Probiotics - What's the Hype About?

Probiotics

I'm sure you've seen the many TV commercials for name brand yogurts and probiotics that 'may help regulate occasional irregularity'. They make everyone in the world seem so uncomfortable and walking around with these vague digestive complaints. Reality is - most of us have digestive issues. It's not uncommon. Let's just be frank about it - gas, constipation, diarrhea - there, I said it! Our guts are mistreated by our diet and chronic dehydration regularly. We take medications to treat illnesses that cause side effects that require more medications. We don't use food as fuel but instead only land ourselves with more problems. That's a whole other discussion and likely future blog post. Food As Medicine... stay tuned!

Today we are focusing on probiotics. The good bacteria in your body! What exactly are they? They are live bacteria and yeast that are in our body and keep us healthy. There are over 500 strains living in our bodies! They help with digestion and keep our immune systems strong. There are many many types of naturally occurring organisms in our bodies and in foods that can be classified as probiotics. 

So when do we need supplementation with probiotics? 

• During and after taking antibiotics
• Antibiotics have a very specific job to do - kill bacteria. Only problem is, they don't particularly care which bacteria they kill. They do a fine job of hitting them all. How many people have you heard complain about getting yeast infections or diarrhea while or just after taking antibiotics? It is not uncommon and so many people think it's an allergy. It's not - it's the body being completely out of balance. By supplementing with probiotics, you can help re-balance the good and bad bacteria and potentially avoid these side effects!
• Frequent illness sufferers
• Probiotics help decrease the amount of 'bad' bacteria in our systems by increasing the 'good' guys and not allowing the 'bad' to take over. This helps keep our bodies working in tip top shape, like they should.
• Motility issues
• Probiotics help move things through our gut at the perfect rate. Those who suffer from IBS, IBD, infectious diarrhea, and/or antibiotic-related diarrhea will benefit from adding probiotics into their daily routine.
• Other complaints and concerns
• Probiotics aren't just helpful for gut issues. Some have found other conditions respond very well to probiotic introduction. These include eczema and other inflammatory skin conditions, urinary and vaginal health, prevention of allergies and colds, and oral health. 

So where do you start? There are so many brands and so many different types, it's difficult to just pick one. First thing I have to recommend is have a chat with your health care provider. Most of us are relatively well versed in probiotics however most patients don't want to hear about them so we don't bring it up. I've begun including prescriptions for probiotic with all my patients that require high dose antibiotics. Once I explain what probiotics are, I have yet to have a family turn me down!

What types of probiotics should you look for? I said earlier there are over 500 strains in the body. But some are definitely more powerful than others and will provide the best bang for your buck. So while most companies will advertise the number of strains they boast are in their product, take a minute and flip it over. Check the label. Here's 6 of the most powerful strains to look for:

• Lactobacillus acidophilus: 
• Maintains the integrity of intestinal walls 
• Promotes absorption of nutrients
• Helps support immune function
• Lactobacillus fermentum: 
• Assists in neutralizing the toxic products that are created during digestion
• Helps keep a healthy balance of bacteria in your gut
• Lactobacillus rhamnosus:
• Most effective in reducing traveler's diarrhea
• Bifidobacteria bifidum:
• Needed by both the small and large intestine for easy digestion
• Helps in the breakdown of dairy products
• Bifidobacteria longum:
• Helps crowd out bad bacteria that can cause discomfort in the gut
• Helps neutralize everyday toxins
• Breaks down carbohydrates efficiently without producing excess gas

Ok, so you're ready to take the probiotic plunge! Boost your immune system, protect yourself from toxins, and help heal your digestive tract from years of abuse. What are you going to invest in?

Food Sources: I recommend for those who don't have any major issues to simply increase their intake of high quality yogurt. I personally love Fage greek yogurt. Other food sources include keifer, sauerkraut, high quality dark chocolate, miso soup, and komboucha tea.

Commercial Brands: Two of the most common brands are Culturelle and Align. These are readily available at most stores and are fairly well tolerated by most people. As I deal with many chronic gut issues and immunity issues, I take a higher quality probiotic that offers a variety of strains of live cultures called Dr. Ohhira's which was recommended to me by a physician and naturopath. For infants, Florastor has been approved for age 2 months and older - this is the one I prescribe for my little patients. You will notice the higher the quality, the higher the price. If you're not suffering from significant digestive ailments or immunity concerns, there's no reason to jump to the biggest, baddest probiotic supplement available. Another thing to take note of is some probiotics require refrigeration from the time of purchase and/or from the time of opening. It's all dependent on how it's produced. Take note of this because failure to do so means a very costly supplement with no benefits!

Now are there any side effects? Of course there can be! Just like when you introduce more fiber into your diet (which you should by the way), if you advance too quickly your gut doesn't have time to adjust and there can be undesirable side effects. Same thing goes for probiotics. I recommend taking the supplement as directed and know you may have very mild cramping, upset stomach, diarrhea, gas, and bloating. This should only be mild and occur during your first week as you adjust to having more good bacteria and the bad guys get put back into proper proportion. Many people will not have these side effects at all. They are more common with higher dose probiotics. 

*Occasionally there can be an allergy to a probiotic - please immediately stop taking the probiotic and consult your physician if you think you are having an allergic reaction.

So that's the general scoop on probiotics. They are the good guys! How many articles do we read about the gut being the key to good health? Well these little probiotics are definitely the right helpers! I recommend them to adults and children regularly and am an avid user myself! 

Cheers to your gut's health!

Fighting Back When the Stomach Flu is After You!

Is the Stomach Flu After You?

I'm not sure if there could possibly be anything worse than a bout with the stomach flu. It's got a lot of different names but the official term is gastroenteritis - meaning inflammation of the stomach and intestines. Aside from what many may think, it actually does not come from the 'flu' or influenza virus. Unfortunately many think that the yearly flu shot will protect against gastroenteritis, but it is a very different 'flu' and will have no effect - sorry folks, there's no shot to protect against this bug!

So where does gastroenteritis come from? Gastroenteritis is really a term for all of the symptoms that accompany the illness. The actual illness can be bacterial, viral, or parasitic in nature. Most commonly, children and adults in the United States will suffer from bacterial or viral causes vs parasites.

• Bacteria
• E-Coli
• Samonella
• Undercooked poultry, eggs, and poultry juices
• Pet reptiles and live poultry
• Campylobacter
• Undercooked poultry, eggs, and poultry juices
• Shigella
• Contaminated food or water and person-to-person contact
• Most commonly spread through day care centers
• Viral
• Norovirus
• Most common cause of serious gastroenteritis outbreaks and foodborne illness in the US
• Rotavirus
• Most common cause of diarrheal illness in infants and young children
• Parasites
• Giardia
• Contaminated water sources and swimming pools
• Cryptosporidium
• Contaminated water sources and swimming pools

Viral gastroenteritis is the most common cause of gastroenteritis outbreaks here in the United States. If you've ever watched the news and heard of numerous people falling ill on a cruise ship or in a nursing home, odds are it was norovirus. 

So how is gastroenteritis spread? Here's the most common ways:

• Food
• Contaminated water
• Close contact with an infected person
• Unwashed hands
• Dirty utensils

How often do we see gastroenteritis? Well, it's hard to come up with an exact number because most people are able to manage their symptoms at home so they are not seen by a physician or hospitalized. But here's the estimated statistics according to The Cleveland Clinic:

• 3 to 5 billion cases of acute diarrhea occur per year in the world
• Not all of these are caused by gastroenteritis
• At least 100 million cases occur in the United States each year
• Approximately 1 to 2.5 cases of diarrhea per child
• Gastroenteritis can be severe and cause life threatening illness and even death
• There are 5 to 10 million deaths worldwide each year
• Approximately 10,000 deaths occur in the United States per year

Who is most commonly affected by gastroenteritis? Well it can affect anyone but usually it spreads quickly among children in day care centers, students living in dormitories, military personnel, and travelers. Those that often get the most serious cases of gastroenteritis include young infants and those with weakened immune systems. 

Alright, so we've talked about what causes gastroenteritis, how it's spread, the statistics on occurrence, and who is most at risk. Now we'll get into the symptoms. Everyone will have a different variety of symptoms. Some only diarrhea while others will have vomiting too. Some will have fevers and others won't. Here's a general list of common symptoms associated with gastroenteritis:

• Nausea and/or Vomiting
• Abdominal pain or cramping
• Fever
• Poor feeding (infants)
• Excessive sweating and/or clammy skin
• Muscle pain and/or joint stiffness
• Incontinence of stool (loss of control)
• Diarrhea

Diarrhea is the most common symptoms of gastroenteritis. Because the colon is infected, it cannot retain fluids and therefore the stool becomes very loose or watery. Symptoms can last 12-24 hours (most typical) however in some cases, symptoms (especially diarrhea) can last for several days.

The most common complication of gastroenteritis is dehydration due to excessive vomiting and diarrhea. It is important to understand what symptoms should be recognized. Anyone suffering from dehydration needs to be evaluated by a health care provider.

• Dark urine and/or decrease in usual amount
• In infants - dry diapers for more than 4-6 hours
• Dry skin or skin that 'tents' when it is pinched and doesn't snap back into place
• Dry mouth
• Little to no saliva, dry lips
• Sunken cheeks and/or eyes
• Significant decrease in activity
• Most who suffer from gastroenteritis will be very tired but lethargy combined with above symptoms is a red flag for dehydration

Not all illnesses that cause vomiting and diarrhea are gastroenteritis. Irritable bowel, pneumonia, blood infections (septicemia), appendicitis, and other abdominal conditions can cause these symptoms. The most important piece to remember is to take a good look at the whole picture. If the person who is ill, whether adult or child, seems to be in moderate to severe pain (that doesn't lessen with vomiting or diarrhea), the pain is localized to one area of the abdomen and doesn't move, has persistent fevers, is becoming more lethargic, or there are any other concerns - do not hesitate to seek out a health care provider's opinion.

Now the most important part of this entire blog post. What are we going to do about the stomach flu? We'll discuss this in two parts. The first is when someone in the home has gastroenteritis. The second will be prevention of gastroenteritis when exposure is suspected or it is prevalent in your area. 

So someone in the home has come down with the stomach bug. They are miserable and odds are, so are you if you are taking care of them! Whether another adult in the home or a child, the care is similar.

• Isolation!
• This is the number one key to preventing the spread of the illness through your home
• Keep the sick person to one area of the home and one bathroom
• Cleaning!
• Use diluted bleach or Lysol products to clean surfaces
• Wash all linens and clothing on hot water with detergent
• Make sure everyone in the home is washing their hands with antibacterial soap
• Wash all dishes and utensils in hot water - better yet is hot water cycle in the dishwasher with heated drying option
• Fluids!
• After vomiting, allow the person to rest with nothing by mouth for the next 20 to 30 minutes
• If there is no further vomiting, offer one teaspoon (5mL) of liquid 
• Pedialyte is ideal with infants and children - it has the perfect balance of electrolytes without so much sugar as Gatorade which will cause further diarrhea
• Continue to offer one teaspoon of fluid every 5 minutes up to 3 times
• After 3 teaspoons, allow the stomach to rest at least 15 minutes and then continue
• If vomiting starts again, give another 20 to 30 minute break and begin at one teaspoon again
• If there is no vomiting and the illness is diarrheal in origin, then offer fluids without hesitation
• Avoid dairy products
• Pedialyte is best for infants and children over Gatorade
• You can also offer diluted juice or ginger ale 
• When vomiting has stopped (or if the illness is only diarrhea), offer foods as soon as possible. Current research shows that the sooner food is reintroduced, the faster healing occurs!
• Avoid foods that are greasy, fatty, and spicy
• Try the BRAT diet
• Bananas, Rice, Applesauce, Toast
• Although appetite may be low, a few bites of food is better than nothing so make each bite count and do not offer any junk food
• Slowly begin to reintroduce a normal diet once the BRAT diet is tolerated - boiled chicken breast, plain scrambled eggs, chicken soup, and other lean protein sources are ideal in small amounts to help the body heal from the illness
• Rest!
• Encourage the ill person to rest as much as possible and keep activity to a minimum
• General rule for returning to school and work:
• Must be 24 hours free of fever, vomiting, and diarrhea!

Ok, now let's talk about prevention! You hear it on the news or the school sends home a letter. The stomach bug is here and it's spreading fast. So far, you and your home are clear of it and you would really like to keep it that way! What can you do?

• Wash your hands!
• If there is one single thing to do, it's this! Wash them often with warm water and antibacterial soap. Wash up the wrists and scrub your fingernails against your palms to help get rid of all the germs.
• Make sure you wash your hands well after using the bathroom and before and after preparing food!
• If soap and water isn't available, use hand sanitizer!
• Clorox offers a product that is proven to kill norovirus (most hand sanitizers that are available do NOT kill this virus!). It is available for purchase on Amazon: HERE
• Food preparation!
• Keep raw poultry and other meats and seafood away from any foods that are eaten raw (like fruits and vegetables)
• Try to store them separately in the fridge - ideally your fruits and vegetables should always be positioned above meat or in a drawer in case juices leak - I always make sure I put my raw meat into large ziplock bags before storing it in the fridge
• Ensure surfaces that come into contact with raw meat are disinfected properly
• If you are traveling outside the US, drink bottled water only and avoid ice in your drinks. Also try to avoid any uncooked foods that were likely washed in water (potential contamination)
• Personal health!
• Maintaining a good immune system is key! Make sure to read my posts on Boosting Immunity.
• Concord grape juice - there is research showing that concord grape juice helps to change the pH of the gastrointestinal system and makes it more difficult for gastroenteritis pathogens to take hold. 
• If I am exposed or there is high prevalence of gastroenteritis in my area, I drink 6-8oz of organic concord grape juice daily or twice daily!
• Essential oils are also an option! I highly recommend using them daily to help boost your immune system (children too!). Also, I recommend keeping peppermint and ginger oils in the home so that anyone suffering from gastroenteritis can dilute a few drops and rub on their abdomen for relief. If you are interested in essential oils, please contact me.
• Watch your food and drink choices. The more whole foods you consume and the more hydrated you are, the more difficult it is for a virus to take hold in your system.
• Make sure you have at least 8 glasses of water per day
• Limit sugar and dairy intake (both of these can cause inflammation in the gut which can put you at higher risk for stomach ailments).
• Personally, I choose to limit eating out during times of outbreaks. I know if I prepare my own food that it is safe because I'm very careful in how I handle it. If you go to a restaurant, you do not have control over how they wash, prepare, and handle your food and it is definitely a risk.

Wishing you good health and hopefully avoidance of the stomach bug as it makes it's way around! Many think this is only a winter ailment but water parks, pools, and lakes are top causes during the summer! Be prepared now so you're not scrambling if it happens!