating
Daily walking can help reduce bloating, aid in digestion, and help balance your blood sugar after a meal.
Incorporating movement such as yoga not only can be beneficial for mental health but can also help with constipation, insomnia and healthy aging
Consider a quick yoga session during the day or in the evening! Certain poses can aid in regulating the bowels and decrease bloating. Some yoga poses
that could be helpful for the digestive system include:
- Child’s pose, camel pose
- The twisted lunge
- Revolved chair pose
- Bridge pose
- The supine twist
If certain poses are uncomfortable, you should not overextend yourself, there are usually modifications to the movement you can do and still receive great benefits!
can help manage the stress of Holiday season by reducing the sympathetic response of the nervous system which is our “fight or flight response”, when we go into “fight or flight” it can negatively affect our digestive
system and in turn cause the digestive system to function improperly. When the stress response is activated, the central nervous system shuts down digestion which causes the slowing down of the digestive muscles and decreased secretions necessary for optimal digestive processes. This can lead to bloating, gas, and constipation.
The digestive system cannot work optimally if the body and mind are constantly stressed.
Practicing a mix of yoga and breath work techniques have many benefits for mental and physical health and this includes aiding in proper digestion. So, grab a yoga mat, and start moving and breathing!
The gut microbiome houses trillions of microbes that play important roles in our digestion and overall health. These microbes help us breakdown the foods we eat and help with absorption of critical vitamins. When there are more bad bacteria than good bacteria present, it results in a condition known as dysbiosis. When you experience dysbiosis, digestion can become harder and you may have more negative GI symptoms after eating such as bloating, gas, and burping.
can help ease the discomfort associated with bloating, and gas and help your body digest the foods that you eat. Before you start taking a probiotic remember that each person is different, and your needs may not match the needs of the people around you.
Bio-individuality is key in determining which probiotic strains are best for you. Probiotics have very little regulatory oversight, so it is important to identify reputable brands that offer evidence-based research related to their specific product.
I hope you find these GI tips useful on Turkey Day, stay safe, and enjoy!
***The following article is not medical advice. Please talk to your doctor before making changes to your wellness routine. ***
If you're living with a constant state of undiagnosable GI distress you should consider learning more about IBS.
Chances are you've heard about the microbiome at this point. But you may have questions about what exactly it is or why it’s so important. This blog will help explain the microbiome, how probiotics help support it, and why choosing a high potency probiotic is best for keeping your microbiome healthy.
The low FODMAP diet has been gaining awareness for treating digestive issues. This article will help explain what exactly this diet is, how it works, and the pros and cons of following it to help you determine if it’s right for you.