Wednesday, September 26, 2012

Bugs, bowels and yoghurt!

Antibiotics have been with us for over half a century now - which is a relatively short time in the evolution of mankind - and we're still learning a lot about how they work and how bacteria work against them! One of the pitfalls of taking antibiotics is that often it leads to the patient developing Diorrhoea - which, if you're already feeling sick, is not something that you want to add to your list of woes! So it would be nice if there were something that we could do to lessen the impact of Antibiotic Associated Diorrhoea (AAD): which leads me onto "what on earth is living in our insides"?

In a previous Blog I have discussed that we are not exactly who we appear to be as much of us is made up of bacteria, fungi and viruses - the genus and function of which are still taxing the minds of some very intelligent scientists around the world. There are, in fact, many more Bacterial cells than human cells in our body: someone pointed out that one way to get an idea of the ratio of human cells to bacterial cells is to look at our bodies and realize that the area below the knee of one leg would represent the number of human cells and the rest of the body the number of bacterial cells! It has also been worked out that there is about 1Kg of bacteria living in our guts and they actually supply approximately 10% of our daily nutrition as well as vital vitamins and mineral. There is also developing evidence to link the bacteria that live in our gut with cell mediated immunity, so we need to think beyond the idea that they're "just friendly germs that live in our bowel", to the idea that they are an essential part of our makeup. So if we upset the balance of "Our" bacteria with inappropriate use of antibiotics, then we are doing harm to ourselves.

First golden rule of antibiotics: only use them when they will do you more good than harm.

But if there is a real need to take them, how can we protect ourselves from the downside of AAD?

Probiotic products are "foods" that contain bacteria, and which are thought to help restore the normal bacterial flora in the bowel - although it doesn't actually work that way. Firstly there are several different strains of bacteria that make up the "probiotic" group, and like different tools for different jobs, they are not a "one size fits all" panacea - they actually need to be matched to a particular condition. And not all gut based conditions will respond to probiotics at this stage, but AAD is one of those conditions that will often benefit from taking probiotics.

Crohns disease and Ulcerative Colitis are known as Inflammatory Bowel Diseases and in CD there is evidence of an exaggerated immune response to certain intestinal bacteria, more so than with UC:  but probiotics seem to have a slightly greater beneficial effect in UC than CD - such are the mysteries of medicine!

IBS or irritable bowel syndrome, is just what it appears to be ... irritable bowel without any definite diagnostic signs. There is no compelling evidence to show that probiotics work, but it's one of those areas where it is quite reasonable to "give it a go" for a period of time to see if there is any benefit.

The use of Probiotics is a very new field in Gastroenterolgy and there will be many discoveries made that I am sure will have an impact on areas of our bodies well away from our gut tube. For now, if you need to take an antibiotic, then a trip to the supermarket to get some Yoghurt containing Lactobacillus Bifidus will probably save you taking a trip to the smallest room in the  house! But for other inflammatory bowel diseases or IBS, you should discuss with your Specialist which Probiotic might be suitable - as they will know what is the latest and best in this fast changing field.

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