Question:

Hello:

I have an ileostomy and I would like to find out how to select a good probiotic that would reduce or prevent blockages. I noticed that today we have a huge selection in the stores.

Thank you in advance for your suggestions and expert advice.

Response:

Probiotics are live micro-organisms intended to provide health benefits when consumed, generally by improving or restoring the gut flora. Probiotics are considered generally safe to consume but may cause bacteria-host interactions and unwanted side effects in rare cases.

What is a probiotic: Probiotics (from the Greek pro bias “A favourable life”), are products that contain large amounts of live micro-organisms, such as lactic acid bacteria. These micro-organisms such as bifidobacteria lactobacilli, can survive in the stomach acid, and thereby reach the intestines alive. There they join the good bacteria and help keep the gut flora in balance. A balanced intestine provides for good natural resistance and offers protection against infections, disease, and intestinal problems.

Today, there are many different probiotics: including fermented milk and yogurt products (Activia), and capsules containing probiotics. Simple yogurt and cottage cheese contain lactic acid bacteria, but because these cannot survive the stomach “acid”, they are not a part of the probiotics.

The bacteria from probiotics that do survive the stomach acid, do not do it that well. Studies show barely 10% actually survive the journey to the intestine. Since a handful of bacteria do very little, it is recommended that bacteria drinks, powders or capsules, contain at least 100 million, and preferably a billion, live bacteria to have any impact.

There have been many studies done on the effects of probiotics and the results vary. Some believe that more research is necessary. There is evidence that using probiotics at the same time as antibiotics, reduces the chance of diarrhea and infections. Further, it is shown the probiotics can be beneficial during diarrhea, but also with chronic constipation.

You can eat and drink anything with a stoma. But having said this, you just have to be more aware. You must find out for yourself which foods cause blockages, diarrhea, gas and/or odour formation, for you individually. Some folks can eat certain foods and have trouble. Other folks can eat the same food and have no effects. It is therefore important for you to determine for yourself what you can and cannot tolerate. So keep experimenting.

To help avoid a blockage it is suggested to eat more and smaller meals throughout the day. That way the intestines have a better chance of absorbing the useful substances from the food. It is also important to chew your food well. Otherwise, you can, especially with an ileostomy get a blockage.

Some foods that can cause a blockage:

Pineapple, apples, asparagus, mushrooms, citrus fruits, peas (large), grapes, dried fruit, coarse uncooked food, coconut, maize, nuts/peanuts, popcorn, leeks, rhubarb, rice, raisins, celery, bean sprouts, carrots, and seeds.

Some foods that can thin stool:

Leaf vegetables, broccoli, chocolate, fried foods, spicy foods, plums, raw vegetables, fresh fruit, fruit juice.

There are very good probiotic products on the market today you can ingest that will support good gut bacteria. The key is to ensure that the bacteria drinks, powders or capsules, contain at least 100 million, and preferably a billion, live bacteria to ensure maximum impact.