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DEAR DR. ROACH: With the current focus on intestinal health, I've heard a lot about probiotic supplements. Who should take them? Does the number of bacteria matter more than the types listed on the container? Are they taken daily, for a short period or for extended periods? – K.V.S.
ANSWER: Probiotics are healthy bacteria in the large intestine that promote digestion and possibly other functions in the body. Scientists are just beginning to understand how intestinal bacteria (called the microbiome) affect many areas of health.
There are some probiotic indications that are well accepted. The most important are in people with gastrointestinal disorders, especially in people with inflammation of the inflammatory bowel disease. Some infections, including Clostridium difficile, can be prevented and treated with probiotics. This is not the primary treatment (which is usually antibiotics against C-diff), but it may be a useful adjunctive treatment or in recurring cases. Gastroenterologists prescribe several different types of probiotics for these conditions. The particular type of probiotic may depend on the underlying condition and symptoms.
Preliminary data suggest that probiotics can help young children prevent allergies, but it is not yet strong enough to recommend it. sure, but there have been some cases of probiotics entering the bloodstream in people with a sick immune system. They are however quite expensive.
Having healthy intestinal bacteria can be beneficial for people without specific problems. However, it is not necessary to take bacteria to switch to a healthier intestinal flora. A diet based more on plants, whole grains and nuts, with fewer dairy products, meat and sweets (like the Mediterranean diet) showed clear changes in the microbiome in a matter of days, compared to a typical Western diet . There are so many benefits to this type of diet, including reducing the risk of heart disease, the risk of diabetes and obesity, that I recommend this diet or a similar diet rather than taking probiotics for people wanting to improve their intestinal health. DEAR DR. ROACH: Please explain the linked spinal cord syndrome. I am 68 years old and I presented with urinary and fecal incontinence and a feeling of heaviness in the legs after undergoing spine surgery last year. What are my options? – KH
Answer: An attached cord is usually a problem that we find in children, where the spinal cord attaches to a structure in spine. This often happens in spina bifida and under similar conditions. However, it happens sometimes after spinal surgery in adults. Symptoms include sensory problems, such as pain or numbness; weakness (a feeling of heaviness is often muscle weakness); and loss of control of the bladder and intestines. In a series of adults with cord attached, surgical release improved sensory symptoms in 80% of people, motor symptoms in 70% and urinary symptoms in 50%. I do not know of any effective nonsurgical therapy. The published literature followed people for two years after the surgery, but noted that the spine can re-insert even after successful surgical repair. It is a rare disease, and the discovery of a neurosurgeon with the experience of tense cord syndrome would be of immense value.
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