Understanding Probiotics

The topic of probiotics can be a bit confusing, especially given all the questions I get from patients concerning them. Today I want to try to clear things up and relay some essential information about probiotics, including a discussion about their utility in the management of urinary tract infections. Thank you Chat GPT for helping me edit this entry.ogurt is a great natural source of probiotics.

Our bodies are host to a whole community of microorganisms called the microbiome. Research shows that a healthy balance of these little guys in/on our body and particularly within our digestive system is key to overall health.

Probiotics are live microorganisms that are good for us. These include bacteria, yeast, and fungi. These are usually sourced from foods or, alternatively, supplements. They pass through our digestive system and can provides some real benefits for our health.

It’s important to note that prebiotics are different—they’re food for the good bacteria in our gut, and not the bacteria themselves. When you combine probiotics and prebiotics, you get synbiotics, which can be extra beneficial.

Probiotic microorganisms can adhere to our cells, produce helpful substances, and even fight off “bad” bacteria. The most well-known probiotics are Lactobacillus and Bifidobacteria—they’re present in a lot of yogurts and other fermented foods. The seven core types of microbial organisms most often used in probiotic products are the following: Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus.

Fermented foods are great sources of probiotics. These include yogurt, kefir, sauerkraut (fermented cabbage), kimchi (fermented Korean cabbage), pickles, miso (fermented soybean-based paste), tamari, tempeh, kombucha (fermented tea), sour cream, cottage cheese, aged cheeses, and buttermilk.  Just be aware that if fermented foods are processed, pasteurized, heated, canned, or subjected to prolonged storage, they might lose their live cultures. So, these products can be awesome for your gut health, but check the labels to make sure they have live cultures.  Furthermore, many microorganisms that start off live will not survive the journey through the stomach or the breakdown in the small intestine by enzymes and bile salts.

If you’re not a fan of fermented foods, no worries—probiotics are also available in supplements, including capsules and powders. These have different strains and doses, measured in colony forming units (CFU). They’re often used to help with problems such as diarrhea, irritable bowel syndrome, and even some skin conditions.

Now, let’s discuss probiotics and urinary tract health. Turns out, our urinary tract isn’t as sterile as we once thought. It’s actually home to some “good” bacteria, including types of Lactobacilli. These bacteria play a role in keeping our urinary system healthy.

For women, particularly before menopause, Lactobacillus species dominate both the vagina and urinary tract, helping to prevent infections.  After menopause, the vaginal pH changes and the predominant flora are no longer Lactobacillus species but become those bacteria that typically inhabit the intestinal tract, the ones usually responsible for causing urinary tract infections, most commonly E. Coli.  The change in the vaginal bacterial ecosystem after menopause is one of the key reasons for the spike in UTIs in postmenopausal females.  

That’s where probiotics can help. By taking Lactobacillus orally or vaginally, you can help maintain a healthy balance of bacteria. Oral or vaginal Lactobacillus therapy is capable of colonizing the urinary tract following intestinal colonization.  Lactobacilli can prevent the adherence, growth, and colonization of the type of bacteria that cause urinary infections and may even decrease antibiotic resistance. 

So, whether you’re looking to boost your gut health or support your urinary tract, probiotics can be a great addition to your routine. Just remember to choose foods or supplements with live cultures and talk to your doctor if you have any concerns. Your body—and your gut—will thank you!