Probiotics. They’re a health trend that refuses to fade away. And on the surface, it’s easy to see why. You take a pill, drink a yogurt, and voila – your gut health is supposedly on its way to being supercharged. But like so many things in the health and wellness world, the truth about probiotics is more complex, a little messier, and not nearly as definitive as we’d like it to be.

Let’s start with what probiotics are supposed to do. The idea is simple: ingest live microorganisms, most commonly from the Lactobacillus and Bifidobacterium genera (type or kind or class), and they go to work in your gut, fighting off harmful bacteria, modulating your immune system, and strengthening your gut barrier1.

That’s the pitch, at least.

But here’s the problem: probiotics are not a one-size-fits-all solution. The field of study is riddled with inconsistencies and variability. For starters, the way probiotics work is strain-specific. What helps with your neighbor’s irritable bowel syndrome (IBS) may do absolutely nothing for yours2. Worse, many studies are short-term, lasting just weeks or months, leaving us in the dark about what happens if you take these supplements for years3.

The enthusiasm around probiotics stems from some genuinely encouraging research. There’s solid evidence that certain probiotics can alleviate symptoms of IBS, reducing bloating and abdominal pain4. And some strains seem to help maintain remission in patients with ulcerative colitis5. But even there, it’s important to note that not all probiotics are created equal. Multi-strain products like VSL#3, for example, show some of the most consistent benefits. Others? Not so much.

And let’s talk about diarrhoea – specifically, diarrhoea caused by antibiotics. Probiotics like Lactobacillus rhamnosus GG and Saccharomyces boulardii have been shown to reduce the risk of developing this unpleasant side effect6. But again, this isn’t universal. The benefits vary depending on the strain and even the individual taking them.

The probiotic narrative also gets more complicated when you look at other conditions. Take atopic dermatitis, or eczema, in infants. Some research suggests that probiotics may help reduce the risk of developing eczema, particularly when given during pregnancy and infancy7. But the evidence here is mixed, and many studies show no significant effect at all.

What we’re left with is a fascinating, but ultimately frustrating, body of research. There are glimmers of hope – clear indications that probiotics can help some people with certain conditions. But as is often the case with health and wellness trends, the story is more nuanced than the headlines let on. The science isn’t quite there yet, and it may never be as definitive as we’d like it to be.

That’s partly because probiotics don’t function in isolation. They’re interacting with the incredibly complex ecosystem that is the gut microbiome. And that microbiome is as unique as a fingerprint, varying dramatically from person to person based on genetics, diet, lifestyle, and even geography. So while probiotics might work wonders for some, they could be useless – or even harmful – for others8.

But probiotics aren’t the only players in this game. Enter prebiotics. These non-digestible fibers feed your gut bacteria, helping the beneficial strains thrive. There’s evidence that prebiotics like inulin and fructooligosaccharides can enhance the production of short-chain fatty acids, which are great for your gut lining9. Prebiotics may also help with things like calcium absorption, potentially benefiting bone health10.

So, where does this leave us? The promise of probiotics is real, but so are the limits of our understanding. For now, the best advice might be to approach probiotics with a healthy dose of skepticism – and to remember that they’re just one part of a much larger puzzle when it comes to gut health.

At Ensocure, we believe in evidence-based care. That means staying up-to-date with the latest research and understanding that sometimes, the best answer is “we don’t know – yet.”

If you’re considering adding probiotics or prebiotics to your regimen, talk to one of our professionals. We’ll help you make a decision based on what’s right for you – not just what’s trendy.

References

1. : Hill, C., et al. (2014). The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology, 11(8), 506-514. Link
2. : Sanders, M. E., et al. (2019). Probiotics and prebiotics: prospects for public health and nutritional recommendations. Annals of the New York Academy of Sciences, 1446(1), 19-30. Link
3. : Bron, P. A., et al. (2017). Can probiotics modulate human disease by impacting intestinal barrier function? British Journal of Nutrition, 117(1), 93-107. Link
4. : Zhang, Y., et al. (2022). Probiotics for the treatment of irritable bowel syndrome: A systematic review and meta-analysis. Alimentary Pharmacology & Therapeutics, 55(4), 484-495. Link
5. : Derwa, Y., et al. (2017). Systematic review with meta-analysis: the efficacy of probiotics in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 46(4), 389-400. Link
6. : Goldenberg, J. Z., et al. (2017). Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database of Systematic Reviews, (12). Link
7. : Panduru, M., et al. (2019). Probiotics and primary prevention of atopic dermatitis: a meta-analysis of randomized controlled studies. Journal of the European Academy of Dermatology and Venereology, 33(7), 1370-1376. Link
8. : Guarino, A., et al. (2015). European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. Journal of Pediatric Gastroenterology and Nutrition, 60(4), 546-560. Link
9. : Vinderola, G., et al. (2017). Are all probiotics the same? Functional characteristics of lactic acid bacteria isolated from kefir. World Journal of Microbiology and Biotechnology, 33(6), 94. Link
10. : Hadi, A., et al. (2020). Effects of probiotic and synbiotic supplementation on body weight, BMI, and fat mass in overweight and obese adults: A systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews, 78(9), 655-667. Link