Diving straight in here!

A prebiotic is soluble fibre. It’s the substrata or food for increasing probiotic colonies in the gut.

A probiotic is a  ‘good gut bacteria’ such as acidophillus

As I wrote in my previous blog I made the huge mistake of jumping into the prebiotic arena no holds barred and I suffered a bloat to outdo anything I had experienced before.  I very nearly wrote off the entire idea. In those days inulin was much more available than oligofructose so this was my intro into prebiotic world. Oligofructose is a much more recent addition in my life and something I started with only this year.

With both inulin & oligofructose I very slowly built up my tolerance levels…after my initial bloat episode I stopped taking the inulin for several weeks then slowly began again - this time sprinkling small doses of it on food.

For most people pre & probiotics seem to be beneficial.  For weight loss surgery patients they also appear to provide many benefits, some that are pretty interesting…weight loss, better bowel function, increased absorption of minerals.

A minor drawback, that does not feel so minor when one is farting away,  is  that both prebiotics and probiotics can cause initial bloating and wind.

I have never had this with probiotics but our mileage as always, varies.

Most of the bloating passes relatively quickly as the gut adjusts, but consider lowering the amount you are taking if you have too much discomfort or are not seeing any improvement.  There’s no harm in taking acidophilus for a day, then resting the next day.  Bloating as a side effect can be dose related.  Increase natural food sources of pre & probiotics first perhaps - using things like artichokes, banana’s, yogurt, chicory based drinks (taken cold or warm but not hot) .  There is no rush and my experience has been that taking things easy has still added up to good longerterm effects.

When I first read that prebiotics might increase weight loss, of course my ears perked up! (In the bariatric link below.) However in my case at this point weight loss is not as much a concern as keeping my weight relatively stable. I’m hoping prebiotics are playing a role in this for me.  The greater reason I take them is because they appear to increase calcium absorption. (Albeit in big doses that I don’t do.) Oligofructose has been shown to be helpful in reducing constipation too - and recently I lean more towards this form of prebiotic than the inulin to beat my constipation. ( I currently take it in a higher % than the inulin…a rough ratio of 2:1)  It does seem to be helping me quite significantly in this department which I am very happy about. It does not cause me diahorrea at all - rather in my case it has generally given me back my original DS Mr Whippy texture which I prefer over any other stool consistency. For me this is a ‘normal’  DS stool.

Constipation is not a good thing.  WLS patients should get medical help if it is an ongoing problem despite trying things like increasing fluids and prunes etc. There are some indications that constipation might play a role in diverticulosis - a condition that frankly I fear having nearly lost my mum to the more severe form of it. And let me not even start on how it wrecks the anal tissues!

If you lean more towards diarrhea, you’ll need to think on using prebiotics carefully - perhaps bounce it off your health professional.  With the low dose I take I don’t get diarrhea. Even when I initially took high doses I only experienced bloating - no diarrhea.  Some people report inulin as causing them diarrhea. Whether this stops over longerterm use I don’t know. Or whether it is because megadoses of the stuff is to blame in some way for their discomfort, who knows?  There are many studies strongly suggesting prebiotics might prevent help to prevent diarrhea, IBS and such.  I read an abstract that had people taking 15gm’s of oligofructose with no side effects being reported.

However if I had diarrhea I would first be looking at getting resolve under my GP’s guidance. I’d want to rule out  bacterial overgrowth and correct it using antibiotics followed by  probiotics.  If I was trying prebiotics with a history of diarrhea unrelated to bowel overgrowth, I would only use trace amounts until I was certain it was giving me no side effects.

As it is, I’m very conservative with my use of prebiotics. I have some difficulty with the idea of huge doses of it based on nothing scientific..but rather on my own bodies responses to it.  My body seems comfy with the dose I take currently, although this might change at some time.  When it comes to the use of prebiotics & probiotics my feeling is that we each need to explore and find our own optimal balances.

I also feel through natural sources we’d not get a concentrated dollop of refined inulin-oligofructose consistently. As it is more and more being added to various foods we probably get some in from these sources as well as natural dietary sources.   My max dose is 5 gms and more often it’s below 2.5gms…many would consider this a very minimal amount, but I still feel it benefits me. I very very seldom need flagyl, or acidophilus for that matter, although I sometimes take the odd probiotic boost. I find where the prebiotics soften my stool — probiotics tend to firm it up…but this is just my personal observation about the effects these have on me.

Both oligofructose & inulin look like fine white powders. Inulin is less sweet to my taste. Both add a nice ‘mouthfeel’ to whatever I add them to…just a bit of extra creaminess factor.  Inulin should not be taken hot or very cold as temperatures might affect it’s performance. Oligofructose on the other hand is stable in temperature extremes and is quite often used in commercial baked products where it may replace some fats and sugars. I like the fact that I can add it to my cooking if I please.

Avoid synthetic forms of prebiotics - these cause gastro intestinal discomfort.

When buying acidophilus buy the best you can afford. Look for one with multiple strains of good bugs. I’m not a fan of the ones that sit outside the fridge on supermarket shelves…I don’t think they do the job.

I use Kudo’s acidophilus and I also keep a bottle of Udo’s 5 chewables in my fridge which  I use mostly when my tongue looks gungy  or when I have a sore throat. It’s designed for oral as well as gut health.  It has a bacteria in it called Lactobacillus Salivarius which I don’t want to know more about!!  But it works very well for me on these issues and also has plenty of gut beneficial bacteria.
 POTENTIAL SIDE EFFECTS:

Aside from the relatively common occurrence of temporary bloating there may be rare side effects with prebiotics & probiotics.  I wrote this into my previous post but again: don’t take acidophilius if you are immunocompromised in any way. It may not be safe and could cause serious problems according to some websites I have looked at. As you know the internet can be brilliant at times but it can also contain plenty of conflicting theories. I looked for more solid medical data about the possible dangers and found very little, but that doesn’t mean much in the grand scheme of things. 

This one did say it could be a risk for those on corticosteroids as these suppress immune function:  http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowFulltext&ProduktNr=223838&Ausgabe=231832&ArtikelNr=94041

I don’t know if prebiotics could cause problems as well. I did read that someone had a serious allergic response to inulin but it’s probably a rare occurrence. Much more often they have been shown to benefit those with allergies:

 http://jn.nutrition.org/cgi/content/abstract/138/6/1091

I think anyone with an immunocompromised system, an illness of any kind or who is taking medical drugs, is better off getting medical advice about anything they take, be it prebiotic or probiotic or for that matter any alternative type of therapy.

Here is a very interesting comprehensive article that explains possible benefits for bariatric patients way better than I can:

http://bariatrictimes.com/2009/11/17/probiotics-prebiotics-gut-microbiota-and-obesity/

More about Prebiotics:

Explanation & some listed food sources:

http://en.wikipedia.org/wiki/Prebiotic_%28nutrition%29

Increases mineral absorption:

http://www.ajcn.org/cgi/content/abstract/73/2/459S

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On another note - here’s my food intake today:

Breakfast:

8 tablespoons of spinach (leftover from yesterday)

1 tablespoon bacon bits

1 small chopped onion

cooked with 2 fried eggs

and 3 tablespoons cheddar cheese

Lunch:

Cherry compote yogurt

2 slices of leftover roast lamb

handful of mixed nuts

Dinner:

1 tablespoon macaroni cheese

1 and half chicken fillets baked in cheese/bacon sauce

Spinach again - creamed! - half of a ready meal sized punnet. ( My son bought it not realising I had eaten a mound of it this morning!)

a small banana

I’m hoping before 10 pm to drink a big glass of milk - and then it’ll just be water until sometime tomorrow!