SCIENTIFIC INSIGHTS
What are probiotics? And what is microbiota?
You have certainly heard about probiotics and microbiota. But what are they?
Probiotics are micro-organisms, belonging to various families, that naturally colonise various parts of our body and are vital for us.
Probiotics naturally present in our gastro-intestinal tract are mainly bacteria and yeasts and they form the gut microbiota, i.e. our intestinal flora. It is an ecosystem that, when in balance, optimally supports our intestinal functions and protects us from external agents that can cause alterations and, consequently, various discomforts.
When the microbiota is balanced, it is in a state called eubiosis. Conversely, when it is not, the state is called dysbiosis.
What can cause imbalance in the gut microbiota?
There are many factors that can lead to dysbiosis, or an imbalance of the intestinal microbiota, such as poor diet, stress, and antibiotic treatments.
The most common consequences of dysbiosis include:
- Meteorism (gas in your belly)
- Bloating
- Diarrhea
- Constipation
- Mixed bowel habits (alternating diarrhea and constipation).
- Digestive difficulties.
Which is no good, indeed!
What to do to maintain a balanced microbiota?
First of all, it is important to address lifestyle factors, such as diet, stress, and generally all those habits that can impact on our well-being. Additionally, it is essential to include specific probiotics. That is why you need to pay attention to the type of product you choose.
What makes a good probiotic for the intestines? First, it should provide a wide variety of probiotics from multiple families, genera, species, and strains.
This is because our intestine hosts a multitude of different species of microorganisms. Hence, providing an altered intestine with only one type of probiotic would therefore be a rather “limited” approach.
Certainly, it might have a beneficial effect in the short term, but if you want to adequately restore your intestinal flora, which is a true ecosystem, you need to support it with a variety of different probiotics to ensure that the colonisation—which, in this case, is a beneficial one —is as diverse as possible.
If you think about it, this concept is similar to that of biodiversity. If an area has a high biodiversity, it is considered healthy. On the other hand, when the plant and animal species present in an area are limited in terms of distribution and variety, then that area is considered as degraded.
This is why in ProbioGea Intestino you will find a rich complex of probiotics—lactobacilli, bifidobacteria, bacilli, and yeasts— belonging to different families, genera, species, and strains, all naturally present in healthy intestines.
Let’s now take a look at some studies conducted on the probiotics we have selected.
Scientific Insights
SynbÆctive® SmilinGut
Presti I, D’Orazio G, Labra M, et al. Evaluation of the probiotic properties of new Lactobacillus and Bifidobacterium strains and their in vitro effect. Appl Microbiol Biotechnol. 2015 Jul;99(13):5613-26. doi: 10.1007/s00253-015-6482-8. Epub 2015 Mar 7. PMID: 25744647.
In this test on Escherichia coli - one of the strains most frequently responsible for severe food poisoning and gastrointestinal infections (diarrhea, nausea, abdominal cramps, fatigue, and fever) - it was observed that the probiotic complex SynbÆctive® SmilinGut was more effective in reducing the concentration of Escherichia coli compared to the individual strains. Essentially, the probiotic complex exhibited an antimicrobial effect that prevents the pathogen from replicating thus stopping the colonisation, and this effect remains stable over time. This demonstrates how important it is to act synergistically with a complex that offers multiple probiotics able to protect the intestines on the long term.
D’Orazio G, Di Gennaro P, Boccarusso M, et al. Microencapsulation of new probiotic formulations for gastrointestinal delivery: in vitro study to assess viability and biological properties. Appl Microbiol Biotechnol. 2015 Nov;99(22):9779-89. doi: 10.1007/s00253-015-6853-1. Epub 2015 Aug 4. PMID: 26239070.
This in vitro study on human intestinal cells showed that the probiotic complex SynbÆctive® SmilinGut can positively influence various aspects of the intestinal mucosa physiology, ensuring protection against inflammatory and oxidative stress. This is because the complex can reduce pro-inflammatory mediators (responsible for inflammation) and increase the anti-inflammatory ones, with better and longer lasting results compared to individual strains. We can therefore reaffirm that it is important to support the intestines with multiple types of probiotics, simultaneously.
Mezzasalma V, Manfrini E, Ferri E, et al. A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation. Biomed Res Int. 2016;2016:4740907. doi: 10.1155/2016/4740907. Epub 2016 Aug 9. Erratum in: Biomed Res Int. 2019 Apr 9;2019:9042956. PMID: 27595104; PMCID: PMC4993960.
This clinical study involved 100 subjects of both sexes, aged between 18 and 65 years, suffering from irritable bowel syndrome with constipation. Participants were divided into two groups and received either the probiotic complex or a placebo for 60 days. After the treatment suspension, a 30-day follow-up was carried out. What came up? In the placebo group, the level of “good” bacteria had remained close to 0 or decreased, while in the probiotic complex group with SynbÆctive® SmilinGut, the “good” bacteria had significantly increased. Additionally, the test group experienced remarkable improvements in terms of constipation, bloating, abdominal pain, flatulence, and abdominal cramps over a long period of time after treatment. This confirms that the probiotic complex is beneficial for the gut microbiota and that the resulting benefits are long-lasting.
Bifidobacterium longum
Bonfrate L, Di Palo DM, Celano G, et al. Effects of Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001 in IBS patients. Eur J Clin Invest. 2020 Mar;50(3):e13201. doi: 10.1111/eci.13201. Epub 2020 Feb 12. PMID: 31960952.
In this clinical study, 25 patients with irritable bowel syndrome received a combined treatment of Bifidobacterium longum and Lactobacillus rhamnosus (the latter from SynbÆctive® SmilinGut) and a placebo. Compared to the placebo, B. longum and L. rhamnosus induced greater reductions in abdominal pain (-50% vs -3.5%), abdominal bloating (-36% vs -7%), and overall symptom severity (-30% vs -0.4%). Additionally, both patients suffering from diarrhea and patients suffering from constipation experienced improvements in stool formation. Finally, the test group also showed a clear improvement in sucralose recovery, a test for colon permeability that indicates whether and to what extent the colon is “leaky”. An increase in short-chain fatty acids was observed, indicating a restoration of metabolic conditions of the intestinal flora. Therefore, treatment with B. longum and L. rhamnosus effectively improves the symptoms and severity of the irritable bowel syndrome, in both diarrhea and constipation cases.
Colecchia A, Vestito A, La Rocca A, et al.; Symbiotic Study Group. Effect of a symbiotic preparation on the clinical manifestations of irritable bowel syndrome, constipation-variant. Results of an open, uncontrolled multicenter study. Minerva Gastroenterol Dietol. 2006 Dec;52(4):349-58. PMID: 17108864.
This clinical study involved over 600 patients with irritable bowel syndrome characterized by constipation. The patients were enrolled in 43 different centres - diverse case histories -and were divided into two groups, receiving either a placebo or a treatment with Bifidobacterium longum and a prebiotic. Results: with the treatment, the number of patients without abdominal bloating increased tenfold, and the proportion of patients without abdominal pain rose from 8.4% to 44.1%. Among patients with moderate to severe symptoms, the frequency of symptoms decreased sixfold for bloating and from 38.8% to 4.1% for abdominal pain. Additionally, the frequency of bowel movements significantly increased after treatment. Therefore, the administration of B. longum may be beneficial for patients with irritable bowel syndrome with constipation.
Skrzydło-Radomańska B, Prozorow-Król B, Cichoż-Lach H, et al. The Effectiveness of Synbiotic Preparation Containing Lactobacillus and Bifidobacterium Probiotic Strains and Short Chain Fructooligosaccharides in Patients with Diarrhea Predominant Irritable Bowel Syndrome-A Randomized Double-Blind, Placebo-Controlled Study. Nutrients. 2020 Jul 5;12(7):1999. doi: 10.3390/nu12071999. PMID: 32635661; PMCID: PMC7400954.
This clinical study involved 68 patients with irritable bowel syndrome characterized by diarrhea (IBS-D). They were administered either a placebo or lactobacilli and bifidobacteria over a period of 8 weeks. Compared to the placebo, the treatment significantly improved all parameters of IBS-D, leading to better scores related to flatulence and bowel habits (the frequency of bowel movements was normalised). Patients reported a significant improvement in the sensation of incomplete bowel movements, flatulence, pain, fecal pressure, and diarrhea. Therefore, lactobacilli and bifidobacteria are also beneficial in cases of irritable bowel syndrome with diarrhea.
Bacillus coagulans
Majeed M, Nagabhushanam K, Paulose S, Arumugam S, Mundkur L. The effects of Bacillus coagulans MTCC 5856 on functional gas and bloating in adults: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2023 Mar 3;102(9):e33109. doi: 10.1097/MD.0000000000033109. PMID: 36862903; PMCID: PMC9982755.
This clinical study involved 68 adults with gas and abdominal bloating. Participants were administered either Bacillus coagulans or a placebo for 4 weeks. The results showed significant changes in clinical scores, corresponding to symptomatic improvement, suggesting that B. coagulans can be a valuable ally in reducing gastrointestinal symptoms in adults with gas production and abdominal bloating.
Gupta AK, Maity C. Efficacy and safety of Bacillus coagulans LBSC in irritable bowel syndrome: A prospective, interventional, randomized, double-blind, placebo-controlled clinical study [CONSORT Compliant]. Medicine (Baltimore). 2021 Jan 22;100(3):e23641. doi: 10.1097/MD.0000000000023641. PMID: 33545934; PMCID: PMC7837859.
This study on patients with irritable bowel syndrome (IBS) showed that the administration of Bacillus coagulans, compared to the placebo, significantly improved a wide range of symptoms: bloating/cramps, abdominal pain, diarrhea, constipation, stomach rumbling, nausea, vomiting, headaches, and anxiety. Therefore, B. coagulans has proved to be effective in alleviating the pathophysiological symptoms of IBS and, consequently, in improving the overall quality of life for those affected by the syndrome.
Saccharomyces boulardii
Fidan I, Kalkanci A, Yesilyurt E, et al. Effects of Saccharomyces boulardii on cytokine secretion from intraepithelial lymphocytes infected by Escherichia coli and Candida albicans. Mycoses. 2009 Jan;52(1):29-34. doi: 10.1111/j.1439-0507.2008.01545.x. Epub 2008 Jun 21. PMID: 18627477.
This in vitro study investigated the influence of Saccharomyces boulardii on cytokine secretion from intraepithelial lymphocytes infected with Escherichia coli and Candida albicans. Results showed that S. boulardii may have protective effects against Escherichia coli and Candida albicans by reducing the pro-inflammatory response.
Carstensen JW, Chehri M, Schønning K, Rasmussen SC, Anhøj J, Godtfredsen NS, Andersen CØ, Petersen AM. Use of prophylactic Saccharomyces boulardii to prevent Clostridium difficile infection in hospitalized patients: a controlled prospective intervention study. Eur J Clin Microbiol Infect Dis. 2018 Aug;37(8):1431-1439. doi: 10.1007/s10096-018-3267-x. Epub 2018 May 3. PMID: 29725956.
Clostridium difficile is a pathogen that often develops further to antibiotic use. The study evaluated the effectiveness of Saccharomyces boulardii in preventing C. difficile infections in hospitalised patients treated with antibiotics. Results showed that preventive treatment with S. boulardii reduces by over 50% the likelihood of contracting infection in hospitals.
Kabbani TA, Pallav K, Dowd SE, et al. Prospective randomized controlled study on the effects of Saccharomyces boulardii CNCM I-745 and amoxicillin-clavulanate or the combination on the gut microbiota of healthy volunteers. Gut Microbes. 2017 Jan 2;8(1):17-32. doi: 10.1080/19490976.2016.1267890. Epub 2016 Dec 14. PMID: 27973989; PMCID: PMC5341914.
During this 14-day study, 49 healthy subjects were divided into 4 groups and were administered S. boulardii, antibiotics (Amoxicillin-Clavulanate), antibiotics + S. boulardii, and a placebo. The subjects treated with S. boulardii associated with antibiotics experienced fewer adverse effects and tolerated antibiotics better than those who received antibiotics only. Besides, the antibiotic group showed significant deteriorations of the microbiota, which had not yet fully recovered two weeks after antibiotic suspension. The addition of S. boulardii to the antibiotic resulted in less pronounced changes in the microbiota and a reduction in antibiotic-associated diarrhea. Hence, the addition of S. boulardii to antibiotics can mitigate some of the microbiota changes induced by antibiotics and may also reduce diarrhea associated with antibiotic therapies.
Inulin from chicory
Qin YQ, Wang LY, Yang XY, et al. Inulin: properties and health benefits. Food Funct. 2023 Apr 3;14(7):2948-2968. doi: 10.1039/d2fo01096h. PMID: 36876591.
This review of studies focuses on the function of inulin and its health benefits, including a proven prebiotic activity, which stimulates the growth of beneficial bacteria and contributes to the balance of the intestinal microbiota
Hughes RL, Alvarado DA, Swanson KS, Holscher HD. The Prebiotic Potential of Inulin-Type Fructans: A Systematic Review. Adv Nutr. 2022 Mar;13(2):492-529. doi: 10.1093/advances/nmab119. Epub 2023 Feb 10. PMID: 34555168; PMCID: PMC8970830.
This review of studies confirms the prebiotic effect of inulin on the intestinal microbiota - where it increases the number of bifidobacteria and lactobacilli - and its beneficial action on the intestinal barrier function.
DISCLAIMER
Our texts are for informational purposes only and should not be considered as indications for diagnosis and treatment of pathological conditions. They cannot replace your physician’s advice.
I nostri testi hanno scopo divulgativo, non vanno intesi come indicazione di diagnosi e cura di stati patologici e non vogliono sostituirsi in alcun modo al parere del Medico.
