What are probiotics? Which is the best probiotic? How do you take them?

Definition

What are Probiotics and their benefits to Gut?

Probiotics are the microorganisms that are beneficial for the deliberate manipulation of the intestinal micro flora. They are stated to be natural methods for disease control and healing, since they don’t generate the side effects like the antibiotics. At the same time they are stated to be more powerful than the other two methods of probiotics and the fecal transplant.

Probiotics Sources

The known sources of probiotics are the foods, cultured milk products, stains of lactic acid bacilli, Escherichia coli, Clostridium butyricum, Streptococcus salivarius, and Saccharomyces boulardii.

Probiotics Research

Scientists are conducting advanced researches on the genetically engineered bacteria that can have positive influence on the human immune system.

Reasons to take probiotics

Intestinal Micro Flora

The primary goal is to eliminate/deactivate the harmful bacteria that cause diseases.  The other reasons to take probiotics are to enable the secretion of immuno-modulators for improving natural immunity, and to prevent the recurrence of diseases and disorders that have the root causes in the intestinal micro flora.

• Overcome Resistance:  Certain species of the intestinal micro flora / pathogens can develop antibiotics resistance. Then the efficacy of the antibiotics will be diminished considerably. In such cases the scientists will have to change the ingredients, concentration, and try the other methods. The Probiotics have no such limitations.
• Avoid/reduce Side Effects: The consistent consumption of antibiotics can lead to many side effects. For example, the probiotics can reduce the infections to the respiratory tracts and diarrhea conditions.  Probiotics also reduce the need for using the antibiotics to prevent the secondary levels of infections.
• Improved Barrier Performance:  The intestinal epithelium acts as the natural barrier for filtering the various types of foreign-antigens, bacteria, and their toxic byproducts. The probiotics can improve the performance of the barrier. The first benefit is the tightening of the epithelial junctions. It is achieved by the synthesis of proteins to strengthen the junctions. The second benefit is the protection of the gut-barrier. They also defend the epithelium from pathogen attacks. The third benefit is the prevention of toxic elements accumulation in the intestine that may lead to diseases like the inflammatory bowels, Celiac, gastrointestinal disorders and the alcoholic liver.
• Pain Reduction/Modulation:  Most of the intestinal disorders and diseases cause unbearable pain in the intestine, liver, kidneys, uterus (female), lower back, and the connected internal organs and the muscles. The Probiotics can generate the numbing effects by interacting with the CB1and CB2 receptors that are present in the brain, liver, kidney, intestine, and the other organs to reduce / suppress the sensations of pain. In many cases they perform the functions of the cannabinoid.
• Improved Immunity: Probiotics can induce the effects of natural immunity into the human body by interacting with the secretion of the Immuno-modulators. They can increase the strength and the efficiency of the immunity systems. The interleukin-10 and the trefoil factors (TFF) are some of them secreted by the probiotics. Breast milk contains large concentration of the TFF which can protect the newborn infant from many of the diseases and disorders. Hence, the medical experts strongly recommend breastfeeding for the babies.

Are Probiotics Good for You

Benefits of Probiotics

The medical reasons to take probiotics are many, including the healing of diseases caused by the intestinal micro flora. The biggest benefits are the secretion of the Probiotics proteins and DNA. They can alter the behavior of the harmful bacteria and the pathogens.

Benefits

The probiotics differ in their function from the antibiotics in the way they interact with the pathogens and the harmful bacteria. Instead of trying to kill or suppress, they alter the primary behavior of the pathogens which cause the diseases and disorders.

• Diarrhea Cure/Prevention: Diarrhea can cause dehydration in the children and the adults. It can also lead to other intestinal and internal organs infections and diseases. Probiotics can naturally heal the symptoms and prevent the effects of the pathogens from causing harmful side effects. They can cure the body from the effects of various types like the infectious diarrhea, rotavirus diarrhea, and the other diarrheal illness like the Collagenous colitis.
• Constipation Cure:  One of the most regularly affecting disorders for the children, teens, adults, and the elders is the constipation. The Probiotics can restore the defecation frequency and the stool consistency to the normal conditions.
• IBS Cure: Probiotics are highly helpful for the curing of irritable bowel syndrome. The efficacy of the treatment is seen more in the experience of the healing effects by the patients.

Representation of Probiotics in the Gut (Human Digestive System)

The biggest benefit of using the Probiotics is the long term suppression of the incurable disorders like the alcoholic liver conditions. Experience has shown that the consumption of the antibiotics only suppresses the effects for a short span of time. The probiotics on the other hand can restructure the intestinal flora which is responsible for the further damages caused to the liver. They preserve the existing health conditions of the liver without letting them deteriorate further. Meanwhile, the patient can try and improve the conditions of the intestine and live through abstinence, diet management, and hydration of the intestine and the liver. Similarly, the probiotics provide healing for many other incurable infections, diseases and disorders.  

Note

The treatments using the probiotics can benefit many of the patients suffering from allergy, H. pylori infection, mesenteric ischemia, hepatic encephalopathy, etc. The scientists are engaged in culturing new stains of the Probiotics for the advanced and chronic stages of the diseases.

Which is the Best probiotic?

One of the best Probiotics – VLS#3

The determination of which is the best probiotic depends on the type of disease for which you seek treatment. There are many parameters involved in the selection of the best Probiotic. For example, they may include the specific disease, at a specific intensity, at a specific stage, and at specific health and immunity conditions for a specific patient. However, we can name a few of the probiotic which have been found to be efficient and effective. They are the VSL#3, Align (B. infantis), Culturelle (L. rhamnosus GG), DanActive (L. casei), Mutaflor (E. coli Nissle 1917), and Florastor (S. boulardii).

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Rectal Bleeding Diagnosis, Management, and Treatment

Acute rectal bleeding, also known as lower gastrointestinal (GI) bleeding, is the loss of fresh blood from the colon.

Blood in stool can result from a number of causes usually categorized as:

• Anatomic or diverticulosis
• Anflammatory such as infections and inflammatory bowel disease
• Vascular such as angiodysplasia, radiation induced causes, and ischemic,
• And neoplastic causes.

Rectal Bleeding Management

Acute lower GI bleeding can also result from polypectomy and other similar therapeutic interventions. This article looks at the clinical manifestations of acute rectal bleeding, its diagnosis, management, and treatment.

Clinical Manifestation

Patients with lower GI bleeding usually report hematochezia, which refers to the passage of bright red or maroon blood or clots from the rectum. Blood from the left side of the colon is usually bright red in color while the blood coming from the right side has a darker or maroon appearance and it may be mixed with the patient’s stool. It’s very rare for patients bleeding from the right side of the colon to have melena.

Patients with acute bleeding from the anus should also have normocytic red blood cells. Chronic lower GI bleeding can also be a sign of iron or microcytic red blood cells deficiency. Contrary to upper GI bleeding, a patient with acute rectal bleeding while showing a normal renal perfusion should also show signs of normal blood urea nitrogen.

Initial Evaluation and Management of Acute Lower GI Bleeding

Rectal Bleeding Treatment

Initial evaluation of a patient with signs of acute rectal bleeding should run parallel with the management of the condition. The goal of the initial evaluation is to find out if the blood is originating from the lower GI tract, check for the severity of the bleeding, find the most appropriate setting for the patient, and implement the necessary supportive measures before initiating resuscitation. After completing these initial steps, other diagnostic studies such as colonoscopy can follow based on the American College of Gastroenterology 2016 guidelines.

 

Initial Evaluation

There are several steps to follow in the initial evaluation which include getting the patient’s history, doing a physical examination, conducting laboratory tests, and if necessary doing a nasogastric lavage or upper endoscopy. The goal of this evaluation is to confirm that the bleeding is not coming from the upper gastrointestinal tract and that the condition can be effectively managed.

• History

It’s important to get the patient’s medical history at the initial stage. Find out if the patient has had previous episodes of lower or upper GI bleeding. This will help you identify potential causes for the bleeding that may influence further management of the condition. Inquire about the patient’s medication use focusing on drugs or agents that could potentially cause bleeding or impair coagulation such as anticoagulants, non-steroidal anti-inflammatory agents, and any other antiplatelet agent the patient may have used in the past.

• Physical Examination

Physical examination involves the assessment of the patient’s hemodynamic stability and his or her stool to check for the presence of melena or hematochezia. Check if the patient has abdominal pain which could be a sign of an inflammatory bleeding source, for example infectious colitis, ischemic, or a perforation such as a perforated peptic ulcer.

• Laboratory Tests

Laboratory tests done on the patient should include serum chemistries, liver tests, complete blood count, and coagulation tests. The patient’s hemoglobin level should be checked after every 2 to 8 hours depending on how severe the bleeding is.

Management

The first step in the management of a patient suspected to have acute rectum bleeding is to find the most appropriate setting for the patient, which could be outpatient, inpatient, or intensive care unit. A colonoscopy and endoscopy doctor in South Florida will also provide the patient with general supportive measures at this stage which can include adequate intravenous access and oxygen supply. Management will also involve giving the patient the necessary blood and fluid product resuscitation and management of anti-coagulants, coagulopathies, and anti-platelet agents.

A patient with high-risk features such as hemodynamic instability usually characterized by orthostatic hypotension and shock, comorbid illness, or persistent bleeding should be transferred to intensive care unit for closer observation and the necessary therapeutic intervention. Close observation for a high-risk patient in the ICU will include electrocardiogram monitoring, pulse oximetry, and automated monitoring of the patient’s blood pressure.

Some of the key features used to categorize high risk and low risk patients include hemodynamic stability, advanced age, comorbid illness, persistent bleeding, rectal bleeding in a patient admitted for another illness, a previous history of angiodysplasia or diverticulosis bleeding, aspirin use, a non-tender abdomen, a high-level of blood urea nitrogen, anemia, and an abnormal count of white blood cells.

Management should also include the following:

• General supportive measures such as supplemental oxygen through the nasal cannula rather than the mouth just in case an upper endoscopy is urgently needed.
• Fluid resuscitation and stabilization with intravenous fluids.
• Blood transfusion. Young patients who don’t have comorbid illness may not require blood transfusion unless their hemoglobin levels drop below 7 g/dL. Older patients will require blood transfusion to maintain higher hemoglobin levels of 9g/dL and above.

Diagnosis

Rectal Bleeding treatment in Florida

After you have ruled out upper GI as the source of the bleeding, the first step of diagnosis is colonoscopy. Other diagnostic studies usually conducted on patients with lower GI bleeding include radionuclide imaging, mesenteric angiography, and computed tomographic or CT angiography.

Colonoscopy in high-risk patients or those with ongoing bleeding should be done within 24 hours after adequate bowel preparation.

Treatment of Lower GI Bleeding

The treatment of the bleeding site focuses on the source of the bleeding. The bleeding can be controlled in most cases by specific therapies applied during colonoscopy or angiography. Surgery is rarely required in most cases but if it has to be done, it will be important to first determine the source of the bleeding and what has caused it.

Conclusion

The treatment of rectal hemorrhoids and bleeding starts with an initial evaluation which includes the patient’s medical history, an overall physical examination, and laboratory tests. In some cases, it may be necessary to conduct upper endoscopy or nasogastric lavage to confirm the source of bleeding is actually in the lower GI tract. The actual treatment will depend on the source and cause of bleeding. In most cases treatment is done during the colonoscopy or angiography phase. Most rectal bleeding patients with red stool or black stool symptoms rarely require surgery.  

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Hepatitis C Treatment and Management

Both acute and chronic hepatitis are caused by the Hepatitis C Virus known in short as HCV. Acute hepatitis rarely leads to hepatic failure but can cause chronic infection. Chronic HCV infection progresses gradually over several years and can eventually result in more serious conditions such as hepatocellular carcinoma, cirrhosis, and even call for a liver transplantation. This article looks at the general management and counseling given to patients with chronic hepatitis C Virus infection by doctors who treat hepatitis C in Florida and elsewhere in the world.

Initial Evaluation

Various Hepatitis C Tests

The main objective of any initial evaluation of patients diagnosed with hepatitis C virus should include the following examinations:

• Evaluation of how extensive the liver disease has spread. Identifying the extent of advanced fibrosis or cirrhosis will call for additional monitoring.
• Evaluation of viral and host factors that help to determine the bet antiviral selection. Viral and host factors to be assessed include the stage of liver fibrosis, the patient’s medical history prior to the antiviral treatment, assessment of the patient’s renal function, and identification of any concurrent medicines the patient uses.
• The objective of the initial evaluation should also focus on identifying comorbidities related to hepatitis C virus infection such as the renal disease associated with HCV, Cryoglobulinemia, and other autoimmune disorders.

Patients with HCV infection should also be tested for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) since these viruses have a common mode of transmission and a rapid rate of progression.

Counseling

Counseling plays a key role in treatment and management of hepatitis C virus infection. The latest treatment for hep C incorporates counseling as a critical component of the management of the condition. This is because most hepatitis C patients are usually asymptomatic at the diagnosis stage but as the infection progresses, the condition can have adverse physical, mental, and emotional consequences on the patient.

Counseling and control of depression are key factors to consider during diagnosis and follow up. Most patients usually have an easier time coping with the condition when they participate in support group sessions with fellow patients and counselors.

Counseling should also focus on the adverse effects of illicit drug use on a patient with HCV infection. There are many HCV patients who also have problems with illicit drug use. In such cases, the patients are advised to seek for psychiatric help, enroll in substance abuse treatment, or go for an opioid substitution therapy.

Hepatitis C counseling should also focus on the transmission of the virus. HCV is mainly transmitted via exposure to infected blood. Patients should be advised on specific routes of the virus transmission and how they can avoid or decrease chances of transmitting the virus to other people. Women who can still bear children should be advised on the risk of prenatal transmission too.

Diet and Lifestyle Behavior

Diet for Hepatitis C Management

It will be important to advise patients on the effect of some lifestyle behaviors to HCV. There are some lifestyle factors that can accelerate HCV infection to a full-blown liver disease or some other equally serious ailment. These habits include continued alcohol use, marijuana use, insulin resistance, and obesity.

Due to the close link between these habits and a rapid progression of liver disease, patients are advised to completely avoid alcohol and drugs. Obese patients are also encouraged to lose weight while cigarette and marijuana smokers are advised to quit the habits.   

For better nutrition, patients are encouraged to take at least two or three cups of coffee every day. Coffee is beneficial to liver health and has been linked to reduced risk of liver disease hospitalization. Taking more than two cups of coffee each day helps in the management of chronic viral hepatitis, alcoholic liver disease, and non-alcoholic steatohepatitis.

General Management of HCV

Hepatitis – C Treatment

Treatment of chronic HCV infection relies heavily on antiviral therapy. If you searched for the best liver doctor near me, you’ll notice that they all use and advocate for antiviral therapy. HCV is comparatively easier to treat today using modern antiviral therapies than it was in the past. The virus can be treated and completely eliminated in most cases using antiviral therapy.

General management of the illness will also involve symptom management, adjustment of medication dosage, and preventing further complications especially when cirrhosis is present. HCV patients will often complain of fatigue and may be susceptible to depression. To combat fatigue and improve the patient’s overall quality of life, a sustained virologic response (SVR) is highly recommended after the antiviral therapy.

Adjustment of medication dosage may not be necessary for prescriptions or over-the-counter medications for HCV-infected patients with normal hepatic function. Most patients may be concerned about taking medications such as acetaminophen because it is believed to cause liver injury when taken in high dosage. It is therefore important to ensure that the patient’s dose of acetaminophen does not exceed 2 grams in every 24 hours.    

Antiviral Therapy

The objective of antiviral therapy in HCV-infected patients is to eliminate HCV RNA through sustained virologic response (SVR). The RNA level should be undetectable 12 weeks after the completion of the therapy.

Monitoring Viral Levels During Antiviral Therapy

During treatment, viral levels are monitored with interferon-free regimens but this has proved to be less effective as large clinical trials on interferon-free regimens have shown that the threshold they achieve does not give an accurate prediction after 4 weeks of treatment. It is therefore recommended to check HCV RNA levels on the 4th week of treatment using quantitative testing.

Conclusion

Hepatitis C is caused by the HCV virus. The first step in the management of HCV-infected patients is an initial evaluation, which involves assessment of various factors including the extent of liver disease, and examination of viral and host factors such as viral genotype, the patient’s history of antiviral treatment, the stage of liver fibrosis, medication use, and renal function. These factors show optimal viral selection and identify the presence of comorbidities linked to HCV infection.  

Counseling is an important step in management of Hepatitis C. Patients are advised on how they can minimize transmission risk and about lifestyle factors that can accelerate liver diseases such as alcohol consumption, smoking, marijuana use, and obesity. Feel free to consult a liver specialist in south Florida for Hepatitis treatment or to get answers to any related question you may have. 

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