Our patients may self-treat with prebiotics, probiotics, symbiotics etc. for gastrointestinal, urogenital, and other complaints. Therefore, it may be wise for healthcare providers to know more about the natural substances that have been given so much research attention. There are different types of products, used for different purposes, and at specific therapeutic doses. Further, along with the benefits, there can be risk associated with the use of these (albeit natural) products sold over the counter as nutritional supplements. Prebiotics are substances that nourish the growth and activity of beneficial gut flora, and aid in digestion. Probiotics are strains of beneficial gut bacteria themselves. Symbiotics are a combination of both. They are used to address what is known as bowel dysbiosis,
A study conducted by Malaguarneraa et al (2010) compared the efficacy of a combination of Bifido bacterium (probiotic) and FOS (prebiotic) to lactulose in patients with hepatic encephalopathy (HE). The researchers concluded that the treatment with this symbiotic (probiotic and prebiotic) is a viable alternative for the management of HE in patients with cirrhosis and mild HE.
HE is a sequel of cirrhosis of the liver. It is secondary to the failure of detoxification of gutt-derived toxins normally cleared by the liver (Malaguarneraa et al, 2010, p.199). Treatment goals are to reduce the production and absorption of intestinal toxins including ammonia. The researchers explains the many mechanism by which a combination of this probiotic & prebiotic works to moderate bacterial over growth in the small intestines and bacterial translocation via the portal system to the liver; as well as normalize pH imbalance and ammoniagentics in the gastrointestinal tract etc. The researchers cite a "placebo-controlled pilot study from China on the use of symbiotic found that symbiotic modified the gut flora, reduce endotoxin levels, increase faecal pH, reduced ammonia levels and led to a reversal of minimal HE" (Malaguarneraa et al, 2010, p. 210).
Wilson-Gratz, Mykkanen & El-Nezami (2010, p. 408) cite studies demonstrating that individuals with underlying conditions such as immunodeficiency, diabetes, cancer, antibiotic therapy, and organ transplantation should use probiotics (lactobacillus and bifidobacterium etc.) with caution due to risk for associated infection such as endocarditis, bacteremia (Wilson-Gratz, Mykkanen & El-Nezami, 2010, p. 408). These researchers also investigated the benefits of probiotics for:
Pennisic, G., Voltid G., Galvanod V. (2010). Bifidobacterium combined with fructo-