The Gut Microbiome: Probiotics vs Prebiotics

Historically, we have thought that adding a probiotic to our diet will enhance digestion and aid in limiting irritable bowel issues like diarrhea or constipation. Savvy marketing also encouraged many to rush to eating yogurts to assist with probiotic growth. Probiotic supplements such as Culturelle and Align can be quite costly to take regularly. New research is showing promising results for prebiotic foods improving the gut microbiome in place of probiotic supplements.

The gut microbiome and why is it important? The gut microbiome is the ecosystem of biota that live in our intestines. These bacteria aid in function of not only digestion, but also our immune, cardiac, and mental function. Perhaps the most surprising functions of the gut is creating dopamine and serotonin - the hormones that make us happy people!

The American GI Association published new guidelines recommending that probiotics NOT be used to treat most digestive conditions, stating that the evidence of their benefit is lacking. In fact, there are only three subsets of conditions that have robust research to support their use.

• Preterm (born before 37 weeks gestation), low birth weight (<2500 g or 5.5 lb) infants where specific probiotics can reduce risk of necrotizing enterocolitis and mortality.

• For the preventions of of C. difficile, a gut bacteria that can cause an infection of the colon, for adults and children on antibiotics

• For management of those with pouchitis, a condition that is a complication of ulcerative colitis.

We have now turned to the effects of adding prebiotic foods to our diets to aid in building the gut microbiome. These are typically rich in fiber and nutrients.

Some of the foods we like to recommend:

• fermented foods such as sourdough, sauerkraut, and kimchi

• dark, leafy greens

• beans/legumes

• kiwis

While addressing diet your physical therapist will address hydration, activity, sleep hygiene, as well as musculoskeletal contributions for optimal bowel function!