Probiotics and the Elderly by t6eW01x


									Probiotics and the Elderly

By David Luckett, PharmD Candidate, Campbell University School of Pharmacy, August 2008

What are Probiotics?                                 supplements, usually sold in capsule form.
                                                     These probiotics are similar to bacteria
The World Health Organization defines                found in peoples’ bodies, especially to that
probiotics as “live microorganisms, which,           of breastfed infants. These beneficial
when administered in adequate amounts,               bacteria are one of the mediators of infant
confer health benefit on the host.”                  immunity.
Probiotics are considered part of
complementary or alternative medicine                People are colonized with numerous
(CAM). Probiotics are commonly called                microorganisms which are beneficial to
“good” or “friendly” bacteria.                       man. They are found on the skin and in the
                                                     mouth, ears, gut, and other bodily nooks
An Example of Probiotic Use                          and crannies. These bacteria are important
O.M. Crabbe is an 88 year old male who               to proper development of the immune
presents to his doctor with soft, creamy             system, as well as protection from harmful
white to yellow, elevated plaques on his             microorganisms. The friendly bacteria act in
tongue. These plaques are easily wiped off           many ways to protect the host. They can
of the affected tissues and leave a red,             provide a physical barrier to prevent
eroded, and ulcerated surface which is very          infection as well as help with digestion and
tender.                                              nutrient absorption. Interactions between a
                                                     person and his/her microorganisms are
Upon examination by his doctor, he is                crucial for a person’s health.
diagnosed as having oral thrush, which is
infection of the mouth. Mr. Crabbe is                Probiotics appear to work by mimicking
treated with the appropriate medication              interactions of bacteria which are normal to
and clears the infection. His doctor suggests        the body. In diarrhea treatment, probiotics
to Mr. Crabbe that he might want to try a            act as normal “belly bugs” by competing for
food or supplement containing probiotics to          food with “bad” bacteria, harming “bad”
reduce the risk of reinfection. Not knowing          bacteria, and producing substances which
what probiotics are, Mr. Crabbe heads for            kill the bad bacteria. Beneficial bacteria may
his local pharmacy to ask some questions.            also provide signals to the body which
                                                     cause the body’s immune system to
                                                     maintain and condition the gut in response
                                                     to injury.
Probiotics, a Primer
                                                     The Balancing Act
Probiotics are found in many different
places. You can find probiotics that have            There is a balancing act in the body with
been added to such foods as yogurt, milks,           regards to bacteria. In a healthy individual,
smoothies, juices, and cheeses. Probiotics           many different types of bacteria work in
can also be found sold separately as dietary         different ways to confer benefit to the
individual. This balancing act between the       Concerns
body and the friendly bacteria can be
thrown off in many ways. One important           There are some concerns with probiotics.
way is the use of antibiotics. Antibiotics can   Since probiotics are classified as food and
                                                 not a drug, there are less rigorous standards
kill the good bacteria in the body while
killing the bad bacteria for which they are      of testing to ensure that the product is what
taken. Diseases such as bacterial infection,     the package states it is. How to take
viruses, yeasts, parasites, and fungi can all    probiotics, how much to take, and the best
upset the delicate balance. Another              ways to get the probiotics where they need
important factor to consider is age related      to go must still be determined. Finally, the
changes. All of these factors can help to        person taking probiotics needs to be aware
                                                 of health claims probiotics suppliers make
provide a better environment for
“unfriendly”, or disease-causing, bacteria.      which may not be accurate.
Some conditions caused by the
“unfriendlies” are diarrhea, irritable bowel
syndrome, inflammatory bowel disease             Elderly Concerns
such as ulcerative colitis and Crohn’s
                                                 Though a person’s friendly bacteria levels
disease, ulcer causing infections, tooth
                                                 tend to remain steady throughout adult life,
decay, and oral thrush.
                                                 some age-related changes can alter the
                                                 population composition. People over 60
                                                 have 1000 times less “friendly” bacteria in
Areas of Encouragement                           their guts than do younger healthy adults.
There are many areas of encouragement for        The elderly have changes in the intestines,
the use of probiotics in treating certain        changes in diet, and changes in their
conditions. The strongest evidence for the       immune system which can throw off the
use of probiotics is for the treatment of        balancing act between the body and the
diarrhea and skin conditions like eczema.        “good” bacteria. In addition, changes in the
                                                 mouth, such as decreased saliva production
They also have the potential to assist with
the problem of antibiotic-resistant bacteria     can cause the friendly mouth bacteria to
in the gut. New research even points to          decrease. This can lead to problems like oral
probiotics as a method to prevent the            thrush, for which our friend, O.M. Crabbe,
return of certain types of cancer; however       was treated. Luckily for Mr. Crabbe, he was
this area of research needs further study.       able to see his local pharmacist. His
Two examples of probiotic foods available        pharmacist provided Mr. Crabbe with a
in stores right now are the Activa® yogurt       name of a cheese which was being made
or the Kraft LiveActive products. There are      with a probiotic that has been shown to
some supplements that contain probiotics         reduce the recurrence of oral thrush.
and these are sold under a variety of            Armed with the knowledge that this cheese
names. Topical probiotic products are            shows promise in helping with oral thrush,
currently under development.                     O.M. Crabbe buys some cheese containing
this probiotic from a local grocery store. His
only problem was combing through the
wide array of products containing (or at
least claiming to contain) probiotics. Mr.
Crabbe remains free from oral thrush.

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