“All disease begins in the gut” said the father of Western Medicine, Hippocrates.

It seems that well before anyone had a name for them, Hippocrates was well ahead of his counterparts when it came to health, disease and a relationship with food and the benefits of ‘good bacteria’ or probiotics in relation to gut health.

So what are probiotics and why is everyone harping on about them?

At any one time our gut is host to a huge number of bacteria. In fact the human body contains more bacterial cells than it does human cells at up to one billion to one trillion cells per gram! Probiotics or ‘good bacteria’ are live microorganisms which can be beneficial to the host when consumed in sufficient amounts. These good bacteria help to digest our food and can help prevent infections by crowding out ‘bad’ or pathogenic bacteria which could potentially be harmful to our health. The ‘good’ bacteria compete with the ‘bad’  for food and thus can eliminate them from our gut. They have also been shown to be helpful in stimulating our own immune system to fight infections better.

So where will you find probiotics?

There are several food sources of probiotics such as fermented dairy products including yoghurt, kefir products and some aged cheeses. There are also some non dairy sources such as miso, sauerkraut, tempeh, soy beverages and kimchi (the national dish of Korea – fermented vegetables). It is also possible to buy probiotics in a supplement form.

Be careful when choosing yoghurts and look for labels that talk about ‘live’ and ‘active cultures’ as many commercially available yoghurts have been pasteurised or heat treated which destroys the probiotics.

So what are the health benefits of probiotics?

Ever been prescribed a course of antibiotics that has resulted in diarrhoea? Whilst antibiotics are great at killing off the harmful bacteria that are causing us to be unwell, they can also mess with the balance of our gut bacteria, resulting in diarrhoea. Numerous studies have shown that when probiotics are taken at the same time as antibiotics are prescribed and continue to be taken one week after completing the antibiotics they have helped prevent people from contracting diarrhoea.

Acute infectious diarrhoea

A review looking at 63 trials totaling 8014 people found shortened duration of diarrhoea and reduced stool frequency in those that took probiotics compared to control cases.

Another review also determined that probiotics can reduce your chances of getting travellers’ diarrhoea when taken for the entirety of your trip.

Inflammatory bowel disease – ulcerative colitis and Crohn’s diease

Diseases – that result in ulceration of the gut and severe diarrhoea. There has been a lot of recent research into this area and whether probiotics are helpful or not. It seems that currently there is some research to suggest there is a benefit of taking probiotics in Ulcerative Colitis, but evidence for their use in Crohn’s Disease remains inconclusive.

Irritable bowel syndrome

This can result in changes to the gut environment and knock our healthy gut bacteria out of balance. There is some evidence that whilst probiotics will not fix IBS, they may improve some of the symptoms associated with IBS such as bloating.

How much should I take?

There is unfortunately no easy answer to this question. If you are taking a supplement, follow the manufacturer’s guidelines.  As the beneficial effects of probiotics only last for a few days , it is recommended that probiotics be consumed daily, and because it can take time for the gut environment to change, it is recommended that probiotics be taken consistently for up to a couple of weeks before benefits may be seen.  If you are taking probiotics in food sources, the numbers needed to add benefit differ from strain to strain and will have different effects from person to person. Research is currently looking at determining the exact amounts needed for different conditions.

That being said, most people do not experience adverse side effects from probiotics, the most being some gastro upset such as gas. There are ongoing trials looking at safety in long term use, use in children and in the critically ill. There is some evidence that the critically ill and immunocompromised individuals should not use probiotics.

We can’t talk about probiotics without mentioning prebiotics. So what are they?

Simply put, prebiotics are the food source for probiotics. They are types of carbohydrate and include fructo-oligosaccharides and galacto-oligosaccharides (don’t worry about the silly names) that are non-digestable. Eating prebiotics therefore encourages the growth of probiotics. Good sources of prebiotics are onions, garlic, leeks, asparagus, artichokes and bananas.

When prebiotics and probiotics work together in products it is called ‘synbiotics’. For dinner tonight you might think about having a stirfry which includes onion, garlic and some tempeh followed by bananas with yoghurt.


In the least, prebiotics and probiotics could potentially enhance your gut health, creating a healthier you. And as Hippocrates said ‘All disease begins in the gut’ Well maybe all health begins in the gut too.


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