Probiotics and Gluten Sensitivity/Celiac Disease

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Bacteria – your gut is full of it! But wait, before you call the doctor for antibiotics, you need to know that not all bacteria are bad. In fact, the “friendly” bacteria that reside in your gut are vital to maintaining a healthy digestive system, and amazingly and perhaps most importantly, a healthy immune system.

Unfortunately, the intestinal flora in many people’s digestive tracts are out of balance, with not enough of the good bacteria. Why the decrease in beneficial gut bacteria? It seems the way we live in our modern society is contributing to the imbalance. Consider some of the following theories as to why:

1.      The use of antibiotics has killed off the good bacteria in addition to the bad.

2.      The sterilization of our society – hand sanitizers and antibacterial cleansers – has eliminated the good bacteria along with the bad.

3.      The decreased consumption of cultured and fermented foods like kefir and sauerkraut means we are not consuming as many probiotics in our diets as we used to.

4.      The increased consumption of whole or processed grains that have not been soaked, sprouted or fermented first has eliminated a source of prebiotics, which feed the good bacteria.

5.      Processing and pasteurization of foods destroys any beneficial bacteria that may naturally occur in the foods.

Given the pace of our society today, it is unlikely that any of the above behaviors will change, so people are going to continue to have this bacterial imbalance.

If you have gluten intolerance or celiac disease like me, your gut flora may especially be out of whack. Despite being on a gluten-free diet, you might still experience digestive issues. It could be that you have other food sensitivities, which unfortunately is often the case with gluten-sensitive people. It might also be that you need to take probiotic supplements to help restore good gut bacteria and to calm your immune system so that it is not overreacting to harmless substances in the body, like food. According to a Swedish report titled “The Intestinal Microflora, the Immune System and Probiotics, “Microbial stimulation of the immune system decreases the reactivity against harmless antigens [substances like nutrients and tissues of the body], which is one of the reasons why scientists are interested in the relationship between the composition and activity of the intestinal microflora and the development of allergies.”

Medical research supports the need for those with celiac disease to take probiotics to restore the balance and to help alleviate the inflammation associated with gluten ingestion. A Science Daily article from May, 2010, reported on research that concluded that changing the intestinal bacteria with probiotics and/or prebiotics may help alleviate the severity of celiac disease for some patients, and improve their quality of life. According to Dr. Scot Lewey, “Probiotics have been shown to reduce the toxicity of gluten. Studies have shown a benefit of probiotic bacteria that are added to gluten containing breads. They may be especially beneficial in those with Celiac disease, potentially protecting against cross-contamination exposure. Probiotics may help heal leaky gut caused by gluten even in those without Celiac disease.”

Taking it a step further, Dr. Alessio Fasano, one of the leading researchers of celiac disease, suggests that perhaps this imbalance in the gut flora actually triggers the onset of celiac disease and that keeping the balance may help in preventing it. In an article in Scientific American from July 2009, Dr. Fasano explains why some people may develop celiac disease later in life:

A Clue to Delayed Onset
People with celiac disease are born with a genetic susceptibility to it. So why do some individuals show no evidence of the disorder until late in life? In the past, I would have said that the disease process was probably occurring in early life, just too mildly to cause symptoms. But now it seems that a different answer, having to do with the bacteria that live in the digestive tract, may be more apt.

These microbes, collectively known as the microbiome, may differ from person to person and from one population to another, even varying in the same individual as life progresses. Apparently they can also influence which genes in their hosts are active at any given time. Hence, a person whose immune system has managed to tolerate gluten for many years might suddenly lose tolerance if the microbiome changes in a way that causes formerly quiet susceptibility genes to become active. If this idea is correct, celiac disease might one day be prevented or treated by ingestion of selected helpful microbes, or “probiotics.”

In the many years that I have been attending conferences on celiac disease, I have heard two gastroenterologists say that when they diagnose someone with celiac, they automatically put them on probiotics as part of their treatment. I don’t believe this is a common approach for doctors to take, and so people either end up taking probiotic supplements based on their own research, or more commonly, they don’t take them at all.

I consulted Sheila Wagner, a Certified Nutritionist who specializes in food intolerance and the treatment of chronic health issues, to find out what probiotics one should be taking. She said first, people need to remember to use a dairy free source if they have dairy intolerance. She prefers to use various brands, alternating every few days, not only to assess if any benefit is being felt from a particular brand, but also because the growing methodologies and strains vary among the different manufacturers.

Sheila Wagner’s other advice for taking probiotics:

  • Bifido bacteria strains can be very helpful with lower bowel issues like Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD)
  • Saccharomyces Boulardii is often suggested when yeast overgrowth is present.
  • Some people can respond negatively to probiotics — those with small bowel overgrowth (SIBO) and especially when using a Pre-biotic like FOS (fructooligosacharides).
  • Infants can benefit from an infant formula of probiotics, especially if any antibiotics have been used, if there are signs of yeast or if delivery has been via C-section, as the microbiome (the community of bacteria residing in the intestinal tract) of the infant has been shown to be less balanced than with those born vaginally.
  • Nursing moms should take probiotics to supplement their infants’ good bug population, particularly if the infant has had to take antibiotics or has yeast.

The bottom line — it’s the good guys versus the bad guys in your gut. If the bad guys outnumber the good, probiotics can help make it a fair fight!

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