By Dr. Amy Gosling

In a healthy state, many bacteria live on the inside of the intestines and do not cause any diseases.  Such bacteria are there to aid digestion and normal functioning of the gut.  This is called bacterial colonization of the intestinal mucosal lining. 

   Anything that throws off the balance of bacterial colonization may result in diarrhea, abdominal pain, gas and cramping—called malabsorption.  Balance is often thrown off because of the use of antibiotics.  The latter are given to treat a bacterial infection somewhere in the body.  Some of the medication (which is taken orally, absorbed through the gut wall to enter the blood stream and delivered to the infection site) is not absorbed and continues through the intestinal tract.

   These drugs then act against the normal colonization—upsetting the balance of normal flora and resulting in the symptoms of malabsorption.  Other events such as Irritable Bowel Syndrome, Inflammatory Bowel Disease, acute gastroenteritis and chronic constipation may also upset the colonized bacteria balance.

    If the underlying problem is resolved and the event causing the imbalance ends, the body will eventually recolonize the intestinal lining with the normal gut flora.  Until that happens, there may be a persistence of loose stools, bloating, gas, abdominal pain and decreased appetite for a period lasting up to two to three weeks.

   Probiotics are a class of medications that contain the normal non-disease causing bacteria in capsule or powder form.  They are used to replace the normal colonized bacteria that are wiped out by disease state or use of antibiotics. They are best used with the onset of antibiotic use or disease symptoms and are usually continued for one week after the end of antibiotic use or resolution of disease symptoms.  For chronic disorders, they may be taken on a more long term basis. Probiotics are the normal bacteria found in the gut and do not cause disease by themselves.  It seems odd to be taking bacteria because the medication used to kill germs are killing the “good” bacteria as well.  However, preliminary studies clearly show some benefit.

   Probiotics are over the counter medications—usually found in the vitamin or health food sections, or behind the counter in the pharmacy.  Look for a Probiotic that includes 3 major bacterial groups:  Lactobacillus, Bifidobacterium and Acidophillus.