Probiotics no longer recommended


For the past several years, probiotics have been all the rage. Probiotics are in everything including yogurt and in every grocery store. They are expensive, especially the refrigerated ones. But the American Gastroenterological Association no longer recommends them for Crohn’s, IBS, or Ulcerative colitis.

The AGA has never specifically recommended probiotics for celiac disease. However, I would guess that most of us have at least tried probiotics. I’m guessing that your doctor may have even recommended them.

I wrote about this issue several times and I re-read my most recent article about probiotics. I think I wrote then exactly what I would say now about probiotics. I’m not going to reinvent the wheel so here is a link to my article.

Here is a link to the page from the AGA discussing probiotics.

Fecal Transplants

Bear with me on this one for a second and I’ll explain fully. FMT stands for fecal microbiota transplant.

Fecal transplants are where stool from a “healthy” donor is put into the “sick” recipient. In the US it is only legal to do a fecal transplant on people with a recurrent C. difficile infection. A C. difficile infection causes intractable diarrhea, can be fatal, and doesn’t respond well to antibiotics.

There are stories in the medical literature and anecdotally about thin people receiving fecal transplants and becoming obese. Their microbiome changes so dramatically after the transplant that their entire metabolism changes. Furthermore, the microbiome has been implicated in mood disorders, Alzheimer’s disease, diabetes onset, and a myriad of other disorders.

Could this be applied to celiac disease? Could dramatically changing our microbiome change the course of celiac?

In 2016 researchers did a FMT in a celiac patient with refractory celiac type 2 and a recurrent C. difficile infection. (Here is more in refractory celiac and what type 1 is vs. type 2.) As a side effect of their FMT, their celiac symptoms went away and the mucosal damage resolved.

Granted its only one person. But stories after FMT like this are not unusual. FMT is an extreme form of modifying the microbiome. I think there is some room for healing of the microbiome and causing a great deal of help. Consuming probiotics just might not be the right way to modify the microbiome.

Specific foods that might help

While taking a pill may not help, there are lots of foods that might help. In looking at dozens of articles about foods that are beneficial to the microbiome a few kept coming up again and again.

  • Fermented foods, like sauerkraut and kimchi
  • Kombucha, kefir, and yogurt
  • Increased fiber intake
  • Bananas
  • Eat a wide variety of foods

There are lots and lots of articles out there about improving the gut microbiome and what to eat. This is a short list. Do the research and find a few foods to add into your diet that might help.

Also, to take a probiotic or not is your choice. Personally, I took them for a long time and did not notice a difference. That’s when I started to research.

Its hard having celiac and sometimes I feel like we are the redheaded step children of the research world. I think that because we don’t bleed and there isn’t any medication for us we don’t get much help. I think and hope that is changing, but that we weren’t even mentioned in the probiotic discussion of the AGA demonstrates how far we still have to go. Pregnant women were mentioned, but not people with celiac disease. Ugh!

Anyway, this is a long article. I thought about it all day yesterday.

Leave a Reply