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Medscape
a day ago
- Health
- Medscape
Fast Five Quiz: Probiotics Facts vs Fiction
Probiotics are undoubtedly a popular choice among many Americans. Consumers cite goals ranging from bowel health and regularity to vaginal health, bone density support, and immune boosts as reasons for using probiotic capsules, gummies, and beverages. However, confusion and concern from patients and healthcare providers persist over probiotic indications, quality, and reliability. How much do you know about probiotics and their applications? Test your knowledge with this quick quiz. Guidance from the AAP states that current evidence does not support the universal, routine administration of probiotics to preterm infants, especially those with birth weight < 1000 g. Despite some studies showing that probiotics reduce the risk of necrotizing enterocolitis in preterm infants or infants with very low birth weight, the AAP does not recommend their use due to conflicting data regarding safety and efficacy as well as the lack of pharmaceutical-grade, FDA-regulated probiotic products in the United States. Additionally, the AAP maintains no evidence of significant reduction of nosocomial sepsis in preterm infants is associated with probiotic supplementation. However, the American Gastroenterological Association (AGA) suggests using probiotics with specific combinations of bacterial species in infants < 37 weeks of gestational age and low birth weight to prevent necrotizing enterocolitis. Learn more about necrotizing enterocolitis. AGA clinical practice guidelines recommend probiotics in patients with C difficile infection only in the context of a clinical trial. Otherwise, the AGA makes no recommendations on the use of probiotics in C difficile colitis. A knowledge gap surrounds this topic as study data has been heterogenous. Learn more about C difficile colitis. Multiple organizations, such as the AGA and the World Gastroenterology Organisation (WGO), do not recommend probiotics for the management of Crohn's disease. According to the WGO, studies have not produced evidence that probiotics are beneficial for the remission or maintenance of remission of Crohn's disease. The AGA only recommends probiotics for Crohn's disease in the context of a clinical trial. Learn more about Crohn's disease. A meta-analysis of trials including a total of more than 1400 participants found that probiotic supplementation was associated with significant reductions in ALT, AST, and GGT in MASLD. Significant reductions in triglycerides, high-density lipoprotein and low-density lipoprotein cholesterols, insulin, insulin resistance, tumor necrosis factor alpha, BMI, and C-reactive protein were also observed with probiotic supplementation. A separate meta-analysis including more than 5100 participants on the effects of probiotics on ALT, AST, and GGT in patients with MASLD also found reductions in all three liver enzymes associated with probiotic use. Learn more about MASLD. Per the International Scientific Association for Probiotics and Prebiotics, probiotics are defined as 'live microorganisms that, when administered in adequate amounts, confer a health benefit.' Probiotics are found in foods such as kimchi, yogurt (with live and active cultures), and certain cheeses. Prebiotics are typically fiber or other complex carbohydrates that function as metabolic food for beneficial microorganisms. Some examples of prebiotic-containing foods include flaxseeds, whole oats, and barley. Prebiotics and probiotics might both be used to treat conditions as well as for disease prevention. Some fermented foods, like miso and sauerkraut, contain live strains of probiotics. Prebiotics are bioactive compounds found in fiber-rich foods, such as whole grains, and undergo fermentation by bacteria in the gut. Probiotics might be found in solid foods, supplement beverages, as well as supplement capsules and gummies. Prebiotics are present in fiber-rich foods and are also available as purchasable supplements. Learn more about about fiber supplementation.
Time of India
2 days ago
- Health
- Time of India
5 most common digestive issues that are on the rise in the US (and how to tackle them)
Digestive health is one of the integral keys to overall healthy living because it allows the body to efficiently break down food and absorb vital nutrients, which are essential for energy, growth, and cell repair. Tired of too many ads? go ad free now A healthy digestive system also plays a significant role in overall well-being, impacting everything from immunity and mental health to the prevention of various diseases. However, digestive health is increasingly in the spotlight as millions of Americans report bloating, pain, irregularity, and heartburn. Digestive issues don't just cause uncomfortable symptoms – they can disrupt travel, social life, and even professional productivity. 40% of Americans say their daily lives are disrupted by digestive problems, says the American Gastroenterological Association. Understanding why these ailments are on the rise – and how to effectively manage them – is crucial for restoring wellness and enjoying daily life. Let's explore the top five issues and practical solutions to them. Irritable Bowel Syndrome (IBS) IBS affects an estimated 25–45 million Americans – about 10–15% of adults, with women disproportionately affected. IBS has been increasingly recognized, partly due to widespread social media awareness. Characterized by abdominal pain, bloating, and irregular bowel habits, this functional disorder is on the rise, fueled by stress, diet, post-COVID gut dysfunction, and social media-driven self-diagnosis. Symptoms include abdominal pain, bloating, and changes in bowel habits, ranging from constipation to diarrhea. Why it's rising: Heightened stress and anxiety post-pandemic, poor dietary trends and microbiome imbalance, and most importantly – greater self-diagnosis and clinical detection are likely to contribute to the rise of IBS. Tired of too many ads? go ad free now How to tackle it: Dietary shifts: A low‑FODMAP diet under professional guidance is first-line. It systematically eliminates and reintroduces fermentable carbs to identify triggers. Psyllium fiber especially benefits constipated individuals. 76% of patients see improvement after switching to this diet. Increase fiber intake for constipation-predominant IBS, while avoiding insoluble fiber if diarrhea is dominant. Stress management: Techniques like mindfulness, relaxation therapy, hypnotherapy, and CBT calm the gut‑brain axis. Lifestyle essentials: Regular exercise, adequate hydration, adequate sleep, and fiber-rich whole foods support healthy gut motility. Gastroesophageal Reflux Disease (GERD) About 20% of US adults experience GERD, which occurs when acid reflux causes bothersome symptoms at least twice weekly. The consequence? Heartburn and chest discomfort impact sleep, quality of life, and carry long-term risks if untreated. Chronic acid exposure may increase the risk of esophageal damage and even cancer. Why it's rising: Sedentary lifestyles, obesity, and diets rich in fatty, spicy, and processed foods are the contributing factors. How to tackle it: Lifestyle tweaks: Eat smaller meals, drop trigger foods/drinks like caffeine, alcohol, spicy and fatty foods, avoid eating within 2–3 hours before bedtime, and elevate your bed's head by 6–8 inches. Weight control: Addressing obesity reduces reflux episodes substantially. Medication when needed: Use OTC antacids or acid blockers (H2 inhibitors or PPIs). Persistent symptoms should prompt evaluation to prevent complications like esophagitis or Barrett's esophagus. Chronic Constipation Constipation affects an estimated 63 million Americans, though surveys show nearly a third regularly feel constipated – often correlating with low fiber intake, dehydration, inactivity, and IBS. Constipation is on the rise due to low fiber consumption, poor hydration, reduced activity, and comorbid conditions like diabetes and IBS. Only 5–9% meet the recommended fiber intake. Why it's rising: Poor hydration and fiber-poor, processed diets, and sedentary lifestyles are the main reasons. How to tackle it: Hydration: Aim for 2–3 L of water daily—roughly 47% of Americans under-hydrate. High‑fiber diet: Gradually increase soluble fiber (20–35 g/day) via grains, vegetables, legumes, fruits, and psyllium supplements. Routine and movement: Establish regular bathroom habits, avoid straining, and incorporate at least moderate physical activity. Realistic treatments: Use bulk-forming laxatives or osmotic agents if necessary – but consult a doctor if symptoms persist. Inflammatory Bowel Disease (IBD: Crohn's and Ulcerative Colitis) IBD – comprising Crohn's disease and ulcerative colitis – affects about 1.4–1.6 million Americans. These chronic inflammatory conditions cause serious symptoms, like abdominal pain, rectal bleeding, persistent diarrhea (often bloody), fatigue, and weight loss, and the incidence is rising. Why it's rising: Genetic susceptibility combined with Western diets, environmental triggers, and immune dysregulation are the main culprits behind the surge in this disease. How to tackle it: Prompt diagnosis: Persistent diarrhea, rectal bleeding, and pain require colonoscopy and lab testing. Medication regimens: Use anti-inflammatories, corticosteroids for flares, immunomodulators, and biologics to maintain remission. Surgery might be needed for complications. Nutrition strategies: During flares, low-residue diets help; dietitian-guided intake during remission prevents malnutrition. Ongoing monitoring: Regular check-ups reduce risks like stricture formation and colorectal cancer. Celiac Disease Around 1–2 million Americans are diagnosed with celiac disease, a serious autoimmune reaction to gluten. Many cases remain undiagnosed, with about 2.5 million people unknowingly affected and undiagnosed. It damages the small intestine lining, impairs nutrient absorption, and leads to symptoms like diarrhea, bloating, anemia, and fatigue. Why it's rising: Improved testing and awareness, and possibly early-life dietary changes, might be the possible reasons behind the surge. How to tackle it: Accurate diagnosis: Requires blood tests for tTGA antibodies and a confirmatory duodenal biopsy. Strict gluten-free diet: Eliminating wheat, barley, and rye is essential – and working with a dietitian reduces the risk of nutritional deficiencies. Nutrient replacement: Monitor iron, folate, calcium, vitamin D, and consider supplements or fortified gluten-free grains. Lifelong compliance: Stay vigilant to avoid hidden gluten in cross-contaminated products. Digestive issues – IBS, GERD, chronic constipation, IBD, and celiac disease – are escalating in prevalence, fueled by modern lifestyles, stress, dietary patterns, and improved diagnosis, significantly impacting daily living. But the narrative isn't hopeless. Through scientifically backed dietary modifications, lifestyle adjustments, stress management, and medical care, you can take control. Early screening, persistent symptom tracking, and professional guidance help restore digestive comfort and well-being. Tackling couple quarantine issues effectively
Newsweek
21-06-2025
- Health
- Newsweek
The Key to Better Sleep Is in Your Gut, Says Gastroenterologist
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Around 25 million U.S. adults suffer from insomnia. At the same time, more than 3.9 million Americans are taking probiotics, usually for gut health, according to the American Gastroenterological Association (AGA). And gut health could be the key to better sleep. A study published in the journal Engineering examined a specific probiotic strain called Lactobacillus helveticus CCFM1320. This probiotic produces a compound known as SAM (S-adenosylmethionine), which helps regulate the body's internal clock and supports the production of melatonin, a hormone that promotes sleep. The researchers found that this probiotic could significantly improve sleep quality. The Gut as a Second Brain Neuroscientist Dr. Chelsie Rohrscheib, the head of sleep at Wesper, a national home sleep disorder diagnostics company, told Newsweek: "The gut essentially acts as a secondary nervous system and creates and releases many crucial neurotransmitters, such as serotonin, which also help to regulate nervous system activity. "This allows for two-way communication between the gut and the brain, called the gut-brain axis. Healthy gut microbes are essential to keeping the gut healthy and functioning, and there is ample evidence that gut microbiota dysregulation can negatively impact the activity of the gut-brain axis. Because the brain is highly sensitive, this can lead to poor sleep quality." Stock image of a woman taking pills from her nightstand before bed. Stock image of a woman taking pills from her nightstand before bed. Liudmila Chernetska/iStock / Getty Images Plus Is CCFM1320 a Game-Changing Strain? To test the effectiveness of CCFM1320 in humans, scientists from Jiangnan University conducted a four-week study with 60 volunteers who experienced sleep difficulties. Participants were divided into two groups: one received the probiotic, while the other took a placebo. Results showed that those who consumed the probiotic had better sleep scores, lower levels of the stress hormone cortisol, and a healthier balance of gut bacteria. Additionally, the probiotic boosted the expression of genes involved in producing and utilizing SAM, a key factor in sleep and overall health. Strain-Specific Benefits Dr. Michel Bass, a board-certified gastroenterologist and the Founding Medical Director at Oshi Health in Philadelphia, Pennsylvania, emphasized the importance of strain specificity: "Not all probiotics are created equal. This study identified CCFM1320 as uniquely beneficial for sleep quality. This isn't a generic 'take-any-probiotic' situation—it's about strain-level specificity," Bass told Newsweek. "That's where a lot of public messaging needs to evolve. Just like different medications target different conditions, different strains do different things. And this one appears to enhance melatonin synthesis via SAM methylation—a novel pathway." Probiotic Supplements vs. Fermented Foods Stock image of an assortment of fresh vegetables and meats. Stock image of an assortment of fresh vegetables and meats. esilzengin/iStock / Getty Images Plus While fermented foods like yogurt, kimchi, and kefir are beneficial for general gut health, Bass explained that they may not provide targeted probiotic strains at therapeutic levels. "If someone wants to improve things like sleep quality or reduce stress hormones like cortisol, a strong, well-researched supplement—especially one with proven strains like CCFM1320—is usually more effective," he said. "That said, eating fermented foods is still a great daily habit and can complement targeted probiotic supplements." Jason Eastty, owner of Healthspan Longevity in Westborough, Massachusetts, and a nutrition specialist, added that overall good nutrition can combat poor sleep. "Having a nutrient deficiency—like low iron, magnesium, or vitamin D—can throw off your gut microbial balance, leading to poor sleep. Clinical trials have shown that correcting these deficiencies helps microbial diversity and improves sleep efficiency," Eastty said. He also emphasized that a whole-foods diet rich in fiber—from fruits, vegetables, legumes, nuts, seeds, and whole grains—is essential to feeding the "good" bacteria in your gut.
Medscape
28-05-2025
- Health
- Medscape
Juice Cleanses Likely Good for Nothing, Bad for Much
'It's a great way to get those fruits and vegetables into my diet, especially since I can't be bothered peeling or preparing them…' 'I lost weight and felt lighter…' 'I'm helping my body detox, and that's a good feeling.' Social media is rife with statements like the above about juice cleanses. It's a favorite topic as well as something patients often ask about. The perception is that by doing a juice cleanse, they're doing something healthy for themselves — yet experts agree that in most cases, they're not. But if they're having a conversation or asking about it, it offers an opportunity to provide evidence-based guidance. American Gastroenterological Association Spokesperson Fazia Mir, MD, clinical assistant professor at the University of New Mexico and a gastroenterologist with Presbyterian Healthcare Services, both in Albuquerque, New Mexico, said some of her patients ask about juice cleanses because they're interested in doing a liver detox or helping their gut inflammation. 'I tell them that, in fact, it does the opposite,' she told Medscape Medical News . 'The majority of juice cleanses impact gut health negatively. They can cause bowel habit irregularity and even precipitate inflammatory bowel disease, as the gut microbiota is disrupted due to the lack of fiber in these cleanses. And we see patients all the time whose irritable bowel syndrome worsens after they've embarked on a juice cleanse.' What the Evidence Says There's little evidence to support the use of juice cleanses for eliminating toxins from the body, according to the US National Center for Complementary and Integrative Health. Furthermore, some juices used in 'detoxes' and 'cleanses' haven't been pasteurized or treated in other ways to kill harmful bacteria, meaning they can expose individuals to toxigenic E coli, Salmonella , hepatitis A, and Cryptosporidium . In addition, some juices are made from foods high in oxalate, such as leafy green vegetables and beets. Individuals susceptible to kidney stone formation should limit their consumption of high-oxalate foods, which can present a health threat. In fact, a case report published several years ago documented acute oxalate nephropathy caused by a 'green smoothie cleanse' prepared from juicing oxalate-rich green leafy vegetables and fruits. 'Reality Check' Two recent studies highlight the negative impact of juice cleanses. In a small randomized, three-arm intervention study with 14 healthy participants published online in Nutrients , 'a 3-day exclusive juice cleanse (800-900 kcal/d) led to shifts in the oral and gut microbiome, with increases in taxa linked to inflammation, gut permeability, and even cognitive decline after juice consumption,' said principal author Melinda Ring, MD, executive director, Osher Center for Integrative Health at Northwestern University in Chicago. Participants followed one of three diets — juice only, juice plus food, or plant-based food — for 3 days. Microbiota samples (stool, saliva, and inner cheek swabs) were collected at baseline, after a pre-intervention elimination diet, immediately after the juice intervention, and 14 days after the intervention. Gene sequencing was used to analyze microbiota taxonomic composition. The juice-only group showed the most significant increase in bacteria associated with inflammation and gut permeability, as well as associated changes in the saliva and cheek microbiota — particularly in the relative abundances of proinflammatory bacterial families. These changes are potentially due to the high sugar and low fiber intake of the juice-related products, the authors suggested. Ring said the study 'offers a reality check' on juice cleanses. 'Whether a cleanse is 'healthy' depends on the individual and the intent behind it,' she told Medscape Medical News . 'A short, structured cleanse, ideally lasting no more than 1-3 days, can be safe for many people if it focuses on polyphenol-rich, low-sugar vegetables rather than fruit, retains some fiber (as in blended rather than pressed juices), and avoids extreme calorie restriction.' Pediatricians should also be aware that a high-sugar, low-fiber diet may promote the growth of pro-inflammatory taxa, first author Maria Luisa Savo Sardaro, PhD, a professor of food microbiology at San Raffaele University in Rome, Italy, told Medscape Medical News . 'Families often rely on juice boxes in lunch packs, believing they're a healthy substitute for whole fruit, and school cafeterias frequently offer sugary drinks throughout the day,' she said. 'Together, these habits may contribute to an early life increase of inflammation in children.' Change Dietary Guidelines? Although it did not address juice cleanses per se, a new review published online in Nutrition Bulletin specifically compared evidence on whole fruit and 100% fruit juice with regard to nutrient composition, impact on hunger and satiety, and association with chronic health conditions. Lead author Hemangi Mavadiya, a PhD candidate at the Joe C. Wen School of Population & Public Health, University of California Irvine, Irvine, California, said that, like the Nutrients study, the review of 83 studies found juicing does indeed remove much of the dietary fiber that has beneficial effects on the gut. In addition, processing and/or storing 100% fruit juice reduces vitamins and other antioxidant contents and transforms intrinsic sugars in the whole fruit into free sugars, which have little nutritional benefit. Furthermore, fruit consumed in solid form provides greater satiety due to delayed gastric emptying and related physiological reactions, and 'the synergistic effects of polyphenols and fiber in whole fruit benefit the gut microbiome by acting as prebiotics and producing short-chain fatty acids that reduce inflammation,' the authors wrote. The review also showed that consuming high amounts of fruit juice is associated with increased risks for certain types of cancer, while results were mixed for type 2 diabetes and hypertension. As a result of their findings, the authors recommended that the next version of the next set of Dietary Guidelines for Americans, coming out at the end of 2025, be updated to better reflect the amount of whole fruit and 100% fruit juice adults and children should consume. Current guidelines recommend that at least half of the daily recommended fruit intake of two cups a day should come from whole fruits, potentially allowing the other half to be fulfilled by 100% fruit juice. Tips for Patients What are clinicians telling their patients regarding juice cleanses? 'When used as a bridge to more sustainable, whole-food, high-fiber eating habits, a brief cleanse might serve as a motivational tool,' Ring said. 'However, clinicians should counsel patients that detoxification is a natural, ongoing function of the liver and kidneys, not something that requires commercial juice products.' Patients should also be told that juice cleanses may temporarily disrupt the body's microbial balance, likely due to their high sugar and low fiber content and may not support long-term gut health. 'Cleanses may offer a psychological 'reset,' but without adequate fiber and protein, they could undermine microbial diversity and resilience, especially if repeated or prolonged.' Patients who love juicing can consider blending instead, to keep the fiber intact, or pairing juices with whole foods to balance the impact on the microbiome, she suggested. Mavadiya advises patients read food labels, which can help distinguish between fruit juice and fruit drinks, since the latter 'is loaded with added sugars,' and it's easy to confuse the two. 'Ultimately, the healthiest path forward is not a periodic cleanse, but a consistent, nutrient-dense, fiber-rich diet that supports gut and systemic health over the long term,' Ring concluded. Furthermore, clinicians should assess for underlying conditions such as diabetes, eating disorders, or frailty, which may make juice cleanses inadvisable. No conflicts of interest were declared.
NDTV
23-05-2025
- Health
- NDTV
Should You Consider Taking Antacids For The Long Run?
Antacids are among the most commonly used over-the-counter medications to relieve heartburn, indigestion, and acid reflux. They offer quick relief by neutralising stomach acid, making them a go-to remedy for millions. But while they are effective in the short term, long-term use of antacids is a growing concern among healthcare professionals. According to the American Gastroenterological Association (AGA), prolonged use of antacids, especially without medical supervision, can lead to nutrient deficiencies, altered gut function, and increased risk of kidney and bone issues. So, should you consider taking antacids for the long haul? Let's explore the science behind long-term use and what you should watch out for. Understanding how antacids work and their implications Antacids work by neutralising excess stomach acid, offering temporary relief from symptoms like heartburn and bloating. However, they don't treat the root cause of acid reflux or indigestion, and prolonged use can suppress natural digestive functions. Here are some key concerns and complications linked to continuous or unsupervised use of antacids. 1. Nutrient deficiencies Long-term use of antacids, especially proton pump inhibitors (PPIs), can hinder the absorption of essential nutrients such as the following mentioned below. The National Institutes of Health (NIH) warns that prolonged PPI use has been linked with osteoporosis-related fractures. a. Vitamin B12 Low stomach acid affects absorption, increasing the risk of anaemia and neurological issues. b. Calcium and magnesium Reduced absorption can lead to weaker bones and muscle cramps. c. Iron Essential for haemoglobin, iron levels may drop over time, leading to fatigue and weakness. 2. Risk of kidney problems Some studies suggest that long-term antacid use may be associated with an increased risk of chronic kidney disease. PPIs in particular have been shown to potentially cause the risk of following health conditions. It is advisable to undergo periodic kidney function tests if you're using antacids regularly. a. Damage kidney tissues b. Contribute to the development of interstitial nephritis c. Lead to long-term renal impairment if left unmanaged 3. Increased risk of infections By suppressing stomach acid, long-term antacid use may reduce the stomach's natural defence mechanism, allowing harmful bacteria to flourish. The Centres for Disease Control and Prevention (CDC) states that reducing stomach acid can compromise your gut's immune function. This may include the following health risks. a. Increase the risk of Clostridium difficile infections b. Lead to bacterial overgrowth in the gut c. Make one more prone to gastrointestinal issues like diarrhoea 4. Masking of underlying conditions Relying on antacids for too long can mask more serious gastrointestinal disorders such as the following. If symptoms like heartburn, bloating, or nausea persist for weeks, a proper medical evaluation is crucial. a. Gastroesophageal Reflux Disease (GERD) b. Peptic ulcers c. Helicobacter pylori infection d. Stomach cancer 5. Rebound acidity When stopped suddenly after long-term use, especially with PPIs, the stomach may produce even more acid than before, a phenomenon known as rebound hyperacidity. This can worsen symptoms and create a dependency loop on antacids. When and how to use antacids safely If you need antacids occasionally, they are generally safe. However, for long-term relief, consider the following. Also, consider alternatives like H2 blockers, only under professional guidance. a. Consulting a gastroenterologist before prolonged use b. Exploring dietary and lifestyle changes to manage symptoms c. Using the lowest effective dose under supervision d. Regularly monitoring nutrient levels and kidney function While antacids are a convenient solution for occasional discomfort, they aren't designed for long-term use without medical advice. Prolonged use can lead to serious health complications and mask underlying conditions. According to the World Health Organisation (WHO) and leading gastroenterologists, it's best to address the root cause of acidity through medical care, lifestyle changes, and proper dietary habits for long-term wellness. Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
