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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