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Bacteria often get the bad rap for causing infection. However, the discovery of probiotics proves that certain bacteria, with a certain amount, can actually be beneficial to our body. The International Scientific Association for Probiotics and Prebiotics defines probiotics as live microorganisms that, when administered in adequate amounts, confer a health benefit on the host (i.e. us).
What are probiotics and where can I find them?
Probiotics should not be confused with prebiotics. Prebiotics are typically complex carbohydrates that the probiotics in the gut use as metabolic fuel. Imagine probiotics as a car, then prebiotics would be petrol for the car to function optimally. Many commercial products today contain both probiotics and prebiotics and are referred to as synbiotics.
Probiotics are identified by the specific strain of microorganisms. The seven most common microorganisms used in probiotic products are Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus.
Apart from the commercial probiotics products you often find in the pharmacies, many foods actually contain probiotics. Yoghurt, kimchi, miso soup, tempeh and cheese, to name a few.
Probiotics may be useful for the following condition:
Probiotics were found to improve diarrhoea in infants and children, as well as diarrhoea caused by long-term antibiotic treatment. Studies show that taking probiotics that contain single or more strains can shorten the duration of diarrhoea and the number of times to pass motion. [1,2] Among all the strains, Lactobacillus rhamnosus GG at the dose of 1010 was found to be the most effective probiotics in treating infectious diarrhoea. [3,4]
Taking antibiotics can disturb your gut microflora, which can lead to diarrhoea as well. In such cases, probiotics can reduce the risk of getting diarrhoea as a result of taking antibiotics. [5,6] However, the effectiveness of probiotics in preventing antibiotic-associated diarrhoea depends on many factors such as types of antibiotics used, strains of probiotics taken, age of the user and whether the patient is being hospitalised or not. 
Surprisingly, there were some promising researches showing that probiotics may be helpful in treating allergic conditions such as eczema. Among infants and children aged 6 months to 9 years old, it was shown that probiotics containing Lactobacillus, Bifidobacterium, and Propionibacterium strains significantly reduced the risk of eczema.  It also found that probiotics are only beneficial to the children if the probiotics were given to the mother before and right after giving birth. Another high-quality study further confirmed that taking probiotics did improve eczema among children, but only limited to children aged 1 to 18 years old.  The strains also mattered a lot, as treatment with Lactobacillus, Lactobacillus fermentum, or a mixture of probiotic strains have shown improvement, but not Lactobacillus rhamnosus GG and Lactobacillus plantarum.
With Malaysia being hailed as the most obese country in Asia, we could really use some of the benefits of taking probiotics. One study found that consumption of milk containing probiotic Lactobacillus gasseri reduces fat in the abdomen.  A high-quality meta-analysis shows that combining a low-calorie diet with probiotics containing Lactobacillus plantarum and Lactobacillus rhamnosus may help to reduce body weight, but not all probiotics demonstrate the same benefits. 
Erm, but probiotics are ‘alive’ right? Would it cause harm?
Probiotics are generally safe to consume. But in some cases, the harm of using probiotics may outweigh the benefits probiotics would bring. These include:
Seriously ill hospitalised patients
We strongly encourage these groups of people to talk to a doctor or pharmacist before taking any probiotics.
Okay wait, so should I take probiotics or not?
The answer is: it depends. The decision of taking probiotics really depends on the condition you are taking probiotics for, the strains of probiotics you take and the number of probiotics containing in the product.
To know if you should take probiotics, chat with any online doctor or pharmacist on Doc2Us® app! Download the app on http://onelink.to/doc2us
Allen S, Martinez E, Gregorio G, Dans L. Probiotics for treating acute infectious diarrhoea. Cochrane Database of Systematic Reviews [Internet]. 2010 [cited 5 March 2020];. Available from: http://10.1002/14651858.CD003048.pub3
Feizizadeh S, Salehi-Abargouei A, Akbari V. Efficacy and safety of Saccharomyces boulardii for acute diarrhea. Pediatrics 2014;134:e176-91.
Szajewska H, Skórka A, Ruszczyński M, Gieruszczak-Białek D. Meta-analysis:LactobacillusGG for treating acute gastroenteritis in children - updated analysis of randomised controlled trials. Alimentary Pharmacology & Therapeutics. 2013;38(5):467-476.
Freedman S, Williamson-Urquhart S, Farion K, Gouin S, Willan A, Poonai N et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. New England Journal of Medicine [Internet]. 2018 [cited 5 March 2020];379(21):2015-2026. Available from: http://10.1056/NEJMoa1802597
Blaabjerg S, Artzi D, Aabenhus R. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients—A Systematic Review and Meta-Analysis. Antibiotics [Internet]. 2017 [cited 5 March 2020];6(4):21. Available from: http://10.3390/antibiotics6040021
Szajewska H, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Alimentary Pharmacology & Therapeutics [Internet]. 2015 [cited 5 March 2020];42(7):793-801. Available from: http://10.1111/apt.13344
Jafarnejad S, Shab-Bidar S, Speakman J, Parastui K, Daneshi-Maskooni M, Djafarian K. Probiotics Reduce the Risk of Antibiotic-Associated Diarrhea in Adults (18–64 Years) but Not the Elderly (>65 Years). Nutrition in Clinical Practice [Internet]. 2016 [cited 5 March 2020];31(4):502-513. Available from: http://10.1177/0884533616639399
Li L, Han Z, Niu X, Zhang G, Jia Y, Zhang S et al. Probiotic Supplementation for Prevention of Atopic Dermatitis in Infants and Children: A Systematic Review and Meta-analysis. American Journal of Clinical Dermatology [Internet]. 2018 [cited 5 March 2020];20(3):367-377. Available from: http://10.1007/s40257-018-0404-3
Huang R, Ning H, Shen M, Li J, Zhang J, Chen X. Probiotics for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Cellular and Infection Microbiology [Internet]. 2017 [cited 5 March 2020];7. Available from: http://10.3389/fcimb.2017.00392
Kadooka Y, Sato M, Ogawa A, Miyoshi M, Uenishi H, Ogawa H et al. Effect of Lactobacillus gasseri SBT2055 in fermented milk on abdominal adiposity in adults in a randomised controlled trial. British Journal of Nutrition [Internet]. 2013 [cited 5 March 2020];110(9):1696-1703. Available from: http://10.1017/S0007114513001037
Crovesy L, Ostrowski M, Ferreira D, Rosado E, Soares-Mota M. Effect of Lactobacillus on body weight and body fat in overweight subjects: a systematic review of randomized controlled clinical trials. International Journal of Obesity [Internet]. 2017 [cited 5 March 2020];41(11):1607-1614. Available from: https://doi.org/10.1038/ijo.2017.161
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