Lactobacillus acidophilus is a friendly strain of bacteria used to make yogurt and cheese. Although we are born without it, acidophilus soon establishes itself in our intestines and helps prevent intestinal infections. Acidophilus also flourishes in the vagina, where it protects women against yeast infections.
Acidophilus is one of several microbes known collectively as probiotics (literally, pro life indicating that they are bacteria and yeasts that help rather than harm). Others include the bacteria L. bulgaricus, L. reuteri, L. plantarum, L. casei, B. bifidus, S. salivarius, and S. thermophilus and the yeast Saccharomyces boulardii. Your digestive tract is like a rain forest ecosystem, with billions of bacteria and yeasts rather than trees, frogs, and leopards. Some of these internal inhabitants are more helpful to your body than others. Acidophilus and related probiotics not only help the digestive tract function, they also reduce the presence of less healthful organisms by competing with them for the limited space available. For this reason, use of probiotics can help prevent infectious diarrhea.
Antibiotics can disturb the balance of your inner rain forest by killing friendly bacteria. When this happens, harmful bacteria and yeasts can move in and flourish. This can lead to vaginal yeast infections. Conversely, it appears that the regular use of probiotics can help prevent vaginal infections and generally improve the health of the gastrointestinal system. Whenever you take antibiotics, you should probably take probiotics as well, and continue them for some time after you are done with the course of treatment.
Acidophilus and Other Probiotics
Sources
Although we believe that they are helpful and perhaps even necessary for human health, we don't have a daily requirement for probiotic bacteria. They are living creatures, not chemicals, so they can sustain themselves in your body unless something comes along to damage them, such as antibiotics.
Cultured dairy products such as yogurt and kefir are good sources of acidophilus and other probiotic bacteria. Supplements are widely available in powder, liquid, capsule, or tablet form. Grocery stores and natural food stores both carry milk that contains live acidophilus.
Dosages
Dosages of acidophilus are expressed not in grams or milligrams, but in billions of organisms. A typical daily dose should supply about 3 to 5 billion live organisms. Other probiotic bacteria are used similarly. The typical dose of S. boulardii yeast is 500 mg twice daily (standardized to provide 3 x 10 colony-forming units per gram), to be taken while traveling, or at the start of using antibiotics and continuing for a few days after antibiotics are stopped.
Because probiotics are not drugs, but rather living organisms that you are trying to transplant to your digestive tract, it is necessary to take the treatment regularly. Each time you do, you reinforce the beneficial bacterial colonies in your body, which may gradually push out harmful bacteria and yeasts growing there.
The downside of using a living organism is that probiotics may die on the shelf. In fact, a study reported in 1990 found that most acidophilus capsules on the market contained no living acidophilus.The container label should guarantee living acidophilus (or bulgaricus, and so on) at the time of purchase, not just at the time of manufacture. Another approach is to eat acidophilus-rich foods such as yogurt, where the bacteria are most likely still alive.
To treat or prevent vaginal infections, mix 2 tablespoons of yogurt or the contents of a couple of capsules of acidophilus with warm water and use as a douche.
Finally, in addition to increasing your intake of probiotics, you can take fructo-oligosaccharides, supplements that can promote thriving colonies of helpful bacteria in the digestive tract. (Fructo-oligosaccharides are carbohydrates found in fruit. Fructo means \"fruit,\" and an oligosaccharide is a type of carbohydrate.) Taking this supplement is like putting manure in a garden; it is thought to foster a healthy environment for the bacteria you want to have inside you. The typical daily dose of fructo-oligosaccharides is between 2 and 8 g.
Because probiotics are not drugs, but rather living organisms that you are trying to transplant to your digestive tract, it is necessary to take the treatment regularly. Each time you do, you reinforce the beneficial bacterial colonies in your body, which may gradually push out harmful bacteria and yeasts growing there.
The downside of using a living organism is that probiotics may die on the shelf. In fact, a study reported in 1990 found that most acidophilus capsules on the market contained no living acidophilus.The container label should guarantee living acidophilus (or bulgaricus, and so on) at the time of purchase, not just at the time of manufacture. Another approach is to eat acidophilus-rich foods such as yogurt, where the bacteria are most likely still alive.
To treat or prevent vaginal infections, mix 2 tablespoons of yogurt or the contents of a couple of capsules of acidophilus with warm water and use as a douche.
Finally, in addition to increasing your intake of probiotics, you can take fructo-oligosaccharides, supplements that can promote thriving colonies of helpful bacteria in the digestive tract. (Fructo-oligosaccharides are carbohydrates found in fruit. Fructo means \"fruit,\" and an oligosaccharide is a type of carbohydrate.) Taking this supplement is like putting manure in a garden; it is thought to foster a healthy environment for the bacteria you want to have inside you. The typical daily dose of fructo-oligosaccharides is between 2 and 8 g.
Uses
Evidence from many but not all trials suggests that acidophilus and other probiotics may be helpful for preventing travelers diarrhea and diarrhea caused by antibiotics, chemotherapy, or radiation therapy, as well as preventing and treating infectious viral diarrhea; it may also help irritable bowel syndrome.
Probiotics may also be helpful for preventing or treating eczema preventing vaginal yeast infections treating ulcerative colitis and improving immunity.
The bacteria Helicobacter pylori is the main cause of ulcers in the stomach and duodenum. Antibiotics can kill H. pylori, but more than one must be used at once, and even then the bacteria is not necessarily eradicated. Probiotics may be helpful. Evidence suggests that various probiotics in the Lactobacillus family can inhibit the growth of H. pylori. While this effect does not appear to be strong enough for probiotic treatment to eradicate H. pylori on its own, preliminary trials (none of which were double-blind) suggest that probiotics may help standard antibiotic therapy work better, improving the rate of eradication and reducing side effects.
Preliminary double-blind trials suggest that probiotics might help prevent heart disease by reducing cholesterol levels.
Probiotic treatment has also been proposed as a treatment for canker sores and Crohns disease, and as a preventative measure against colon cancer, but there is no solid evidence that it is effective
There is some evidence that probiotics can help reduce symptoms of milk allergies when added to milk.
Finally, probiotics may be helpful in a controversial condition known as yeast hypersensitivity syndrome (also known as chronic candidiasis, chronic candida, systemic candidiasis, or just candida). As described by some alternative medicine practitioners, yeast hypersensitivity syndrome consists of a population explosion of the normally benign Candida yeast that live in the vagina and elsewhere in the body, coupled with a type of allergic sensitivity to it. Probiotic supplements are widely recommended for this condition because they establish large, healthy populations of friendly bacteria that compete with the Candida that is trying to take up residence.
A year-long open trial of 150 women found Lactobacillus probiotics ineffective for preventing urinary tract infections as compared to cranberry juice or no treatment.
Probiotics may also be helpful for preventing or treating eczema preventing vaginal yeast infections treating ulcerative colitis and improving immunity.
The bacteria Helicobacter pylori is the main cause of ulcers in the stomach and duodenum. Antibiotics can kill H. pylori, but more than one must be used at once, and even then the bacteria is not necessarily eradicated. Probiotics may be helpful. Evidence suggests that various probiotics in the Lactobacillus family can inhibit the growth of H. pylori. While this effect does not appear to be strong enough for probiotic treatment to eradicate H. pylori on its own, preliminary trials (none of which were double-blind) suggest that probiotics may help standard antibiotic therapy work better, improving the rate of eradication and reducing side effects.
Preliminary double-blind trials suggest that probiotics might help prevent heart disease by reducing cholesterol levels.
Probiotic treatment has also been proposed as a treatment for canker sores and Crohns disease, and as a preventative measure against colon cancer, but there is no solid evidence that it is effective
There is some evidence that probiotics can help reduce symptoms of milk allergies when added to milk.
Finally, probiotics may be helpful in a controversial condition known as yeast hypersensitivity syndrome (also known as chronic candidiasis, chronic candida, systemic candidiasis, or just candida). As described by some alternative medicine practitioners, yeast hypersensitivity syndrome consists of a population explosion of the normally benign Candida yeast that live in the vagina and elsewhere in the body, coupled with a type of allergic sensitivity to it. Probiotic supplements are widely recommended for this condition because they establish large, healthy populations of friendly bacteria that compete with the Candida that is trying to take up residence.
A year-long open trial of 150 women found Lactobacillus probiotics ineffective for preventing urinary tract infections as compared to cranberry juice or no treatment.
Scientific Evidence
Travelers Diarrhea
According to several studies, it appears that regular use of acidophilus and other probiotics can help prevent "travelers diarrhea" (an illness caused by eating contaminated food, usually in developing countries).One double-blind placebo-controlled study followed 820 individuals traveling to southern Turkey, and found that use of a probiotic called Lactobacillus GG significantly protected against intestinal infection.
Other studies using S. boulardii have found similar benefits including a double-blind placebo-controlled trial enrolling 3,000 Austrian travelers.The greatest benefits were seen in travelers who visited North Africa and Turkey. The researchers noted the benefit depended on consistent use of the product, and a dosage of 1,000 mg daily was more effective than 250 mg daily.
Infectious Diarrhea
Probiotics may also help prevent or treat acute infectious diarrhea in children and adults.
A review of the literature published in 2001 found 13 double-blind placebo-controlled trials on the use of probiotics for acute infectious diarrhea in infants and children; 10 of these trials involved treatment, and 3 involved prevention.Overall, the evidence suggests that probiotics can significantly reduce the duration of diarrhea and perhaps help prevent it. The evidence is strongest for the probiotic Lactobacillus GG, and for infection and with a particular virus called rotavirus.
For example, one double-blind placebo-controlled trial of 269 children (age 1 month to 3 years) with acute diarrhea found that those treated with Lactobacillus GG recovered more quickly than those given placebo.The best results were seen among children with rotavirus infection (rotavirus is a virus that can cause severe diarrhea in children). Similar results with Lactobacillus GG were seen in a double-blind study of 71 children.
In addition, a double-blind study evaluated the possible benefits of the probiotic L. reuteri in 66 children with rotavirus diarrhea.The study found that treatment shortened the duration of symptoms, and the higher the dose, the better the effect.
A double-blind placebo-controlled study of 81 hospitalized children found that treatment with Lactobacillus GG reduced the risk of developing diarrhea, particularly rotavirus infection.A double-blind placebo-controlled study found that Lactobacillus GG helped prevent diarrhea in 204 undernourished children.
The probiotics B. bifidum, Streptococcus thermophilus,L. casei, Lactobacillus LB, and S. boulardii may also help prevent or treat diarrhea in infants and children.One study found that bacteria in the B. bifidum family can kill numerous bacteria that cause diarrhea.
Keep in mind that diarrhea in young children can be serious. If it persists for more than a day, you should take your child to a physician.
A large (211 participant) double-blind, placebo controlled study found that adults can benefit from probiotic treatment as well.
Antibiotic-Related Diarrhea
The results of many but not all double-blind and open trials suggest that probiotics, including S. boulardii and Lactobacillus GG, may help prevent or reduce antibiotic-related diarrhea.One study evaluated 180 individuals, who received either placebo or 1,000 mg of saccharomyces daily along with their antibiotic treatment, and found that the treated group developed diarrhea significantly less often.A similar study of 193 individuals also found benefit.However, a study of 302 individuals found no benefit with Lactobacillus GG.
Other Forms of Diarrhea
Preliminary evidence suggests that probiotics may be helpful for reducing diarrheas and other gastrointestinal side effects caused by cancer treatment (radiation or chemotherapy).
Small double-blind studies suggest S. boulardii might be helpful for treating chronic diarrhea in people with HIV, hospitalized patients being tube-fed, and individuals with Crohns disease.
Ulcerative Colitis
A double-blind trial of 116 individuals with ulcerative colitis compared probiotic treatment against a relatively low dose of the standard drug mesalazine.The results suggest that probiotic treatment might be equally effective as low-dose mesalazine for controlling symptoms and maintaining remission. Evidence of benefit was seen in other trials as well.
Probiotics might be useful for individuals with ulcerative colitis who have had part or all of the colon removed. Such individuals frequently develop a complication called "pouchitis," inflammation of part of the remaining intestine. A 9-month double-blind trial of 40 individuals found that a combination of three probiotic bacteria could significantly reduce the risk of a pouchitis flare-up.Participants were given either placebo or a mixture of various probiotics, including four strains of Lactobacilli, three strains of Bifidobacteria, and one strain of Streptococcus salivarius. The results showed that treated individuals were far less likely to have relapses of pouchitis.
Irritable Bowel Syndrome
People with irritable bowel syndrome (IBS) experience crampy digestive pain as well as alternating diarrhea and constipation and other symptoms. Although the cause of irritable bowel syndrome is not known, one possibility is a disturbance in healthy intestinal bacteria. Based on this theory, probiotics have been tried as a treatment for IBS.
In a 4-week double-blind placebo-controlled trial of 60 individuals with IBS, treatment with L. plantarum reduced intestinal gas significantly.The benefits persisted for an additional year after treatment was stopped.
In another 4-week, double-blind trial, 40 individuals with IBS again received either L. plantarum or placebo.The results showed improved overall symptoms in the treated group as compared to the placebo group.
A small 6 week trial using L. acidophilus also found indications of benefit.However, in a double-blind, placebo-controlled crossover study of 24 individuals with irritable bowel syndrome, use of Lactobacillus GG failed to produce any noticeable benefit.
Eczema
Use of probiotics during pregnancy and after childbirth may reduce risk of childhood eczema. In a double-blind placebo-controlled trial that enrolled 159 women, participants received either placebo or Lactobacillus GG capsules beginning 2 to 4 weeks before expected delivery.After delivery, breast-feeding mothers continued to take placebo or the probiotic for 6 months; formula-fed infants were given placebo or probiotic directly for the same period of time. The results showed that use of Lactobacillus GG reduced childrens risk of developing eczema by approximately 50%.
According to two-double blind trials, infants who already have eczema may benefit from probiotics as well.
Vaginal Yeast Infections
A review of the many studies on the use of oral and topical acidophilus to prevent vaginal yeast infections concluded that it may be effective, but more study is needed.
Immunity
A number of studies suggest that various probiotics can enhance immune function; however, most of them were not double-blind.One 12-week double-blind placebo-controlled trial evaluated 25 healthy elderly individuals, half of whom were given milk containing a particular strain of Bifidobacterium lactis, the others milk alone.The results showed various changes in immune parameters which the researchers took as possibly indicating improved immune function. Another double-blind placebo-controlled study of 50 people using B. lactis had similar results.
In addition, a 7-month double-blind placebo-controlled study of 571 children in day-care centers in Finland found that use of milk fortified with Lactobacillus GG reduced the number and severity of respiratory infections.
Cholesterol
An 8-week double-blind placebo-controlled trial of 70 overweight individuals found that a probiotic treatment containing S. thermophilus and Enterococcus faecium could reduce LDL ("bad") cholesterol by about 8%.Similarly positive results were seen in other trials of the same or other probiotics.However, a 6-month double-blind placebo-controlled trial found no long-term benefit.Researchers speculate that participants stopped using the product regularly toward the later parts of the study.
According to several studies, it appears that regular use of acidophilus and other probiotics can help prevent "travelers diarrhea" (an illness caused by eating contaminated food, usually in developing countries).One double-blind placebo-controlled study followed 820 individuals traveling to southern Turkey, and found that use of a probiotic called Lactobacillus GG significantly protected against intestinal infection.
Other studies using S. boulardii have found similar benefits including a double-blind placebo-controlled trial enrolling 3,000 Austrian travelers.The greatest benefits were seen in travelers who visited North Africa and Turkey. The researchers noted the benefit depended on consistent use of the product, and a dosage of 1,000 mg daily was more effective than 250 mg daily.
Infectious Diarrhea
Probiotics may also help prevent or treat acute infectious diarrhea in children and adults.
A review of the literature published in 2001 found 13 double-blind placebo-controlled trials on the use of probiotics for acute infectious diarrhea in infants and children; 10 of these trials involved treatment, and 3 involved prevention.Overall, the evidence suggests that probiotics can significantly reduce the duration of diarrhea and perhaps help prevent it. The evidence is strongest for the probiotic Lactobacillus GG, and for infection and with a particular virus called rotavirus.
For example, one double-blind placebo-controlled trial of 269 children (age 1 month to 3 years) with acute diarrhea found that those treated with Lactobacillus GG recovered more quickly than those given placebo.The best results were seen among children with rotavirus infection (rotavirus is a virus that can cause severe diarrhea in children). Similar results with Lactobacillus GG were seen in a double-blind study of 71 children.
In addition, a double-blind study evaluated the possible benefits of the probiotic L. reuteri in 66 children with rotavirus diarrhea.The study found that treatment shortened the duration of symptoms, and the higher the dose, the better the effect.
A double-blind placebo-controlled study of 81 hospitalized children found that treatment with Lactobacillus GG reduced the risk of developing diarrhea, particularly rotavirus infection.A double-blind placebo-controlled study found that Lactobacillus GG helped prevent diarrhea in 204 undernourished children.
The probiotics B. bifidum, Streptococcus thermophilus,L. casei, Lactobacillus LB, and S. boulardii may also help prevent or treat diarrhea in infants and children.One study found that bacteria in the B. bifidum family can kill numerous bacteria that cause diarrhea.
Keep in mind that diarrhea in young children can be serious. If it persists for more than a day, you should take your child to a physician.
A large (211 participant) double-blind, placebo controlled study found that adults can benefit from probiotic treatment as well.
Antibiotic-Related Diarrhea
The results of many but not all double-blind and open trials suggest that probiotics, including S. boulardii and Lactobacillus GG, may help prevent or reduce antibiotic-related diarrhea.One study evaluated 180 individuals, who received either placebo or 1,000 mg of saccharomyces daily along with their antibiotic treatment, and found that the treated group developed diarrhea significantly less often.A similar study of 193 individuals also found benefit.However, a study of 302 individuals found no benefit with Lactobacillus GG.
Other Forms of Diarrhea
Preliminary evidence suggests that probiotics may be helpful for reducing diarrheas and other gastrointestinal side effects caused by cancer treatment (radiation or chemotherapy).
Small double-blind studies suggest S. boulardii might be helpful for treating chronic diarrhea in people with HIV, hospitalized patients being tube-fed, and individuals with Crohns disease.
Ulcerative Colitis
A double-blind trial of 116 individuals with ulcerative colitis compared probiotic treatment against a relatively low dose of the standard drug mesalazine.The results suggest that probiotic treatment might be equally effective as low-dose mesalazine for controlling symptoms and maintaining remission. Evidence of benefit was seen in other trials as well.
Probiotics might be useful for individuals with ulcerative colitis who have had part or all of the colon removed. Such individuals frequently develop a complication called "pouchitis," inflammation of part of the remaining intestine. A 9-month double-blind trial of 40 individuals found that a combination of three probiotic bacteria could significantly reduce the risk of a pouchitis flare-up.Participants were given either placebo or a mixture of various probiotics, including four strains of Lactobacilli, three strains of Bifidobacteria, and one strain of Streptococcus salivarius. The results showed that treated individuals were far less likely to have relapses of pouchitis.
Irritable Bowel Syndrome
People with irritable bowel syndrome (IBS) experience crampy digestive pain as well as alternating diarrhea and constipation and other symptoms. Although the cause of irritable bowel syndrome is not known, one possibility is a disturbance in healthy intestinal bacteria. Based on this theory, probiotics have been tried as a treatment for IBS.
In a 4-week double-blind placebo-controlled trial of 60 individuals with IBS, treatment with L. plantarum reduced intestinal gas significantly.The benefits persisted for an additional year after treatment was stopped.
In another 4-week, double-blind trial, 40 individuals with IBS again received either L. plantarum or placebo.The results showed improved overall symptoms in the treated group as compared to the placebo group.
A small 6 week trial using L. acidophilus also found indications of benefit.However, in a double-blind, placebo-controlled crossover study of 24 individuals with irritable bowel syndrome, use of Lactobacillus GG failed to produce any noticeable benefit.
Eczema
Use of probiotics during pregnancy and after childbirth may reduce risk of childhood eczema. In a double-blind placebo-controlled trial that enrolled 159 women, participants received either placebo or Lactobacillus GG capsules beginning 2 to 4 weeks before expected delivery.After delivery, breast-feeding mothers continued to take placebo or the probiotic for 6 months; formula-fed infants were given placebo or probiotic directly for the same period of time. The results showed that use of Lactobacillus GG reduced childrens risk of developing eczema by approximately 50%.
According to two-double blind trials, infants who already have eczema may benefit from probiotics as well.
Vaginal Yeast Infections
A review of the many studies on the use of oral and topical acidophilus to prevent vaginal yeast infections concluded that it may be effective, but more study is needed.
Immunity
A number of studies suggest that various probiotics can enhance immune function; however, most of them were not double-blind.One 12-week double-blind placebo-controlled trial evaluated 25 healthy elderly individuals, half of whom were given milk containing a particular strain of Bifidobacterium lactis, the others milk alone.The results showed various changes in immune parameters which the researchers took as possibly indicating improved immune function. Another double-blind placebo-controlled study of 50 people using B. lactis had similar results.
In addition, a 7-month double-blind placebo-controlled study of 571 children in day-care centers in Finland found that use of milk fortified with Lactobacillus GG reduced the number and severity of respiratory infections.
Cholesterol
An 8-week double-blind placebo-controlled trial of 70 overweight individuals found that a probiotic treatment containing S. thermophilus and Enterococcus faecium could reduce LDL ("bad") cholesterol by about 8%.Similarly positive results were seen in other trials of the same or other probiotics.However, a 6-month double-blind placebo-controlled trial found no long-term benefit.Researchers speculate that participants stopped using the product regularly toward the later parts of the study.
Safety Issues
There are no known safety problems with the use of acidophilus or other probiotics. Occasionally, some people notice a temporary increase in digestive gas.
Interactions
If you are taking antibiotics, it may be beneficial to take probiotic supplements at the same time, and to continue them for a couple of weeks after you have finished the course of drug treatment. This will help restore the balance of natural bacteria in your digestive tract.
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