Probiotic supplement/lactose intolerance

Probiotic supplements & lactose intolerance

There is a high level of evidence for positive effects of probiotic supplements in the alleviation of lactose intolerance.11-13 Probiotics are traditionally defined as viable microorganisms that have a beneficial effect in the prevention and treatment of specific pathologic conditions when they are ingested.12 Lactobacillus acidophilus and Bifidobacterium have been reported to be beneficial probiotic organisms that provide excellent therapeutic benefits.14 It is suggested that at adequate feeding levels, Lactobacillus acidophilus may facilitate lactose digestion in lactose-intolerant subjects.15 The results of an in vitro study concluded that supplementation with L. acidophilus enhance lactose fermentation causing efficient utilization of lactose.16

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Management of Lactose intolerance with Probiotics

Narinder Duggal, MD, FRCPC

 

Lactose intolerance affects nearly 70% of the world population.1 Lactose intolerance is the inability to digest significant amounts of lactose, the major sugar found in milk and dairy products. It is caused by intestinal lactase deficiency, an enzyme produced by the cells lining the small intestine that breaks down lactose into the simple forms of sugar, glucose and galactose, so they can be absorbed and used by the body. Generally lactose intolerance is inherited but it can be the consequence of an intestinal disease.2 Colonic metabolism of lactose may play a role in lactose intolerance.3 Lactose left undigested in the intestines causes gastrointestinal symptoms2,4 because of the excessive amounts of water that are drawn into the intestines by lactose. These symptoms include abdominal pain, bloating, flatulence and diarrhea.5 Many people may suffer symptoms reminiscent of irritable bowel syndrome.6  Lactose intolerance is commonly diagnosed by a lactose hydrogen breath test. 

Fermented and unfermented milk products containing lactic acid bacteria have been used for years for specific health effects.7 A number of human studies have clearly demonstrated that yogurt containing viable bacteria improves lactose digestion and eliminates symptoms of lactose intolerance.8 Studies have also shown that in spite of its lactose content yogurt is very well tolerated by lactose intolerant persons. This advantage is due to the presence of living lactic acid bacteria in fermented dairy products which survive passage through the stomach and also to the lactase present in these products.9 The intact cell walls of lactic acid bacteria protect lactase during gastric transit and release it in the small intestine.10

There is a high level of evidence for positive effects of probiotic supplements in the alleviation of lactose intolerance.11-13 Probiotics are traditionally defined as viable microorganisms that have a beneficial effect in the prevention and treatment of specific pathologic conditions when they are ingested.12 Lactobacillus acidophilus and Bifidobacterium have been reported to be beneficial probiotic organisms that provide excellent therapeutic benefits.14 It is suggested that at adequate feeding levels, Lactobacillus acidophilus may facilitate lactose digestion in lactose-intolerant subjects.15 The results of an in vitro study concluded that supplementation with L. acidophilus enhance lactose fermentation causing efficient utilization of lactose.16

Similarly, another in vitro study demonstrated that lactose was rapidly metabolized with Bifidobacteria supplementation at a pH of 6.7. The study concluded that Bifidobacteria have the potential to improve lactose fermentation.17 A human study in 1996 also provided similar conclusions. It was found that strains of B. longum have the potential to significantly reduce the symptoms from lactose malabsorption.18 Recently, a group of Chinese researchers investigated modification of the colonic microflora of lactose intolerant subjects with a 2-week supplementation of B. longum. The results of the study suggested that supplementation modified the amount and metabolic activities of the colonic microflora and alleviated symptoms in lactose intolerant subjects.19

All these studies have provided evidence for the possibility of managing lactose intolerance with probiotics especially with strains of Lactobacillus acidophilus and Bifidobacteria. If you are lactose intolerant, you may no longer need to avoid all dairy products.  Instead, try Bioflora plus from Synergy Therapeutics Rx. Bioflora Plus is a probiotic supplement developed to promote a healthy digestive system.  Bioflora Plus, formulated with 12 billion CFU of lactobacillus acidophilus, B. longum, B.bifidum and B.lactis, can help relieve your lactose intolerance symptoms.

 

References:

1.    Savaiano DA, Levitt MD. Milk intolerance and microbe-containing dairy foods. J Dairy Sci 1987;70(2):397-406. (PUBMED Abstract)
2.    Montalto M, Curigliano V, Santoro L, et al. Management and treatment of lactose malabsorption. World J Gastroenterol 2006;12(2):187-91. (PUBMED Abstract)
3.    He T, Venema K, Priebe MG, et al. The role of colonic metabolism in lactose intolerance. Eur J Clin Invest 2008;38(8):541-7. (PUBMED Abstract)
4.    Sibley E. Genetic variation and lactose intolerance: detection methods and clinical implications. Am J Pharmacogenomics 2004;4(4):239-45. (PUBMED Abstract)
5.    Lomer MC, Parkes GC, Sanderson JD. Review article: lactose intolerance in clinical practice–myths and realities. Aliment Pharmacol Ther 2008;27(2):93-103. (PUBMED Abstract)
6.    Szilagyi A. Redefining lactose as a conditional prebiotic. Can J Gastroenterol 2004;18(3):163-7. (PUBMED Abstract)
7.    Ouwehand AC, Salminen S, Isolauri E. Probiotics: an overview of beneficial effects. Antonie Van Leeuwenhoek 2002;82(1-4):279-89. (PUBMED Abstract)
8.    Guarner F, Perdigon G, Corthier G, et al. Should yoghurt cultures be considered probiotic? Br J Nutr 2005;93(6):783-6. (PUBMED Abstract)
9.    Sieber R, Stransky M, de Vrese M. [Lactose intolerance and consumption of milk and milk products]. Z Ernahrungswiss 1997;36(4):375-93. (PUBMED Abstract)
10.    de Vrese M, Stegelmann A, Richter B, et al. Probiotics–compensation for lactase insufficiency. Am J Clin Nutr 2001;73(2 Suppl):421S-9S. (PUBMED Abstract)
11.    Marteau PR. Probiotics in clinical conditions. Clin Rev Allergy Immunol 2002;22(3):255-73. (PUBMED Abstract)
12.    Rolfe RD. The role of probiotic cultures in the control of gastrointestinal health. J Nutr 2000;130(2S Suppl):396S-402S. (PUBMED Abstract)
13.    de Vrese M, Schrezenmeir J. Probiotics, prebiotics, and synbiotics. Adv Biochem Eng Biotechnol 2008;111:1-66. (PUBMED Abstract)
14.    Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol 2000;78(1):80-8. (PUBMED Abstract)
15.    Sanders ME, Klaenhammer TR. Invited review: the scientific basis of Lactobacillus acidophilus NCFM functionality as a probiotic. J Dairy Sci 2001;84(2):319-31. (PUBMED Abstract)
16.    Jiang T, Savaiano DA. In vitro lactose fermentation by human colonic bacteria is modified by Lactobacillus acidophilus supplementation. J Nutr 1997;127(8):1489-95. (PUBMED Abstract)
17.    Jiang T, Savaiano DA. Modification of colonic fermentation by bifidobacteria and pH in vitro. Impact on lactose metabolism, short-chain fatty acid, and lactate production. Dig Dis Sci 1997;42(11):2370-7. (PUBMED Abstract)
18.    Jiang T, Mustapha A, Savaiano DA. Improvement of lactose digestion in humans by ingestion of unfermented milk containing Bifidobacterium longum. J Dairy Sci 1996;79(5):750-7. (PUBMED Abstract)
19.    He T, Priebe MG, Zhong Y, et al. Effects of yogurt and bifidobacteria supplementation on the colonic microbiota in lactose-intolerant subjects. J Appl Microbiol 2008;104(2):595-604. (PUBMED Abstract)

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