Probiotics, or good bacteria, are live microorganisms which replenish the 'good' bacteria found in our guts. The reason probiotics are called 'good' bacteria is because they provide us with positive health benefits. The World Health Organisation (WHO) defines probiotics as live microorganisms which, when taken in adequate amounts, provide health benefits to the host.
Probiotics play various roles in our bodies and are directly involved in helping digest food that our bodies cannot break down efficiently, increasing the body's metabolism by extracting more energy from the nutrients in food, producing B vitamins, eliminating toxins, and helping maintain intestinal wall integrity.
Researchers are looking more closely into how these little bacteria can influence, and sometimes even improve, our health. This is good news as many Malaysians place very little emphasis on their digestive health. The Health Facts 2017 released by the Ministry of Health (MOH) stated that diseases of the digestive system were the fourth principal cause of hospitalisation in private hospitals, seventh principal cause of hospitalisation in MOH hospitals, and sixth principal cause of death recorded in both MOH and private hospitals.
Based on a local research in 2017 by Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), it was found that irritable bowel syndrome (IBS) affects as many as 1 in 9 Malaysians1. IBS patients also normally suffer from other digestive-related disorders such as constipation or diarrhoea, stomach discomfort, bloating, or any combination of these symptoms. The research also investigated how probiotics (i.e. Lactobacillus acidophilus and Lactobacillus paracasei) could benefit both local healthy subjects and IBS patients.
Good for digestive health
Associate Professor Dr Raja Affendi Raja Ali, Consultant Physician and Gastroenterologist who is based at Hospital Canselor Tuanku Muhriz, PPUKM, explains, "What we (the research team) found were improvements across the board for everything that we tested for. These include investigating the intestinal transit time (ITT, the time taken from eating food until it is eliminated), symptoms of diarrhoea and constipation, the 'hardness' of stool, and also time spent in the toilet."
Significant findings and improvements were found:
- 96% of research subjects reported improvements in constipation symptoms
- 45% of research subjects spent less than 10 minutes in the toilet
- 36% of research subjects had lesser straining when going to toilet
- 31% of research subjects experienced much softer stools
- 33% faster food digestion time from 20-45 hours and reduced by 5-15 hours
- 73% of research subjects with IBS benefited from enhanced immunity as the body produces less pro-inflammatory chemicals which reduce inflammation and enhance the immune system
"We know that our gut is home to a large and intricate community of microorganisms which has evolved with us. In our recently concluded study, the two probiotic strains had a positive influence on all our research subjects' digestive health," he remarks.
"What this tells us is that a healthy lifestyle depends not only on eating healthily and getting enough exercise, sleep, and water – we have to keep our gut microbiota in balance too. The balance of the good and bad bacteria in our gut must also be maintained," he advises.
Good for the immune system
In addition to that, the gut is also the body's first line of defence against infections. "As your digestive system represents around 80% of your body's immune system, we wanted to learn more about how probiotics affects the body's immune system. We continued the research for about a year and half and looked at three pro-inflammatory cytokines produced in the body, namely Interleukin-6 (IL-6), Interleukin-8 (IL-8), and tumour necrosis factor (TNF)-alpha. High levels of these cytokines indicate high levels of inflammation, which is not desirable."
According to Assoc Prof Dr Raja Affendi, the research revealed that consuming cultured milk drinks containing Lactobacillus acidophilus and Lactobacillus paracasei for 30 days led to significant reduction of IL-6, IL-8, and TNF-alpha among research subjects. Among them 73% of research subjects with IBS benefited from enhanced immunity. "These findings all support the fact that probiotics are beneficial to digestive health and our body's immune system," he states.
Maintaining digestive health
Regular consumption of probiotics helps ensure good digestive health. Assoc Prof Dr Raja Affendi recommends making probiotic-rich foods a regular fixture in our diet. Sources include fermented food products such as cultured milk drinks, tempeh, kimchi, home-made yoghurt (tairu), and tapai pulut. "You will need to constantly replenish the good bacteria in your gut in order to maintain a balanced gut microbiota."
Of course, one should also eat sufficient amounts of dietary fibre as these help regulate bowel movement, increase stool bulk, thus lowering one's risk of digestive problems (e.g. haemorrhoids, diverticular disease, even colon cancer). Certain dietary fibres, known as prebiotics, are necessary – while these cannot be digested by our body, the good bacteria feed on them. These dietary fibres include fruits, vegetables, whole grains and legumes.
"Don't neglect the other basic factors of a healthy lifestyle such as eating right, exercising regularly, getting enough sleep, and managing your stress. Changing our lifestyle is never easy but necessary. Furthermore by taking probiotics, it helps to maintain the balance of gut microbiota, which will further optimise and improve our digestive health and overall health. The results are definitely worth the effort!" he concludes.
- 1 Modulation of intestinal dysbiosis in patients with constipation-predominant irritable bowel syndrome using lactobacillus-containing cultured milk drink