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What should we know about Probiotics and Prebiotics?

Medically reviewed by Nathan Merriman, MD, Kevin Tin, MD, Susan Kerrigan, MD and Marianne Madsen on February 16, 2023

Probiotics have expanded rapidly onto the nutrition scene in recent years. Supermarkets, drug stores, and other retailers now contain probiotic foods and supplements, including yogurts and probiotic drinks, which are marketed on their probiotic content. We are also now seeing products advertised with prebiotics. 


The questions are: What are probiotics and prebiotics? What are their health benefits? What can they do (and not do) for our gastrointestinal health? And which probiotics and prebiotics work best for which individuals?


Your gut contains an organism-based ecosystem containing billions of bacteria and other microbes that help you maintain a healthy digestive tract. For this micro-ecosystem to work optimally, a balance needs to be maintained between all the different strains of bacteria and other microbes, and this where probiotics and prebiotics can help.




Probiotics are essentially healthy live microorganisms, found in specific food sources, like yogurt and dietary probiotic supplements. These probiotic foods and supplements add probiotic bacteria to each individual’s baseline gut bacteria in the digestive tract, which is essential for protecting each of us against harmful bacteria and other organisms. These friendly bacteria also help your immune system function, regulate inflammation, and potentially impact our metabolism and weight as well as intestinal gas production and gastrointestinal tract movement and regulation that relate to conditions such as irritable bowel syndrome (IBS) for some people.


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What are Probiotics?

What are Probiotics?



Prebiotics are non-digestible substances found in certain foods that can help microorganisms and beneficial bacteria like probiotics to grow and function. They are found in a wide variety of fruits and vegetables and fermented foods, beans, and legumes.


Intestinal Permeability and Probiotics


As well as helping to maintain a healthy gastrointestinal tract, researchers have looked at other areas where probiotics may have beneficial effects. One area is intestinal permeability.


The walls of your intestine act as a barrier between your digestive system and your bloodstream. Small gaps called tight junctions allow water and nutrients to enter and be transported to your organs while blocking harmful substances from entering the bloodstream. When the tight junctions become loose, the intestines’ permeability increases, potentially allowing toxins and bacteria into the bloodstream. 


Researchers are currently examining whether probiotics can help reduce intestinal permeability. The theory is that some probiotics can help the intestinal bacteria control inflammation, reducing its damaging effects on the intestine wall. In some cases, they may help contribute to the protective mucous that lines the intestinal wall.


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Prebiotics vs. Probiotics

Prebiotics vs. Probiotics

SIBO and Probiotics


Small intestinal bacterial overgrowth (SIBO) occurs when more antagonistic and often gas producing bacteria grow in the small intestine in larger amounts. SIBO typically causes diarrhea, bloating, and abdominal pain, and if left untreated, potentially can negatively impact some vital nutrients in our bodies.


The effectiveness of probiotics in treating or preventing SIBO is debatable, and reviews claim that clinical trials have produced mixed results. In one study, the results appeared to show that they might be more effective than antibiotics, typically given as a treatment. However, another study indicated that while probiotics might help alleviate some symptoms of SIBO, like abdominal pain, they are ineffective in preventing SIBO.


Probiotics and prebiotics have become an important part of attempts to improve people’s digestive health. They help retain a good balance between good, helpful bacteria in your gut and intestinal tract and bad bacteria. Maintaining this balance with a healthy diet and potentially the right probiotic and prebiotic combination for you can help to improve your overall intestinal health. The health benefits and effectiveness in treating specific digestive conditions with probiotic and prebiotic supplements are still debatable with variable results across individuals.


Many people are now looking to add probiotics and prebiotics to their diet either as a separate or combined probiotic or prebiotic supplement or as part of a specific regular dietary supplement. Each of us should work with our doctor or other healthcare provider team member to discuss the potential benefits and potential unknown risks or unintended consequences of probiotics or prebiotics for each of our digestive and general health.  There continues to be a significant amount of research into which individuals with which medical conditions can benefit from which prebiotic and probiotic combinations.  There is much more to come in this area of gut health.

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