Pregnancy Use

Likely to be safe in pregnancy; however, use of concentrated forms should be supervised by a healthcare professional.

PRACTICE POINTS/PATIENT COUNSELLING

• There is good clinical evidence that probiotics may be beneficial in the treatment of infant diarrhoea, travellers' diarrhoea, acute diarrhoea, antibiotic-induced diarrhoea, urogenital infections, irritable bowel syndrome, inflammatory bowel diseases, H. pylori infections, food intolerances and allergies, leaky gut and eczema.

• There is also some evidence that probiotics are essential for both the development and maintenance of a healthy immune system.

• There is some evidence that probiotics have a modest effect improving the LDLHDL-cholesterol ratio.

• Probiotics can be administered orally or intravaginally. They can also be taken as yoghurt or other cultured dairy products. It should be noted that only products containing actual probiotic strains will be beneficial. The so-called starter cultures do not necessarily have the same beneficial effects.

• Although probiotics may improve the long-term bowel flora, probiotic supplementation has other benefits not associated with direct colonisation of the gastrointestinal tract.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What can probiotics do for me?

Probiotics are beneficial in the treatment of digestive disorders such as diarrhoea and inflammatory bowel diseases and other conditions not directly connected with the digestive tract. Clinical studies have found probiotics to be beneficial in the treatment of antibiotic-induced and travellers' diarrhoea, for vaginal thrush and recurrent cystitis, irritable bowel syndrome, colitis, food allergies and eczema.

© 2007 Elsevier Australia

When will they start to work?

Probiotics can start to exert beneficial effects in digestive disorders within a few days. Long-term benefits are seen after weeks to months of continuous use. Greater results may be obtained if the so-called prebiotics are also added to the diet. Prebiotics refer to the use of compounds that modify the environment of the gastrointestinal tract to favour proliferation of the intestinal microflora. Herbal and nutritional prebiotics include the fibre known as slippery elm (Ulmus fulva), oligofructose and inulin. Are there any safety issues?

Many species of probiotics are integral to the production of fermented foods and have been consumed safely as part of the daily diet for millennia. Other probiotics used as supplements are actually normal, non-pathogenic inhabitants of the human intestinal tract. There have been no reports of probiotics interacting with prescription medication.

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