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++++++++++++++++++++++++++++++++++++++ + + ++++++++++++++++++++++++++++++++++++++ GASTROENTEROLOGY SPOTLIGHT +++ +++ Probiotics: Why They May Benefit Your Patient By Lawrence Hoberman, M.D. AS A GASTROENTEROLOGIST, I have cared for a large number of patients who suffered from intestinal symptoms affecting the quality of their daily lives. Despite extensive testing, no cause was identified for many of the symptoms. These patients' disorders fell into the category of functional bowel disorders like irritable bowel syndrome (IBS). Unfortunately, many did not improve with diet alterations, drug therapy or psychotherapy. It seemed to me we were missing some other cause for their gastrointestinal symptoms. That is when I became interested in learning about the importance of our intestinal bacterial flora. What They Didn't Teach InMedical School Here are a few of things that I have learned: + There are 100 trillion bacteria in the intestines consisting of 500–1,000 different species. Generally, 99% of the bacteria for each person are a composite of 30–40 different species. + The bacteria ferment resistant starches in our diet and produce short-chain fatty acids like butyrate, which the colonocytes depend on for their nutrition and function. + The flora creates a barrier against harmful bacteria by stimulating the production of a mucus layer, maintaining the integrity of the intestinal lining and producing bacteriocins that can destroy pathogens. + The flora interacts with the intestinal immune system to stimulate immunologic responses against pathogens and to regulate the intestinal inflammatory reactions. What Probiotics Can Do Unfortunately, when we eat unhealthful diets, travel, experience stress or take medications like antibiotics, the healthy intestinal bacterial balance can be disrupted. Harmful organisms start to multiply, which can result in a variety of intestinal disorders. Probiotics can help to reestablish a healthy flora and lessen gastrointestinal symptoms like IBS. Probiotics are mainly derived from healthy intestinal flora. These bacteria are selected if they can be shown to: + survive exposure to gastric acid, bile and digestive enzymes + adhere to colon-lining cells and proliferate + be free of any toxicity and safe to ingest As more scientific studies have been published on the mecha- nisms of action and the clinical benefits of probiotics, mainstream medicine has become more comfortable recommending probiotics to patients. Consider a probiotic supplement: + to lessen the risk of antibiotic-related diarrhea (Advise the patient to take a probiotic two hours before or after the antibiotic dose.) + for patients with ongoing symptoms of IBS + for patients, especially those on acid-suppressive therapy, traveling to third-world countries, which increases the risk of developing traveler's diarrhea + for children with infantile colic or IBS + for infants with a strong family history of atopic disease + for children receiving antibiotics like Augmentin for otitis media Dr. Hoberman is board certified in internal medicine and gastroenter- ology. He has a passion for helping people achieve their maximum health and wellness. For further information, e-mail endomune@satx.rr.com or visit www.endomune.com. s