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Key Terms and Related Words: probiotics, lymphedema, dietary supplements, antibiotics, microorganism, microbes, lactic acid bacteria, bifidobacteria, inflammatory bowel disease, Ulcerative colitis, Crohn’s disease, IBD, Bacteria; Cell surface, prebiotics, synbiotics

Probiotics is another “fad” word/subject in todays health world. The proponents of propbiotics claim wonderful and miraculous cures and untold health from taking them…usually those that they themselves happen to be selling.

But, what is the clinical evidence to support their claims? Is there anything really beneficial about taking probiotics.

What are probiotics and what exactly is their relationship to our lymphedema?.

Important when seeking information on probiotics, it is best to look at sites that do NOT sell them. A list of some sites is provided below.

Hopefully, we can answer these questions in our info page.

Be Well Be Safe


What are Probiotics?

MedicineNet describes probiotics as: A microbe that protects its host and prevents disease. The best-known probiotic is Lactobacillus acidophilus, which is found in yogurt, acidophilus milk, and supplements. Probiotics counter the decimation of helpful intestinal bacteria by antibiotics. Probiotics given in combination with antibiotics are therefore useful in preventing antibiotic-associated diarrhea. The yeast S. boulardii and three strains of Lactobacillus have also been shown to be useful in this regard. (1)

According to both the Food and Agriculture Organization of the United Nations and World Health Organization (WHO) probiotics are “Live microorganisms which when administered in adequate amounts confer a health benefit on the host”.

The problem is, there is very little research available on probiotics and almost no clinical evidence to support any type of claim. The best I could come up with are terms like “May be effective, may be beneficial. may help.”

Furthermore, probiotics are considered a food and as such are NOT regulated by the FDA or required to prove their efficacy. So the manufacturers are under no close scrutiny or examination as to “proving” probiotics can do what they claim.

Probiotics exert their beneficial effects through several mechanisms. Probiotics lower intestinal pH, decreasing colonization nd invasion by pathogenic organisms and modifying the host immune system.

WARNING the long term effects of heavy probiotic intake is not yet known, so I would urge caution here. Also, should you decide you need probiotics, please, you must discuss this with your doctor to make sure it doesn’t contradict any medicines you might be on. A pharmacist should be helpful in that as well. Always keep your doctor informed on what you are taking

Probiotic bacteria

Scientific Name(s): Lactobacillus spp., (eg, L. acidophilus, L. casei, L. rhamnosus, L. bulgaricus, L. plantarum, L. helveticus ), Bifidobacterium spp. (eg, B. bifidum, B. longum, B. breve, B. infantis), Sacchromyces boulardii, Streptococcus salvarius, Enterococcus faecium

Common Name(s): Probiotics, yogurt, sour milk, VSL-3, Indian yogurt, various commercial preparations

Conditions Claimed to be helped by Probiotics

The list is long and includes diarrhoea, including antibiotic associated diarrhoea, lactose intolerance, colon cancer, cholesterol, blood pressure immune function , infection, inflammation, bacterial growth under stress, irritable bowel syndrome, and colitis. has an extensive list of conditions claimed to be helped by probiotics.

Conditions contraindicated with Probiotics

People who are hypersensitive to any component of a probiotic-containing product. Lactose-sensitive people may develop abdominal discomfort from dairy products. Caution is also advised when using neonate born prematurely or with immune deficiency.

The information regarding safety and efficacy of specific preparation I npregnancy and lactation is lacking. Trials investigatin probiotics have been conducted in pregnant women without obvious problems. (2)

Risks of Ingesting Probiotics

Side effects. Probiotics seem to have few side effects. Some may cause intestinal gas and bloating. However, this is likely to get better over time. If your probiotics are causing these side effects, try decreasing the dose or using it every other day.

Interactions. If you take any medicines regularly, talk to your doctor before you start using probiotics. They could interact with medicines such as antibiotics or immunosuppressive drugs.

Risks. If you have intestinal disease or damage, HIV, cancer, a weakened immune system, or excessive bacteria in your intestines, don't use probiotics without checking first with your doctor. (3)

Antibiotic-associated diarrhea and lymphedema

Because of our serious susceptibility to infections, those of us with lymphedema usually will take a significant amount of antibiotics in our lifetime. Some of us, like myself are actually on a daily prophylactic course of antibiotics.

The antibiotics kill not only the “bad” bacteria, but also the good bacteria I nour digestive tract. As a result, there can be constant diarrhea.

There have been studies, which indicate taking probiotics can help reduce and/or prevent this. For me, I prefer to eat foods rich in probiotics, in lieu of taking more pills. Infact, this may be the area where there is the strongest evidence that probiotics are beneficial.

Top Foods with Probiotics

Probiotics are provided in products in one of three way. First, as a culture concentrate added to a food (usually a dairy product), at medium levels with little or no opportunity for bacterial growth. Second, inoculated into a milk-based food (or dietary supplement) and allowed to grow to achieve high levels in a fermented food, third and finally as concentrated and dried cells packaged as dietary supplements such as powders, capsule or tablets.

These are the “top ten” foods with probiotics, according to one site: yogurt, Kefir (fermented dairy product similar to yogurt, sauerkraut (which I question eating due to the acid indigestion associated with antibiotics), dark chocolate, microalgae which are found in ocean-based plants such as spirulina, chorella, and blue-green algae, miso soup, pickles, tempeh (fermented probiotics-rich grain made from soybeans), kimchi, kombucha tea (fermented tea),.

Some sites also recommend soy beverages but caution is urged here as they have been found to cause gastrointestinal symptoms, and allergic reactions according to the Cleveland Clinic.

Others recommend buttermilk, sour cream, cottage cheese, as being rich in probiotics.

If you do decide upon probiotic supplements look for those containing live bacteria.



(3) WebMD

Abstracts and Studies

Probiotic and postbiotic activity in health and disease: comparison on a novel polarised ex-vivo organ culture model.

Feb 2012

Tsilingiri K, Barbosa T, Penna G, Caprioli F, Sonzogni A, Viale G, Rescigno M.


European Institute of Oncology, Milan, Italy.


Background and aimsProbiotics and their metabolic products, here called postbiotics, have been proposed as food supplements for a healthier intestinal homeostasis, but also as therapeutic aids in inflammatory bowel disease (IBD) with, however, very little clinical benefit. This may be due to the lack of reliable preclinical models for testing the efficacy of different strains.MethodsThe activity of three probiotic strains of Lactobacillus (or a postbiotic) was analysed and compared with a pathogenic strain of Salmonella on a novel organ culture system of human healthy and IBD intestinal mucosa developed in our laboratory. The system maintains an apical to basolateral polarity during stimulation due to the presence of a glued cave cylinder. The cylinder is detached at the end of the experiment and the tissue is processed for histology and immunohistochemistry. Cytokines released from the basolateral side are analysed.ResultsThe model system provides several physiological characteristics typical of a mucosal microenvironment including the presence of an organised mucus layer and an apical to basolateral polarity. Polarised administration of bacteria is critical to control the ensuing immune response as it mimics the physiological entrance of bacteria. The authors show that probiotics are not always beneficial for the healthy host and can also be detrimental in inflamed IBD. This study shows that a potent postbiotic can protect against the inflammatory properties of invasive Salmonella on healthy tissue and also downregulate ongoing inflammatory processes in IBD tissue.ConclusionsProbiotics can have inflammatory activities in both healthy and IBD tissue. Valid preclinical data on proper model systems should therefore be obtained before specific probiotic strains enter the clinics, especially if administered during acute inflammatory responses. Postbiotics may be a safe alternative for the treatment of patients with IBD in the acute inflammatory phase.


Towards a nanoscale view of lactic acid bacteria.

Jan 2012

Tripathi P, Beaussart A, Andre G, Rolain T, Lebeer S, Vanderleyden J, Hols P, Dufrêne YF. Source Université catholique de Louvain, Institute of Condensed Matter and Nanosciences, Croix du Sud, 1, bte L7.04.01., B-1348 Louvain-la-Neuve, Belgium; K.U.Leuven, Centre of Microbial and Plant Genetics and INPAC, Kasteelpark Arenberg 20, Box 2460, B-3001 Leuven, Belgium.


Keywords: Atomic force microscopy; Bacteria; Cell surface; Probiotics; Single-molecule force spectroscopy

Probiotic bacteria have a strong potential in biomedicine owing to their ability to induce various beneficial health effects. Bacterial cell surface constituents play a key role in establishing tight interactions between probiotics and their host. Yet, little is known about the spatial organization and biophysical properties of the individual molecules. In this paper, we discuss how we have been using atomic force microscopy imaging and force spectroscopy to probe the nanoscale surface properties of Gram-positive lactic acid bacteria, with an emphasis on probiotic strains. Topographic imaging has enabled us to visualize bacterial cell surface structures (peptidoglycan, teichoic acids, pili, polysaccharides) under physiological conditions and with unprecedented resolution. In parallel, single-molecule force spectroscopy has been used to localize and force probe single cell surface constituents, providing novel insights into their spatial distribution and molecular elasticity.


Probiotics for inflammatory bowel disease: a critical appraisal.


Sans M.


IBD Unit, Gastroenterology Department, Hospital Clínic i Provincial/IDIBAPS, CIBER EHD, Barcelona, Spain.


The notion that the intestinal microbiota plays a key role for the development of intestinal inflammation, initially based on a series of clinical observations both in human inflammatory bowel disease and experimental colitis, has been reinforced by a growing body of evidence demonstrating that the abnormal recognition of bacterial and other microbiota antigens by the innate immune system is one of the earliest events in the pathogenesis of inflammatory bowel disease. In keeping with our present knowledge of inflammatory bowel disease pathophysiology, the search for therapeutic approaches aimed at modifying the composition of the intestinal microbiota to obtain new, more targeted treatments for inflammatory bowel disease that are basically free of side effects has been a subject of intense research activity. Probiotics are defined as live organisms capable of conferring health benefits beyond their nutritional properties. Numerous micro-organisms have been evaluated to induce or maintain remission, or both, in ulcerative colitis, Crohn's disease and pouchitis. Overall, probioticshave successfully demonstrated some efficacy in some inflammatory bowel disease scenarios. However, a critical review of the available scientific literature shows that: (1) in spite of great expectations, reflected by a high number of review and editorial articles in top journals, the number of published, well-designed clinical trials using probiotics in inflammatory bowel disease is small, often with few patients; (2) the range of microbial agents makes it particularly difficult to draw global conclusions; (3) the quality of the evidence on the efficacy of probiotics in pouchitis is clearly better than that in ulcerative colitis, while there is virtually no evidence of probiotic efficacy in Crohn's disease. The appropriate selection of probiotic agents combined with convincing clinical trials will determine whether probiotics can jump from promise to reality in inflammatory bowel disease clinical practice.


Comparison of the immunomodulatory properties of three probiotic strains of Lactobacilli using complex culture systems: prediction for in vivo efficacy.

Sept 2009

Mileti E, Matteoli G, Iliev ID, Rescigno M.


Department of Experimental Oncology, European Institute of Oncology, Milan, Italy.


BACKGROUND: While the use of probiotics to treat or prevent inflammatory bowel disease (IBD) has been proposed, to this point the clinical benefits have been limited. In this report we analyzed the immunological activity of three strains of Lactobacillus to predict their in vivo efficacy in protecting against experimental colitis.

METHODOLOGY/PRINCIPAL FINDINGS: We compared the immunological properties of Lactobacillus plantarum NCIMB8826, L. rhamnosus GG (LGG), L. paracasei B21060 and pathogenic Salmonella typhimurium (SL1344). We studied the stimulatory effects of these different strains upon dendritic cells (DCs) either directly by co-culture or indirectly via conditioning of an epithelial intermediary. Furthermore, we characterized the effects of these strains in vivo using a Dextran sulphate sodium (DSS) model of colitis. We found that the three strains exhibited different abilities to induce inflammatory cytokine production by DCs with L. plantarum being the most effective followed by LGG and L. paracasei. L. paracasei minimally induced the release of cytokines, while it also inhibited the potential of DCs to both produce inflammatory cytokines (IL-12 and TNF-alpha) and to drive Th1 T cells in response to Salmonella. This effect on DCs was found under both direct and indirect stimulatory conditions - i.e. mediated by epithelial cells - and was dependent upon an as yet unidentified soluble mediator. When tested in vivo, L. plantarum and LGG exacerbated the development of DSS-induced colitis and caused the death of treated mice, while, conversely L. paracasei was protective.

CONCLUSIONS: We describe a new property of probiotics to either directly or indirectly inhibit DC activation by inflammatory bacteria. Moreover, some immunostimulatory probiotics not only failed to protect against colitis, they actually amplified the disease progression. In conclusion, caution must be exercised when choosing a probiotic strain to treat IBD.


External Links


You may run across the following terms in researching information about probiotics.

Prebiotic - |A prebiotic is a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-being and health.” (2007 Journal of Nutrition) defines them as: Prebiotics are non-digestible foods that make their way through our digestive system and help good bacteria grow and flourish. Prebiotics keep beneficial bacteria healthy.

Synbiotiic - a synbiotic is a supplement that contains both a prebiotic and a probiotic that work together to improve the “friendly flora” of the human intestine. A synbiotic product should be considered a “functional food” rather than some obscure chemistry formulation. (InnVista).

Using prebiotics and probiotics in combination is often described as synbiotic, but the United Nations Food & Agriculture Organization (FAO) recommends that the term “synbiotic” be used only if the net health benefit is synergistic. A further restriction is to require that the prebiotic be shown to increase the population and/or function of the probiotic it is paired with.

Dysbiosis - When the bad bacteria and yeast become overgrown in your intestinal tract, you have a condition called dysbiosis. Dysbiosis has been linked with disorders like yeast infections, irritable bowel syndrome and rheumatoid arthritis. A common cause of dysbiosis is antibiotic therapy. The antibiotics that you take for killing an infection will also kill the healthy bacteria in your digestive tract..

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probiotics.txt · Last modified: 2012/10/16 14:40 (external edit)