TREATMENT DATABASE

Probiotic bacteria, primarily Lactobacillus acidophilus and Bifidobacterium bifidus, aid in many digestive processes and help maintain balance in the intestines.

Digestive tract bacteria (intestinal flora) have evolved within humans to aid in completing the breakdown and absorption of many foods. Without the thousands of "friendly" bacteria that inhabit the intestines, malnutrition would develop no matter how much food was eaten. These bacteria not only aid in digestion, but are responsible for manufacturing many nutrients that are essential to survival, such as the B vitamin complex. Some bacteria, such as bifidus, live in the large intestine; others, such as acidophilus, live in the small intestine.

As long as the intestinal flora are working well, a minimum of digestive problems can be expected. However, once the function of friendly flora is upset, harmful bacteria can proliferate, causing bloating, stomach upset, poor digestion, constipation, gas, and malabsorption problems. The most common sources of flora upset are recurrent use of antibiotics, oral contraceptives, aspirin, corticosteroids, poor diet, stress, and Candida infections. In these cases, it may be necessary to use a probiotic supplement to reestablish a healthy balance of intestinal flora.

USES IN ME/CFS: Patients with gastrointestinal symptoms or recurring yeast infections, or who regularly take antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, or cortisone are advised to use a probiotic supplement. Products that contain bifidus seem to help with leaky gut.

According to a study by Butt et al in Australia, the colonic bacterial population in ME/CFS patients is deficient in Bifidobacterium and E. Coli. In contrast, the lactic acid bacteria, Enterococcus, is significantly higher – 28.7% of the total aerobic flora in CFS/ME patients – than in the healthy subjects (3-5%).

The researchers also found that specific changes in gastrointestinal flora were associated with ME/CFS symptoms. A high enterococcal count positively correlated with neurological and cognitive functions: nervousness, memory loss, forgetfulness, confusion, and “mind going blank.” Similarly a high aerobe/anaerobe ratio significantly correlated with poor colonic functions, poor digestion, and malabsorption of the gastrointestinal tract. The implications of this study are that the composition of bacterial flora has a significant impact on both digestion and the nervous system, and that in people with ME/CFS the two are linked.

In a paper published in 2003, Logan et al proposed that probiotics might serve to enhance immune function in people with ME/CFS. The authors pointed out that people with ME/CFS have marked alterations in intestinal flora as well as oxidative stress. They state that “lactic acid bacteria (LAB) have the potential to influence the immune system in CFS patients by supporting . . . cellular immunity and may decrease allergies. In addition LAB are strong antioxidants, may improve EFA status, can enhance absorption of micronutrients by protecting the intestinal epithelial barrier.” The authors suggested that lactic acid bacteria might have a therapeutic role in the treatment of ME/CFS.

Probiotics may be useful for other reasons as well. Due to disruptions in the balance of neurotransmitters which are responsible for maintaining gut motility, people with ME/CFS often have motility problems. When motility is slowed, the bacteria from the large intestine can travel upward, where they colonize the small intestines. This leads to a condition known as SIBO (small intestinal bacterial overgrowth). Once established in the small intestines, the bacteria interfere with the breakdown of fats and carbohydrates. Many gastroenterologists recommend treatment with probiotics, in particular Lactobacillus GG for SIBO in order to restore beneficial flora, especially after antibiotic treatment.

Treatment rating for Probiotics