Colon Health & Probiotics: Unpacking the Benefits - Dr. Michael Ruscio, DC

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Colon Health & Probiotics: Unpacking the Benefits

The Latest Research & Insights on the Effects of Probiotics on Colon Health.

Key Takeaways:

  • Probiotics have been shown to alleviate intestinal symptoms like gas, bloating, constipation, and diarrhea.
  • The vast majority of beneficial microbial life in your body resides in your colon.
  • Probiotics can improve leaky gut, rebalance the gut microbiome, alter gut chemistry, and reduce inflammation.
  • Probiotics have been shown to improve symptoms associated with colorectal cancer, ulcerative colitis, diverticular disease, IBS, and gut disruptions related to antibiotics.

If a client asked me to recommend a single supplement that would offer the greatest potential for improvement across large swaths of human health, I would choose a probiotic supplement. Probiotics are known for their comprehensive health benefits, including immune health, digestive health, mood, cognition, sleep, hormonal health, cardiovascular health, and metabolic health [1, 2, 3].

Although humans are covered in microbes from head to toe, the vast majority of the beneficial bacteria and fungi that have such a massive impact on your wellness reside in your colon. So it makes sense that fortifying that colony of bacteria through a supplement—alongside a helpful diet and lifestyle—is one of the best things you can do for your health. It also makes sense that probiotics would directly impact colon health as well.

But what does the research say about colon health & probiotics specifically? Are there particular strains or categories that are better for addressing digestive issues than others? Have probiotics been shown to address conditions like ulcerative colitis or Crohn’s disease? And how safe are these supplements to take? Are there any potential side effects? Let’s do a deep dive into the latest research on colon health & probiotics to help you best understand the risks and benefits.

What We Know About Probiotics and the Gut Microbiome

As I said above, the vast majority of the microbial life in our bodies resides in the large intestine (aka the colon). This includes both helpful and harmful species. A healthy microbiota—one that has a balance of organisms and doesn’t create adverse symptoms—generally means a healthy colon. And probiotics (especially when paired with a supportive diet and great sleep) can help improve your microbiota by refortifying the colon with good bacteria.

Studies have shown that probiotics can improve colon health via the following mechanisms:

  • Improve recovery time from gut imbalances and restore healthy gut flora [4]
  • Help fight and displace harmful bacteria and the toxic byproducts they create in the gut [5, 6, 7]
  • Produce antimicrobial compounds that directly prevent multi-drug resistant bacteria from reproducing [8]
  • Reduce inflammation in the gut [9
  • Improve leaky gut syndrome [10, 11, 12]
  • Help strengthen the intestinal wall and promote tissue recovery in the tight junctions of the intestinal lining [13, 14]
  • Improve immune status and function and reducing inflammation [13, 14, 15
  • Alter gut biochemistry [16]
  • Increase short-chain fatty acids and modifying pH to improve motility and transit time [17]
  • Stick to the intestinal lining and compete for resources there to indirectly limit multi-drug resistant bacteria [8, 15]
  • Producing SCFAs and aid in butyrate production, the primary fuel for colon cells [18]

All of the following activities are beneficial for your overall digestive health and, ultimately, general health. By strengthening colon health through probiotic fortification, you’re protecting yourself against harmful invaders, whether it’s a virus that might give you a cold or partially digested food leaking through the gut lining and leading to systemic inflammation or food sensitivities.

Colon-Specific Conditions that Probiotics May Help Address

Probiotics are beneficial to the whole digestive system, but they’ve also been studied for their effects on colon-specific ailments. Studies have shown that probiotics are effective at improving symptoms related to:

Combined with my own clinical experience as well as those of other functional health colleagues, this research bolsters the benefits of probiotics for colon health.

Which Kinds of Probiotics Are Most Effective for Colon Health?

The study of specific strains of probiotics is still in its early days, but it seems to be the general consensus that using a diversity of strains, species, and categories is an effective strategy for covering all your bases. You also want a product that measures the CFUs in the billions, ideally the 10s of billions.

Most of the available research didn’t specify particular bacteria over others, but the most commonly analyzed were single or multi-strain probiotics containing Bifidobacteria and/or Lactobacilli species [13, 15, 19, 21, 26, 34].

Lacto acidophilus is a very well-studied bacterial species because it was among the first to be marketed to the public in products like yogurt and Culturelle, but there’s no evidence that it’s any more effective than other Lacto strains. It’s simply gotten more attention.

That being said, one meta-analysis and one systematic review did specify that a multi-strain probiotic that included Lactobacillus and Bifidobacterium was the best choice for relieving IBD, especially ulcerative colitis [22, 27].

In our clinic, we’ve found that clients see the greatest and most rapid improvement with a triple therapy approach to a daily probiotic supplement. The triple therapy approach involves supplementing with bacteria across the three main categories:

  1. Lactobacillus and Bifidobacterium (this is the most common kind you see at your health foods store)
  2. Saccharomyces Boulardii (a well-studied beneficial fungal-based probiotic)
  3. Soil-based probiotics 

By combining these three, you may achieve a synergistic effect that helps rebalance dysbiosis (like SIBO and yeast), remove parasites, and repair the gut wall. Doing all this helps reduce:

  • Gut infections [46, 47, 48]
  • Inflammatory bowel disease [49, 50]

While there’s still more work to be done to better understand the effects of different probiotic strains on various issues and ailments, the cumulative evidence supports our clinical experience that a more diverse probiotic is the best option for most people [8, 14, 16, 27].

Probiotics Safety and Side Effects

Most of the studies looking at the effects of probiotics across the wide array of conditions they may be used for didn’t look at safety. That’s because most researchers consider probiotics to be safe. The randomized controlled trials that did specifically assess safety also considered probiotics well-tolerated and safe when used appropriately [14, 15, 16, 17, 18, 21, 32, 34, 51]. Although there’s likely no harm in consuming an expired probiotic, you always want to check the bottle for time of expiry, as well as whether or not the particular product you’re looking at contains something you’re allergic or sensitive to.

Colon Health & Probiotic

While just about all probiotics are gluten-free, some may be cultured on lactose, and some probiotic caplets and capsules are made with gelatin, which isn’t vegetarian. Some companies also indicate that they are free of GMOs, which is another thing to look for on the label. Everyone is different with different requirements, so be sure to look over the product information before you get to the checkout line.

And, as with any other supplement or medication, you’ll want to make sure you’re storing them out of the reach of children. Many probiotics require refrigeration, so be sure to keep them safe from accidental consumption. This is especially important with gummies and chewable tablets that may seem like candy to a child. Even (and maybe especially) if the probiotic is formulated for children, you want to make sure you’re monitoring the dosage to prevent any unwanted side effects.

Potential Side Effects

There are a few potential side effects of using probiotics, but they’re usually in the short-term until your body acclimates. Short-term side effects may include mild, temporary intestinal symptoms, such as loose stool, constipation, flatulence, appetite loss, abdominal pain, indigestion, or nausea [18].

This is especially true if the one you choose also contains prebiotics in the formulation. That’s because many prebiotics are also FODMAPs. Prebiotics are the foods that feed the bacteria in your gut. Foods like alliums (garlic, onions, leeks), and cruciferous veggies (broccoli, cabbage, cauliflower) are prebiotic foods. In supplements, prebiotics are often named in the label and include things like pectin, oligosaccharides (the “O” in FODMAP), or chicory. If you’re sensitive to FODMAPs, you might specifically opt for a probiotic that doesn’t include prebiotics in it.

That being said, any potential side effects from probiotics are likely less severe than those of laxative products, as those can be habit-forming if used for too long.

Bottom Line on Colon Health & Probiotics

Using a probiotic as part of your daily care regimen is a good thing for your overall health and wellness in general, as well as your digestive health, in particular. Probiotics promote a healthy immune system, hormonal health, metabolic and cardiovascular health. They may also help reduce brain fog and stabilize mood when combined with a supportive diet and positive lifestyle practices.

The potential upsides are plentiful, including relief from a number of digestive symptoms and possibly even more severe digestive conditions such as ulcerative colitis, IBS, and diverticulitis.

If you’d like support on your gut health journey, please reach out to our clinic to book a time to connect. Or, if you’d like to learn more about how probiotics can improve your digestive health as well as your overall health, Healthy Gut Healthy You is a great resource.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

➕ References
  1. Güvenç IA, Muluk NB, Mutlu FŞ, Eşki E, Altıntoprak N, Oktemer T, et al. Do probiotics have a role in the treatment of allergic rhinitis? A comprehensive systematic review and meta-analysis. Am J Rhinol Allergy. 2016 Sep 1;30(5):157–75. DOI: 10.2500/ajra.2016.30.4354. PMID: 27442711.
  2. Frändemark Å, Jakobsson Ung E, Törnblom H, Simrén M, Jakobsson S. Fatigue: a distressing symptom for patients with irritable bowel syndrome. Neurogastroenterol Motil. 2017 Jan;29(1). DOI: 10.1111/nmo.12898. PMID: 27401139.
  3. Ng QX, Peters C, Ho CYX, Lim DY, Yeo W-S. A meta-analysis of the use of probiotics to alleviate depressive symptoms. J Affect Disord. 2018 Mar 1;228:13–9. DOI: 10.1016/j.jad.2017.11.063. PMID: 29197739.
  4. Sanders ME. Impact of probiotics on colonizing microbiota of the gut. J Clin Gastroenterol. 2011 Nov;45 Suppl:S115-9. DOI: 10.1097/MCG.0b013e318227414a. PMID: 21992949.
  5. Wang F, Feng J, Chen P, Liu X, Ma M, Zhou R, et al. Probiotics in Helicobacter pylori eradication therapy: Systematic review and network meta-analysis. Clin Res Hepatol Gastroenterol. 2017 Sep;41(4):466–75. DOI: 10.1016/j.clinre.2017.04.004. PMID: 28552432.
  6. García-Collinot G, Madrigal-Santillán EO, Martínez-Bencomo MA, Carranza-Muleiro RA, Jara LJ, Vera-Lastra O, et al. Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis. Dig Dis Sci. 2020 Apr;65(4):1134–43. DOI: 10.1007/s10620-019-05830-0. PMID: 31549334.
  7. Greco A, Caviglia GP, Brignolo P, Ribaldone DG, Reggiani S, Sguazzini C, et al. Glucose breath test and Crohn’s disease: Diagnosis of small intestinal bacterial overgrowth and evaluation of therapeutic response. Scand J Gastroenterol. 2015 May 19;50(11):1376–81. DOI: 10.3109/00365521.2015.1050691. PMID: 25990116.
  8. Wieërs G, Verbelen V, Van Den Driessche M, Melnik E, Vanheule G, Marot J-C, et al. Do Probiotics During In-Hospital Antibiotic Treatment Prevent Colonization of Gut Microbiota With Multi-Drug-Resistant Bacteria? A Randomized Placebo-Controlled Trial Comparing Saccharomyces to a Mixture of Lactobacillus, Bifidobacterium, and Saccharomyces. Front Public Health. 2020;8:578089. DOI: 10.3389/fpubh.2020.578089. PMID: 33763399. PMCID: PMC7982943.
  9. Hoveyda N, Heneghan C, Mahtani KR, Perera R, Roberts N, Glasziou P. A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome. BMC Gastroenterol. 2009 Feb 16;9:15. DOI: 10.1186/1471-230X-9-15. PMID: 19220890. PMCID: PMC2656520.
  10. Mujagic Z, de Vos P, Boekschoten MV, Govers C, Pieters H-JHM, de Wit NJW, et al. The effects of Lactobacillus plantarum on small intestinal barrier function and mucosal gene transcription; a randomized double-blind placebo controlled trial. Sci Rep. 2017 Jan 3;7:40128. DOI: 10.1038/srep40128. PMID: 28045137. PMCID: PMC5206730.
  11. Sindhu KNC, Sowmyanarayanan TV, Paul A, Babji S, Ajjampur SSR, Priyadarshini S, et al. Immune response and intestinal permeability in children with acute gastroenteritis treated with Lactobacillus rhamnosus GG: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2014 Apr;58(8):1107–15. DOI: 10.1093/cid/ciu065. PMID: 24501384. PMCID: PMC3967829.
  12. Lamprecht M, Bogner S, Schippinger G, Steinbauer K, Fankhauser F, Hallstroem S, et al. Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial. J Int Soc Sports Nutr. 2012 Sep 20;9(1):45. DOI: 10.1186/1550-2783-9-45. PMID: 22992437. PMCID: PMC3465223.
  13. Liu D, Jiang X-Y, Zhou L-S, Song J-H, Zhang X. Effects of Probiotics on Intestinal Mucosa Barrier in Patients With Colorectal Cancer after Operation: Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore). 2016 Apr;95(15):e3342. DOI: 10.1097/MD.0000000000003342. PMID: 27082589. PMCID: PMC4839833.
  14. Lyra A, Hillilä M, Huttunen T, Männikkö S, Taalikka M, Tennilä J, et al. Irritable bowel syndrome symptom severity improves equally with probiotic and placebo. World J Gastroenterol. 2016 Dec 28;22(48):10631–42. DOI: 10.3748/wjg.v22.i48.10631. PMID: 28082816. PMCID: PMC5192275.
  15. Wu X-D, Xu W, Liu M-M, Hu K-J, Sun Y-Y, Yang X-F, et al. Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta-analysis of randomized controlled trials. J Surg Oncol. 2018 Jun;117(7):1394–404. DOI: 10.1002/jso.25038. PMID: 29572838.
  16. Ibarra A, Latreille-Barbier M, Donazzolo Y, Pelletier X, Ouwehand AC. Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: A double-blind, randomized, placebo-controlled, and dose-ranging trial. Gut Microbes. 2018 Feb 8;9(3):236–51. DOI: 10.1080/19490976.2017.1412908. PMID: 29227175. PMCID: PMC6219592.
  17. Riezzo G, Orlando A, D’Attoma B, Linsalata M, Martulli M, Russo F. Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation. Benef Microbes. 2018 Jan 29;9(1):51–60. DOI: 10.3920/BM2017.0049. PMID: 29022390.
  18. Merenstein D, Fraser CM, Roberts RF, Liu T, Grant-Beurmann S, Tan TP, et al. Bifidobacterium animalis subsp. lactis BB-12 Protects against Antibiotic-Induced Functional and Compositional Changes in Human Fecal Microbiome. Nutrients. 2021 Aug 17;13(8). DOI: 10.3390/nu13082814. PMID: 34444974. PMCID: PMC8398419.
  19. Chen Y, Qi A, Teng D, Li S, Yan Y, Hu S, et al. Probiotics and synbiotics for preventing postoperative infectious complications in colorectal cancer patients: a systematic review and meta-analysis. Tech Coloproctol. 2022 Jun;26(6):425–36. DOI: 10.1007/s10151-022-02585-1. PMID: 35348943.
  20. Cruz BCS, Sarandy MM, Messias AC, Gonçalves RV, Ferreira CLLF, Peluzio MCG. Preclinical and clinical relevance of probiotics and synbiotics in colorectal carcinogenesis: a systematic review. Nutr Rev. 2020 Aug 1;78(8):667–87. DOI: 10.1093/nutrit/nuz087. PMID: 31917829.
  21. Kaur L, Gordon M, Baines PA, Iheozor-Ejiofor Z, Sinopoulou V, Akobeng AK. Probiotics for induction of remission in ulcerative colitis. Cochrane Database Syst Rev. 2020 Mar 4;3(3):CD005573. DOI: 10.1002/14651858.CD005573.pub3. PMID: 32128795. PMCID: PMC7059959.
  22. Pabón-Carrasco M, Ramirez-Baena L, Vilar-Palomo S, Castro-Méndez A, Martos-García R, Rodríguez-Gallego I. Probiotics as a Coadjuvant Factor in Active or Quiescent Inflammatory Bowel Disease of Adults-A Meta-Analytical Study. Nutrients. 2020 Aug 28;12(9). DOI: 10.3390/nu12092628. PMID: 32872272. PMCID: PMC7551006.
  23. Losurdo G, Iannone A, Contaldo A, Ierardi E, Di Leo A, Principi M. Escherichia coli Nissle 1917 in Ulcerative Colitis Treatment: Systematic Review and Meta-analysis. J Gastrointestin Liver Dis. 2015 Dec;24(4):499–505. DOI: 10.15403/jgld.2014.1121.244.ecn. PMID: 26697577.
  24. Avalueva EB, Uspenskiĭ IP, Tkachenko EI, Sitkin SI. [Use of Saccharomyces boulardii in treating patients inflammatory bowel diseases (clinical trial)]. Eksp Klin Gastroenterol. 2010;(7):103–11. PMID: 21033091.
  25. Naidoo K, Gordon M, Fagbemi AO, Thomas AG, Akobeng AK. Probiotics for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD007443. DOI: 10.1002/14651858.CD007443.pub2. PMID: 22161412.
  26. Zhong C, Qu C, Wang B, Liang S, Zeng B. Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence. J Clin Gastroenterol. 2017 Apr;51(4):300–11. DOI: 10.1097/MCG.0000000000000814. PMID: 28267052.
  27. Zhang X-F, Guan X-X, Tang Y-J, Sun J-F, Wang X-K, Wang W-D, et al. Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: a systematic review and meta-analysis. Eur J Nutr. 2021 Aug;60(5):2855–75. DOI: 10.1007/s00394-021-02503-5. PMID: 33555375.
  28. Ojetti V, Petruzziello C, Cardone S, Saviano L, Migneco A, Santarelli L, et al. The use of probiotics in different phases of diverticular disease. Rev Recent Clin Trials. 2018;13(2):89–96. DOI: 10.2174/1574887113666180402143140. PMID: 29607785.
  29. Abhari K, Saadati S, Hosseini-Oskouiee F, Yari Z, Hosseini H, Sohrab G, et al. Is Bacillus coagulans supplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management? Eur J Nutr. 2020 Aug;59(5):2111–7. DOI: 10.1007/s00394-019-02060-y. PMID: 31327047.
  30. Vasant DH, Paine PA, Black CJ, Houghton LA, Everitt HA, Corsetti M, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut. 2021 Jul;70(7):1214–40. DOI: 10.1136/gutjnl-2021-324598. PMID: 33903147.
  31. Dumitrascu DL, Baban A, Bancila I, Barboi O, Bataga S, Chira A, et al. Romanian guidelines for nonpharmacological therapy of IBS. J Gastrointestin Liver Dis. 2021 Jun 18;30(2):291–306. DOI: 10.15403/jgld-3581. PMID: 33951120.
  32. Airaksinen K, Yeung N, Lyra A, Lahtinen SJ, Huttunen T, Shanahan F, et al. The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: a double blind, randomised, placebo controlled 2-week trial. Benef Microbes. 2019 Jul 10;10(6):617–27. DOI: 10.3920/BM2018.0163. PMID: 31131616.
  33. Kang S, Park MY, Brooks I, Lee J, Kim SH, Kim JY, et al. Spore-forming Bacillus coagulans SNZ 1969 improved intestinal motility and constipation perception mediated by microbial alterations in healthy adults with mild intermittent constipation: A randomized controlled trial. Food Res Int. 2021 Aug;146:110428. DOI: 10.1016/j.foodres.2021.110428. PMID: 34119240.
  34. Iheozor-Ejiofor Z, Kaur L, Gordon M, Baines PA, Sinopoulou V, Akobeng AK. Probiotics for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2020 Mar 4;3(3):CD007443. DOI: 10.1002/14651858.CD007443.pub3. PMID: 32128794. PMCID: PMC7059960.
  35. Wen Y, Li J, Long Q, Yue C-C, He B, Tang X-G. The efficacy and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: A systematic review and meta-analysis based on seventeen randomized controlled trials. Int J Surg. 2020 Jul;79:111–9. DOI: 10.1016/j.ijsu.2020.04.063. PMID: 32387213.
  36. Zhang C, Jiang J, Tian F, Zhao J, Zhang H, Zhai Q, et al. Meta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults. Clin Nutr. 2020 Oct;39(10):2960–9. DOI: 10.1016/j.clnu.2020.01.005. PMID: 32005532.
  37. Miller LE, Ouwehand AC, Ibarra A. Effects of probiotic-containing products on stool frequency and intestinal transit in constipated adults: systematic review and meta-analysis of randomized controlled trials. Ann Gastroenterol. 2017 Sep 21;30(6):629–39. DOI: 10.20524/aog.2017.0192. PMID: 29118557. PMCID: PMC5670282.
  38. Liao W, Chen C, Wen T, Zhao Q. Probiotics for the Prevention of Antibiotic-associated Diarrhea in Adults: A Meta-Analysis of Randomized Placebo-Controlled Trials. J Clin Gastroenterol. 2021 Jul 1;55(6):469–80. DOI: 10.1097/MCG.0000000000001464. PMID: 33234881. PMCID: PMC8183490.
  39. McFarland LV, Goh S. Are probiotics and prebiotics effective in the prevention of travellers’ diarrhea: A systematic review and meta-analysis. Travel Med Infect Dis. 2019;27:11–9. DOI: 10.1016/j.tmaid.2018.09.007. PMID: 30278238.
  40. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008 May 7;14(17):2650–61. DOI: 10.3748/wjg.14.2650. PMID: 18461650. PMCID: PMC2709042.
  41. Martoni CJ, Srivastava S, Leyer GJ. Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABla-12 Improve Abdominal Pain Severity and Symptomology in Irritable Bowel Syndrome: Randomized Controlled Trial. Nutrients. 2020 Jan 30;12(2). DOI: 10.3390/nu12020363. PMID: 32019158. PMCID: PMC7071206.
  42. Whelan K. Probiotics and prebiotics in the management of irritable bowel syndrome:  a review of recent clinical trials and systematic reviews. Curr Opin Clin Nutr Metab Care. 2011 Nov;14(6):581–7. DOI: 10.1097/MCO.0b013e32834b8082. PMID: 21892075.
  43. Ford AC, Quigley EMM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014 Oct;109(10):1547–61; quiz 1546, 1562. DOI: 10.1038/ajg.2014.202. PMID: 25070051.
  44. Rogha M, Esfahani MZ, Zargarzadeh AH. The efficacy of a synbiotic containing Bacillus Coagulans in treatment of irritable bowel syndrome: a randomized placebo-controlled trial. Gastroenterol Hepatol Bed Bench. 2014;7(3):156–63. PMID: 25120896. PMCID: PMC4129566.
  45. Khalighi AR, Khalighi MR, Behdani R, Jamali J, Khosravi A, Kouhestani S, et al. Evaluating the efficacy of probiotic on treatment in patients with small intestinal bacterial overgrowth (SIBO)–a pilot study. Indian J Med Res. 2014 Nov;140(5):604–8. PMID: 25579140. PMCID: PMC4311312.
  46. Demirel G, Celik IH, Erdeve O, Saygan S, Dilmen U, Canpolat FE. Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants. Eur J Pediatr. 2013 Oct;172(10):1321–6. DOI: 10.1007/s00431-013-2041-4. PMID: 23703468.
  47. Dinleyici EC, Eren M, Dogan N, Reyhanioglu S, Yargic ZA, Vandenplas Y. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection. Parasitol Res. 2011 Mar;108(3):541–5. DOI: 10.1007/s00436-010-2095-4. PMID: 20922415.
  48. Besirbellioglu BA, Ulcay A, Can M, Erdem H, Tanyuksel M, Avci IY, et al. Saccharomyces boulardii and infection due to Giardia lamblia. Scand J Infect Dis. 2006;38(6–7):479–81. DOI: 10.1080/00365540600561769. PMID: 16798698.
  49. Kruis W, Fric P, Pokrotnieks J, Lukás M, Fixa B, Kascák M, et al. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut. 2004 Nov;53(11):1617–23. DOI: 10.1136/gut.2003.037747. PMID: 15479682. PMCID: PMC1774300.
  50. Hedin C, Whelan K, Lindsay JO. Evidence for the use of probiotics and prebiotics in inflammatory bowel disease: a review of clinical trials. Proc Nutr Soc. 2007 Aug;66(3):307–15. DOI: 10.1017/S0029665107005563. PMID: 17637082.
  51. Spaiser SJ, Culpepper T, Nieves C, Ukhanova M, Mai V, Percival SS, et al. Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM-2 Ingestion Induces a Less Inflammatory Cytokine Profile and a Potentially Beneficial Shift in Gut Microbiota in Older Adults: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study. J Am Coll Nutr. 2015 Apr 24;34(6):459–69. DOI: 10.1080/07315724.2014.983249. PMID: 25909149.

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