The 2 Times You Should Take Probiotic Supplements, According to Gastroenterologists

Probiotic supplements are good for two specific issues that affect your GI system.
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Probiotics play an important role in protecting your health. But unless you're part of a couple select groups, you probably won't benefit from taking a supplement.

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Probiotics are the good bacteria that help keep your body's community of microorganisms balanced, which supports immune system function and controls inflammation.

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The friendly microbes also aid in digestion and fighting off illness-causing germs, create vitamins and help your body break down and absorb medicine.

With so many important jobs, "giving your body more good bacteria with a probiotic supplement might sound like it makes sense. But they're absolutely not necessary for the majority of people," Supriya Rao, MD, a gastroenterologist with Tufts Medicine Lowell General Hospital in Lowell, Massachusetts, tells LIVESTRONG.com.

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Simply eating plenty of high-fiber foods (e.g., fruits, veggies, legumes, whole grains) — which are rich in prebiotics that nourish your body's probiotic bacteria — is the only thing most of us need to do to keep our levels of good bacteria where they ought to be, notes the Cleveland Clinic.

In fact, the American Gastroenterological Association (AGA) says a probiotic supplement is only likely to benefit adults if they fall into one of two groups:

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1. You're Taking Antibiotics

If you're currently using antibiotics to treat an infection, taking a probiotic can help reduce the risk of serious GI infections like C. difficile or C. diff, the AGA notes.

Antibiotics work by wiping out both the bad ‌and‌ good bacteria in your gut. And when there's less good bacteria to defend against invading germs, you could be at higher risk of getting sick, according to the Centers for Disease Control and Prevention (CDC).

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The AGA says it's more important to take a probiotic if you're at high risk for C. diff. Your risk is higher if you're taking antibiotics for more than a week, you're older than 65, you've recently stayed at a hospital or nursing home or you have a weakened immune system.

Still, you don't ‌have‌ to take a probiotic after taking antibiotics, especially if the above criteria doesn't apply to you. It's more important to fill your plate with fiber-rich foods that will help "feed" the good bugs and get your gut back to baseline.

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2. You Have a J-Pouch

If you've had J-pouch surgery, supplementing with a probiotic can help manage pouchitis, the AGA says. This complication can happen when a J-pouch becomes infected and inflamed.

J-pouch surgery (aka, ileoanal anastamosis surgery) is sometimes done after the entire large intestine has been removed, per the Mayo Clinic, and is used to treat severe cases of inflammatory bowel disease, some cases of colon or rectal cancer and inherited conditions that put you at a higher risk for colon and rectal cancer.

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What About Other Conditions?

There's not enough evidence to show that probiotic supplements will help with other gastrointestinal problems, says the AGA.

In other words, despite what you may have heard, there's no guarantee that popping a probiotic will ease any of the following:

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If you're thinking about trying a probiotic to manage one of these issues, talk with your doctor. Together you can weigh the benefits and risks to decide if a supplement is worth trying.

At best, you may waste money by taking a probiotic supplement when you don't need one (they can be pricey, after all).

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At worst, you may end up upsetting the bacteria balance in your gut — basically the opposite of the effect you want.

"You're supposed to have a balance of good and bad bacteria. Adding too much good [by taking a supplement] could actually offset those levels," Dr. Rao warns.

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On the other hand? "If someone tells me they're on a probiotic and they're doing well with it and seem to be deriving some benefit, I won't necessarily tell them to stop," she adds.

Which Probiotic Supplement Should You Take?

Not all probiotics are created equal — there are many different strains that can affect your gut in different ways.

If you're taking a probiotic to manage a specific condition, you should choose a supplement with bacterial strains that have been shown to be effective for that problem.

Here's what to look for, per the AGA:

Antibiotic Use

Look for any of the following:

  • S boulardii
  • The two-strain combination of ‌L acidophilus‌ CL1285 and ‌Lactobacillus casei‌ LBC80R
  • The three-strain combination of ‌L acidophilus‌, ‌Lactobacillus delbrueckii subsp bulgaricus‌ and ‌Bifidobacterium bifidum
  • The four-strain combination of ‌L acidophilus, L delbrueckii subsp bulgaricus, B bifidum‌ and ‌Streptococcus salivarius subsp thermophilus

Pouchitis

Look for an eight-strain combination of the following:

  • L paracasei subsp paracasei
  • L plantarum
  • L acidophilus
  • L delbrueckii subsp bulgaricus
  • B longum subsp longum
  • B breve
  • B longum subsp infantis
  • S salivarius subsp thermophilus

When Is the Best Time to Take a Probiotic Supplement?

Should you take your probiotic in the morning or at night? With a meal or without? There's no clear evidence on what's best.

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One December 2011 ‌Beneficial Microbes‌ study found that more probiotic bacteria survived when supplements were taken with a meal. But another, published in the April 2017 issue of the ‌World Journal of Gastroenterology‌, found similar benefits no matter what time the supplements were taken.

The bottom line? Experts can't give a definitive answer on timing. If your doctor recommends taking a probiotic supplement, talk with them about the best time of day for dosing and whether you should take your probiotic with a meal.

When to See a Doctor

If you're considering taking a probiotic to manage a GI condition or another health problem, talk with your doctor. Together, you can talk more about your symptoms to determine what the underlying cause might be and the best way to treat it.

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references

Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.

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