Prebiotics & Digestive Diseases

There has been a huge amount of medical research into the effect of prebiotics on general good health and in a variety of gastrointestinal disorders. These have been well-summarized by a state-of the-science medical paper in 2010*.

General Good Health

There is now considerable evidence in the medical research literature that prebiotics promote good health in many ways. These include increased calcium absorption, stronger bones, strengthened immune system, bowel regularity and many others.

Infectious Diseases, including C. Diff (Clostridium Difficile)

The amount of data is limited but suggests a protective effect with inulin type of prebiotics in the recurrence of C. diff infection. These prebiotics seemed to reduce the incidence of recurrence.

Irritable Bowel Syndrome (IBS)

IBS is a functional bowel disorder consisting of abdominal distension and fullness, recurrent distress or discomfort and changes in flatulence and stool. Prebiotics have been shown to modulate the bacterial mix in a favorable way and to provide symptomatic relief in some patients. Even so, prebiotics should initially be used in low doses and increased only gradually, depending on symptoms of bloating and gas.

Inflammatory Bowel Disease (IBD)

It is now well-established that both ulcerative colitis (UC) and Crohn’s Disease (CD) start with gut bacteria invading the wall of the colon. Modulating the bacterial mix in the colon with prebiotics, either in food and/or a supplement, has a sound theortical basis. A few early trials of inulin-type prebiotic showed a reduction in inflammatory factors in UC patients. In CD, likewise, it is felt that a healthy positive mix of bacteria would favor an improvement.

Celiac Disease and Gluten Intolerance

For the celiac and gluten intolerant, a gluten free diet is tough to follow but it is the only treatment available. For most people, wheat contains the major source of prebiotics for the best growth of good colon bacteria. The diet for the celiac and gluten intolerant, therefore, must not only remove gluten in all its forms, but must add those foods that are prebiotic rich as well as gluten-free.  Additionally, a prebiotic rich supplement should be considered. See our article on Prebiotics: An Important Nutrient for the Gluten-Free Diet. Also, see answers to frequently asked questions about Celiac Disease and Prebiotics.

Pouchitis

Reduced inflammation has already been shown by inulin type of prebiotics. Further testing is warranted but for now prebiotics strongly suggest a protective effect.

Colon Polyps and Cancer

Obesity, processed meats and alcohol have been associated with increased risk of these tumors. Likewise, fiber, garlic, milk and calcium have shown protective effects. The activity and makeup of the colon bacteria is the key. Prebiotics are felt to, therefore, offer a degree of protection. This has certainly been the case in medical studies of colon polyps and cancer done in the laboratory as well as in some animal models.

*Roberfroid M, Gibson GR et al. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010 Aug; 104 Suppl 2:S1-63.