Top 10 Health Benefits of Probiotics | How to Improve Good Gut Bacteria Naturally?

Top 10 Health Benefits of Probiotics | How to Improve Good Gut Bacteria Naturally?

Although most of the time we think of bacteria as a cause of infection or developing certain diseases, there are actually billions of beneficial bacteria present in the human body. In fact, human body is in an interdependent relationship with microbes. Different parts of the body such as skin, digestive tract, respiratory system, eyes, ears, and reproductive system each has a unique microbial profile. Healthy body is consists of a range of microorganisms including bacteria, viruses, fungi and eukaryotes. These microorganisms are recognized as essential to our health.

Micobiome is originally referred to the genes of these microorganisms and microbiota is referred to the different microbial species. However, nowadays these terms are used interchangeably, including both species and their genetic material.

Studies suggest that the number of microbial cells to be at least equal to the number of human body's cells. Human microflora consists of the 10–100 trillion symbiotic microbial cells in each person. Human gut microbiome consists of the largest quantity and diversity, including over 1,000 different bacterial species across individuals and it makes up 2-4 pounds of the body weight. There are about 5 million of only gut microbial genes which is significantly greater than all human's 22,000 protein-encoding genes.

New scientific studies provide vast information on how the microbiome interacts with our cells influencing our health, how it is shaped, maintained and could be used to prevent and treat disease. Since 2008, The Human Microbiome Project has begun working to identify microbial groups and their variations in healthy humans, starting with the gastrointestinal tract, respiratory tract vaginal tract, skin, and oral cavity. Main goal of this project is to gather data to determine that how changes in microbial patterns may contribute to disease and how to restore healthy microbial balance. Recent advancements in gene sequencing techniques has helped to speed up our ever increasing knowledge about the microbiome.


What are the functions of microflora?

Human gut microflora produce enzymes to help with digesting certain food categories that our digestive enzymes alone could not digest. The population of these microbes adapt to the food groups that are mainly consumed. Diet high in animal protein alters the population of the gut flora to include more of those bacteria which are able break down protein. Often metabolites of these digested proteins are harmful to the digestive tract and are known to increase risks of diseases such as colon cancer.

Intestinal microflora metabolizes and activates many plant polyphenols and other phytochemicals which are important to our health. For instance, certain intestinal bacteria are found to be able to modify lignans and isoflavones into active compounds which are related to a better female hormone signaling.

Gut flora through fermentation metabolise the dietary fiber to short chain fatty acids which is used as a source of energy for the intestinal cells and play an important role to regulate immune system, reduce inflammation, prevent infections, can impact on cholesterol levels, and improve absorption of minerals such as calcium.

These beneficial bacteria help to produce B vitamins , vitamin K, and amino acids such as tryptophan. Amino acid tryptophan the is utilized by the body to produce compounds which have an important role in the immune and nervous systems. About 90% of the serotonin is made in the gastrointestinal tract from tryptophan.

Gut flora also may produce other neurotransmitters, such as acetylcholine, norepinephrine, dopamine, and gamma-aminobutyric acid (GABA) which impact on modulating stress response, influencing brain function and mood.

Intestinal flora are important in metabolizing some medications. Micro flora can help to improve body's tolerance to certain medications and improve their bioavailability. Gut microbes help process and detoxify harmful environmental toxins such as carcinogens.

Other important role of the micro flora is to prevent infections by limiting the over growth of the harmful microorganisms. These friendly bacteria provide this benefit via different mechanisms, such as maintaining the PH level, producing anti microbial compounds, calling up the local immune system, competing for food source, preventing the attachments of the harmful bacteria at the site.

Microflora help regulating the immune system . In this way most of our body is impacted by their function. Micro flora influence the immune system development, immune responses, and could help to improve health conditions associated with poor immune health such as, allergies and chronic inflammation which is found in conditions like rheumatoid arthritis, inflammatory bowel disease, dermatitis, and many more. Also, relation between the intestinal micro flora and immune system is important for renewal and repair of the intestinal lining.

Intestinal microflora in particular is found to greatly impact our metabolism. Research has shown that altered intestinal micro flora profile in infancy can indicate the risk of developing obesity and other metabolic conditions. Some factors such as maternal antibiotic or breastfeeding have been shown to impact the infant microbiome. Imbalanced Intestinal microbial profile is often observed in conditions such as obesity, fatty liver (none alcoholic), and type 2 diabetes. Adapting a high fiber diet and weight loss is shown to improve the intestinal microbiome and metabolism; while, high fat and animal protein based diet is found to disrupt micro flora health.

The sleep and intestinal micro flora are also found to be related. In an animal studies, interruptions in circadian rhythms by creating conditions of jet lag or night-shift work, caused change in the normal turnover of the micro flora and caused metabolic disturbances. Other evidence suggests that this may be a two way relationship, further explaining that imbalanced micro flora can affect circadian signaling, which alters biological rhythms and metabolism.


How is the human microflora formed?

Human microflora and the immune system start shaping during infancy, and factors such as the type of diet, genetic , and geography, childhood sickness, use of antibiotics, contact with other people, and even animals and pets, all could have a lifelong impact on forming a balanced microflora and immune health. Bifidobacterium bacteria, along with Lactobacillus species, are the main micro flora of the infant gut, where they help with development of a healthy microbiome and immune system. Microbiome transmission from the mother to the newborn is shown to be also important for the newborn's brain development. Maternal stress during pregnancy, may alter mother's microbiome and its transmission to the infant.

Mother's milk contains certain prebiotics (oligosaccharides) which further supports the growth of Bifidobacterium species, as well as healthy development and function of the intestinal mucus lining and the immune system.

The infant gut microbiome gradually changes in the first two to four years of life, and becomes more stable and similar to the adults microbiome. Healthy Micro Flora in general resists against changes of its environment, and returns to the previous state later; however, it is susceptible to certain factors and its recovery varies between individuals. For instance, antibiotics and changes in eating habits are well known to cause a rapid modification in micro flora and the ability to recover to the primary microbial balance differs from person to person.

Other contributors factors to cause change in microbiome are including; hormonal cycles, hormonal treatments, travel, illness, and aging.


What is Dysbiosis and how would it affect our health?

Dysbiosis is also known as dysbacteriosis. Dysbiosis is referred to as the microbial imbalance or its improper adaptation inside or on the body. Dysbiosis, for instance, can occur on the skin, in the gastrointestinal tract, and vaginal canal. Dysbiosis is often seen in the digestive system, especially in conditions known as small intestine bacterial overgrowth (SIBO) or small intestine fungal overgrowth (SIFO). Dysbiosis could be explained as a shift in the microbial balance away from a healthy pattern.

A healthy microflora is very diverse and generally resilient to physiological stress or changes; while, dysbiotic conditions are associated with lower number of beneficial species and higher number of potentially disease-causing species.

Intestinal dysbiosis is found to increase the risk of immune disturbances and inflammation on the inside and outside of the digestive tract. Dysbiosis has been linked to a number of chronic diseases and conditions such as; allergies, asthma, autoimmune flare ups, cardiovascular conditions, diabetes, IBD, IBS, colitis, cancer, obesity, vaginal infections, chronic fatigue syndrome , and mood and cognitive conditions.


Dysbiosis and increased intestinal permeability:

Bacterial, select viral infections, parasites and some other stressors like certain deficiencies, can affect the tight cellular junctions of intestinal lining, impacting its structure and function which eventually may lead to the development of chronic intestinal disorders and could act as a trigger for diseases. Thight junctions of intestinal lining is modulated by a protein known as zonulin. Increased zonulin levels in the circulation are considered as an indication for an impaired intestinal barrier.

Once intestinal tight intercellular junctions is impacted, it allows the absorption of microbes, microbial products, food antigens, and foreign antibodies, which can then activate the immune system and increased production of inflammatory markers. Increased intestinal permeability is linked to several diseases such as crohn's, celiac disease, irritable bowel syndrome, inflammatory bowel disease, fatty liver, diabetes, rheumatoid arthritis, weight gain, allergic reactions, and mood disorders.

Amino acid glutamine is shown to play an important role in signalling entrocytes which are part of intestinal barrier. Pre-biotics and probiotics are also shown to reduce increased intestinal permeability.


Dysbiosis and SIBO:

Large intestine is populated with a vast diversity of microflora, while the small intestine contains limited number of microflora. SIBO is the dysbiosis of the small intestine which is commonly associated with indigestion and other digestive conditions such as bloating, flatulence, and a probable underlying cause of irritable bowel syndrome. Results from clinical trials suggest that therapy with only probiotics containing Saccharomyces boulardii and Lactobacillus casei or in combination with antibiotic, may help to improve SIBO condition.


Dysbiosis and oral health:

Periodontitis is an oral infection that can damage the bones supporting teeth and lead to tooth loss. Disruption of the oral microbiome is considered one of the major risk factors for periodontitis due to overgrowth of the pathogenic bacteria.


How to support and maintain a healthy microflora?

In recent years studies found an inevitable link between the gut microflora, diet, and physiology; suggesting that diet should be considered the main factor in maintaining a healthy microbiome and therefore a healthy body. Diet high in saturated fat is shown to promote dysbiosis, and intestinal permeability, and intestinal inflammation; while, diet rich in fiber supports growth of the microflora.

Prebiotics are the type of carbohydrates that are indigestible or partially get digested. Prebiotics promote and stimulate the growth or activity of advantageous microflora. Prebiotics are mainly sourced from plant-derived carbohydrate compounds called oligosaccharides. Fructans and Galactans are the main oligosaccharides known as Inulins, Fructooligosaccharides (FOS ) and Galactooligosaccharides (GOS) . Both FOS and GOS are found to stimulate the activity and growth of intestinal beneficial bacteria. Other dietary fibers such as pectin, beta glucans, and Xylooalsooligosaccharides(XOS) are also provide similar benefits and considered prebiotics.

Fermentable carbohydrates from fructans and xylans are very well documented examples of prebiotics. The FOS and inulin content in food sources is very low, so it is difficult to get sufficient prebiotics from food alone. Indigestible carbohydrate compounds that are categorized as prebiotics are a type of fermentable fiber; however, not all dietary fiber could be source of perbiotics. Raw oats, raw dry chicory root, artichoke, dandelion leaf, garlic, asparagus, and wheat bran are source of prebiotics. Usually 4-8 grams daily is recommended to help maintaining general digestive health, while 15 grams or more is recommended for those with digestive disorders.

Human breast milk contains oligosaccharides which are structurally similar to GOS. Human milk oligosaccharides (HMOs) are suggested to increase the Bifidobacteria bacterial population in breastfed infants, and to strengthen the infant immune system.

Consuming alcoholic beverages has been associated with dysbiosis, inflammation and increased permeability of the intestinal mucosa. Some evidence suggests certain individuals with increased gut permeability demonstrate higher rate of depression, anxiety, and cravings. Improving microbiome in this group may possibly reduce the risk of relapse.

Stress and poor sleep are shown to negatively impact the healthy balance of gut microbes. Research suggests that a sudden acute stressful situations, such as a disease, trauma, or burn injury, cause a significant reductions in gut microbial population and activity. Therefore, high stress conditions in the body trigger changes in the gut microflora and the regulation of some neurotransmitters. Reducing stress and getting healthy sleep might improve the health of the microbiome.

The digestive system has its own nervous tissue, which is known as the enteric nervous system. Enteric nervous system responds to the intestinal environment and regulates its activity. Although the enteric nervous system acts independently, it also communicates with the central nervous system via a network referred to as the gut-brain axis. This further defines the fact that the intestinal health and nervous system are mutually related.

Intestinal microbes produce variety of neuroactive compounds to help control intestinal barrier function, and modulate immune and inflammatory response. It has been shown that there is a link between intestinal microflora and several neurological disorders. In a study microbial transplant from human with Parkinson disease to genetically susceptible mice prompt manifestations of the disease while the a transplant from healthy human did not cause any change.

Animal studies also suggest that, most likely the intestinal microbiome play a role in controlling appetite, feeding behavior, and taste through the gut-brain axis.


Probiotics and their beneficial impact on digestive conditions:

The World Health Organization (WHO) defines probiotics as live micro-organisms that, "...when administered in adequate amounts, confer a health benefit on the host". Most probiotic supplements contain bacteria, and commonly include species from the Lactobacillus and Bifidobacterium genera. Some species of yeast Saccharomyces are also used in probiotic supplements. Probiotic supplements are usually measured in colony forming units (CFUs), which represent the number of live cells. Safety and the therapeutic efficacy of the probiotics are well documented. However, there are potential of concerns for very young or very old age, individuals with compromised immune system, those who are critically ill in intensive care, and individuals with advanced damage to the lining of the intestinal tract like cases with sever colitis.

Recent developments in genetic sequencing technology has provided better understanding of the probiotics and their possible health benefits. Many studies are exploring probiotics effects on intestinal inflammation, diarrhea, urogenital infections, immune modulating, and much more.

Data show the Lactobacillus reuteri can decrease duration of diarrhea in children, and L. rhamnosus GG is beneficial for diarrhea due to antibiotics in both adults and children. Results from randomized controlled clinical trials showed that the participants are 51% less likely to develop antibiotic-associated diarrhea when supplemented with L. rhamnosus GG and S. boulardii in daily doses higher that 5 billion CFUs appeared to be more protective.

Saccharomyces boulardii and other probiotics include L. rhamnosus GG, L. acidophilus, and B. bifidum are also suggested to prevent traveler's diarrhea .

Evidence from multiple clinical trials are indicative of probiotic supplements are beneficial to stimulate intestinal motility and therefore relieving constipation. The results from all the studies showed that probiotic supplementation offers a significant improvement in consistency and the frequency of the stool, bowel movement, and decreased severity of constipation. Clinical trials using different strains of B. lactis , L. casei, L. reuteri , and L. paracasei, L. plantarum were able to manage chronic constipation in participant.

Studies on probiotic B. longum BB536 , have found this probiotic is able to provide a modulatory effect on the intestinal movement and it is beneficial for both conditions of low and frequent intestinal activities.

Probiotic supplementation is also found to be helping improve overall symptoms and quality of life in patients with IBS. Results from studies suggest that the IBS conditions respond better to treatments with a single strain Probiotic instead of the multi-strain formulations. IBS patients reported improvements in their symptoms by Probiotics containing only Lactobacillus species, reduction in abdominal pain while taking S.cerevisiaeand general improvementwith probiotics containing strains of Bacillus coagulans .

IBD (Inflammatory bowel disease) represents major autoimmune conditions of ulcerative colitis and Crohn's disease. The intestinal microflora population in individuals with IBD is very unstable. Dysbiosis, immune condition, and inflammation are commonly observed initially and during flare-ups. Data from several randomized controlled trials have found probiotics safe and effective for colitis and help to contain their remission.

Clinical trials from VSL3 which contains four Lactobacillus species (L. acidophilus, L. plantarum, L. casei, and L. bulgaricus), three Bifidobacterium species (B. longum, B. breve, and B. infantis), and one Streptococcus species (S. thermophilus ) has shown higher rates of clinical response and remission is those given VSL#3 compared with placebo group.

Clinical trials also found some single-species probiotic supplements to be useful in managing ulcerative colitis. For instance, B. longum BB536, at higher doses of 200–300 billion CFUs per day, induced the clinical remission rate and improved the appearance of the colon tissue. Similarly adding L. rhamnosus GG or S. boulardii to the treatment has shown to induce remission of colitis symptoms .

Some other studies, showed when S. boulardii added to standard medical treatment for Crohn's disease it helped to reduce some of its symptoms and clinical relapses.

Gastritis and Peptic Ulcer Disease are common digestive conditions which often caused by Helicobacter pylori infection, certain anti inflammatory medications, alcohol, and smoking. Research suggests over half of the population worldwide carry gastric H. pylori while most do not demonstrate any symptoms. However in some H. pylori may initiate changes to the digestive system and lining of the upper intestine which increases risk of gastric or duodenal ulcer and gastric cancer. H. pylori resistance to common treatments by antibiotics has led to much lower success rate in treating this condition.

Probiotics although unable to eradicate H.Pylori, they can reduce its adhesion to the mucosal lining, reduce digestive inflammation, and improve immune response to the infection. Some probiotics are also able to produce antimicrobial compounds which can suppress H.Pylori. Several clinical trials used probiotics with no other treatment and found while probiotic do not eliminate H. pylori, they can reduce the number of H. pylori. Probiotics from the Lactobacillus, Bifidobacterium, or Saccharomyces species and range of single-and multi-strain probiotics shown to effectively improve H.Pyloi's elimination rate and treatment tolerance.


Probiotics and Cardiovascular health:

There are some evidence from clinical trials that have shown probiotic and prebiotic supplements could help weight management and improve metabolic and inflammatory markers related to the cardiovascular health.

For example, data from multiple trials including 485 participants are indicative of probiotic therapy being able to effectively reduce total and LDL-cholesterol levels. In this research, L. acidophilus strains were found to have great lipid-lowering effects.  Also, other Lactobacillus bacteria like; L. reuteri and L. plantarum, have shown to decrease total cholesterol and LDL- levels.


Probiotics and oral health:

Several studies found that probiotics can reduce oral conditions such as; gum bleeding, gingivitis, cavities, and periodontal pocket depth in patients with periodontal disease. Probiotics benefits have been linked to their abilities to compete with harmful microbes for nutrients, produce antimicrobial compounds which restrict other harmful bacteria, and trough improving immune response.

Probiotics lozenges with bacterium L. salivarius has shown to reduce levels of harmful bacteria in dental plaque,

plaque formation, gum disease, gum bleeding, and the risk of periodontal disease. A randomized controlled trial found that L. reuteri lozenges helped to improve inflammatory conditions related to the tissues around a dental implant.

Probiotic Streptococcus salivarius has exhibited antibacterial effects against S. mutans, which is an oral bacterium known to be responsible for the formation of dental cavities. In addition, Streptococcus salivarius produces an enzymes that decrease dental plaque accumulation and acidification. Data from a randomized controlled study on children found that significantly better results are achieved with higher doses of S. salivarius to control plaque formation and promote higher elimination rate of harmful S. mutans.

Chewable probiotic combinations including types of Lactobacillus and Bifidobacterium species have also shown to inhibit S. mutans, reduce plaque and improve gum health better than a placebo in children.

Xyletol has been vastly studied for its prebiotic benefits for oral and intestinal health. Xylitol, in toothpastes, mouth rinses, chewing gums, and candies, has been shown to be able to decrease number of cavity-causing bacteria in the saliva and plaque, reduce plaque formation, and suppress tooth decay.


Probiotics and urinary & vaginal infection:

Trials in healthy women indicate that both oral and vaginal use of Lactobacillus probiotic species such as L. casei rhamnosus, L. rhamnosus, L. paracasei, L. fermentum, L. plantarum , and L. gasseri may help to improve their vaginal colonization over time. Data analysis suggests that probiotics containing at least one type of Lactobacillus could be considered as an important part of prevention and treatment for bacterial vaginosis and urinary tract infections in women.

Lab research found Probiotic Lactobacillus to provide antifungal effects and ability to regulate the immune response against Candida yeast species in laboratory research . Certain probiotic strains, such as L. rhamnosus GR-1 and L. reuteri RC-14 , may be able to interrupt the metabolic activity of yeast cells and even affect genes of resistance to antifungal medication.

Lactobacillus may reduce risks of urinary tract infection by inhibiting colony formation of infection-causing microbes near the outer of the urinary tract, and via improving immune response. In a clinical study a preventative treatment by oral administration of L. rhamnosus GR-1 and L. reuteri RC-14 daily to postmenopausal women with recurrent urinary tract infections helped lowering the frequency of urinary tract infections.


Probiotics and respiratory health:

Microflora of the throat, nose, and sinuses are much like the intestinal microbiome, help limit the presence of harmful microbes and regulate immune response. There are some similarities with the oral and nasal microbial types, but the lungs also contain a specific type of microflora which is important to maintain health and immunity .

Oral probiotics have shown to reduce the frequency and duration of upper respiratory tract infections. New research is exploring the benefits of nasal spray probiotics to restore a healthy microbial balance in the upper respiratory tract. Nasal spray of Streptococcus salivarius 24SMB is suggested that might help children with chronic or recurrent otitis media.


Probiotics and skin health:

The skin microflora is not the same across the body in the same individual and also between individuals. The skin microflora stays stable within the body even with its exposure to changing conditions. Skin dysbiosis has been linked to skin conditions such as; acne, atopic dermatitis (eczema), psoriasis, rosacea, seborrhea, and dandruff.

As an example use of probiotic supplements during pregnancy and when given in the first years of life may help prevent atopic dermatitis. Review of many studies on preventing eczema in infants and children, indicated supplements with Lactobacillus species, and Bifidobacterium species, or both, provide protective effects.


Probiotics and mood:

In a human double-blind placebo-controlled clinical trial supplementing with a formulation containing L. helveticus R0052 and B. longum R0175 , improved psychological conditions within 30 days. Participants who took the probiotic showed improvements in depression, anger-hostility, and problem solving.

In animal studies the same probiotic combination reduced anxiety-like behavior and depression scores, after a heart attack; restored intestinal permeability, decreased cell death in different brain regions, it also prevented brain changes due to chronic psychological stress.

The human body is in a dynamic and interdependent relationship with beneficial microorganisms all of which are recognized as essential to our health.  Probiotics have received renewed attention in the 21st century from product manufacturers, research studies, and consumers. The history of probiotics can be traced to the first use of cheese and fermented products, Bifidobacteria were first isolated from a breast-fed infant by Henry Tissier, who also worked at the Pasteur Institute. Preliminary research is evaluating the potential physiological effects of multi-strain Probiotics, as opposed to a single strain. As the human body contains several hundred microbial species, theories suggest that the body may benefit more from consuming multi-strain probiotics.


Articles and products featured by Health Palace are collected from a variety of sources and are provided as a service by Health Palace. These newsletters, while of potential interest to readers, do not necessarily represent the opinions nor constitute the advice of Health Palace. Presented materials are only for information purposes and do not intent to treat, cure, or prevent any disease.


Related articles:


Select References:

1.Conly JM, Stein K. The production of menaquinones (vitamin K2) by intestinal bacteria and their role in maintaining coagulation homeostasis. Progress in food & nutrition science. Oct-Dec 1992;16(4):307-343.

2.Correa-Oliveira R, Fachi JL, Vieira A, Sato FT, Vinolo MA. Regulation of immune cell function by short-chain fatty acids. Clinical & translational immunology. Apr 2016;5(4):e73.

3.Costabile A, Buttarazzi I, Kolida S, Quercia S, Baldini J, Swann JR, . . . Gibson GR. An in vivo assessment of the cholesterol-lowering efficacy of Lactobacillus plantarum ECGC 13110402 in normal to mildly hypercholesterolaemic adults. PloS one. 2017;12(12):e0187964.

4.Costantini L, Molinari R, Farinon B, Merendino N. Impact of Omega-3 Fatty Acids on the Gut Microbiota. International journal of molecular sciences. Dec 7 2017;18(12).

5.Daliri EB, Lee BH, Oh DH. Current Perspectives on Antihypertensive Probiotics. Probiotics and antimicrobial proteins. Jun 2017;9(2):91-101.

6.Davenport ER, Sanders JG, Song SJ, Amato KR, Clark AG, Knight R. The human microbiome in evolution. BMC Biol. Dec 27 2017;15(1):127.

7.Tamboli CP, Neut C, Desreumaux P, Colombel JF (January 2004). "Dysbiosis in inflammatory bowel disease". Gut. 53 (1): 1–4. doi:10.1136/gut.53.1.1. PMC1773911. PMID14684564.

8.Moos WH, Faller DV, Harpp DN, Kanara I, Pernokas J, Powers WR, Steliou K (2016). "Microbiota and Neurological Disorders: A Gut Feeling". BioResearch Open Access. 5 (1): 137–45. doi:10.1089/biores.2016.0010. PMC4892191. PMID27274912. As reviewed in this report, synthetic biology shows potential in developing microorganisms for correcting pathogenic dysbiosis (gut microbiota-host maladaptation), although this has yet to be proven.

9.Fujimori S (June 2015). "What are the effects of proton pump inhibitors on the small intestine?". World Journal of Gastroenterology. 21 (22): 6817–9. doi:10.3748/wjg.v21.i22.6817. PMC4462721. PMID26078557. Several meta-analyses and systematic reviews have reported that patients treated with PPIs, as well as post-gastrectomy patients, have a higher frequency of small intestinal bacterial overgrowth (SIBO) compared to patients who lack the aforementioned conditions. Furthermore, there is insufficient evidence that these conditions induce Clostridium difficile infection. At this time, PPI-induced dysbiosis is considered a type of SIBO.

10.Erdogan A, Rao SS (April 2015). "Small intestinal fungal overgrowth". Current Gastroenterology Reports. 17 (4): 16. doi:10.1007/s11894-015-0436-2. PMID25786900. Small intestinal fungal overgrowth (SIFO) is characterized by the presence of excessive number of fungal organisms in the small intestine associated with gastrointestinal (GI) symptoms. Candidiasis is known to cause GI symptoms particularly in immunocompromised patients or those receiving steroids or antibiotics. However, only recently, there is emerging literature that an overgrowth of fungus in the small intestine of non-immunocompromised subjects may cause unexplained GI symptoms. Two recent studies showed that 26 % (24/94) and 25.3 % (38/150) of a series of patients with unexplained GI symptoms had SIFO. The most common symptoms observed in these patients were belching, bloating, indigestion, nausea, diarrhea, and gas. The underlying mechanism(s) that predisposes to SIFO is unclear but small intestinal dysmotility and use of proton pump inhibitors has been implicated. However, further studies are needed; both to confirm these observations and to examine the clinical relevance of fungal overgrowth, both in healthy subjects and in patients with otherwise unexplained GI symptoms.

11.Nath SG, Raveendran R (July 2013). "Microbial dysbiosis in periodontitis". Journal of Indian Society of Periodontology. 17 (4): 543–5. doi:10.4103/0972-124X.118334. PMC3800425. PMID24174742.

12."Periodontitis - Symptoms and causes". Mayo Clinic. Retrieved 2018-06-27.

13.Fasano A (Jan 2011). "Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer". Physiol. Rev. (Review). 91 (1): 151–75. doi:10.1152/physrev.00003.2008. PMID21248165.

14.Rapin JR, Wiernsperger N (2010). "Possible links between intestinal permeability and food processing: A potential therapeutic niche for glutamine". Clinics (Sao Paulo) (Review). 65 (6): 635–43. doi:10.1590/S1807-59322010000600012. PMC2898551. PMID20613941.

15.O'Hara, JR; Buret, AG (2008). "Mechanisms of intestinal tight junctional disruption during infection". Frontiers in Bioscience. 13: 7008–21. doi:10.2741/3206. PMID18508712.

16.Suzuki, Takuya (2013-02-01). "Regulation of intestinal epithelial permeability by tight junctions". Cellular and Molecular Life Sciences. 70 (4): 631–659. doi:10.1007/s00018-012-1070-x. ISSN1420-682X.

17.Márquez, M; Fernández Gutiérrez, Del Álamo C; Girón-González, JA (2016). "Gut epithelial barrier dysfunction in human immunodeficiency virus-hepatitis C virus coinfected patients: Influence on innate and acquired immunity". World J. Gastroenterol. 22: 1433–48. doi:10.3748/wjg.v22.i4.1433. PMC4721978. PMID26819512.

18.Bischoff SC, Barbara G, Buurman W, Ockhuizen T, Schulzke JD, Serino M, Tilg H, Watson A, Wells JM (Nov 18, 2014). "Intestinal permeability--a new target for disease prevention and therapy". BMC Gastroenterol (Review). 14: 189. doi:10.1186/s12876-014-0189-7. PMC4253991. PMID25407511.

19.Viggiano D, Ianiro G, Vanella G, Bibbò S, Bruno G, Simeone G, et al. (2015). "Gut barrier in health and disease: focus on childhood" (PDF). Eur Rev Med Pharmacol Sci. 19 (6): 1077–85. PMID25855935.

20.Yeoh N, Burton JP, Suppiah P, Reid G, Stebbings S (Mar 2013). "The role of the microbiome in rheumatic diseases". Curr Rheumatol Rep (Review). 15 (3): 314. doi:10.1007/s11926-012-0314-y. PMID23378145.

21."Leaky gut syndrome". NHS Choices. 26 February 2015. Retrieved 15 August 2016.

22.Yarandi SS, Peterson DA, Treisman GJ, Moran TH, Pasricha PJ (2016). "Modulatory Effects of Gut Microbiota on the Central Nervous System: How Gut Could Play a Role in Neuropsychiatric Health and Diseases". J Neurogastroenterol Motil (Review). 22 (2): 201–12. doi:10.5056/jnm15146. PMC4819858. PMID27032544. In patients with schizophrenia, there are increased intestinal permeability and change in intestinal function

23.Severance EG, Yolken RH, Eaton WW (2016). "Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling". Schizophr Res (Review). 176 (1): 23–35. doi:10.1016/j.schres.2014.06.027. PMC4294997. PMID25034760.

24.Teixeira TF, Collado MC, Ferreira CL, Bressan J, Peluzio Mdo C (September 2012). "Potential mechanisms for the emerging link between obesity and increased intestinal permeability". Nutr Res (Review). 32 (9): 637–47. doi:10.1016/j.nutres.2012.07.003. PMID23084636.

25.Mor A, Antonsen S, Kahlert J, Holsteen V, Jorgensen S, Holm-Pedersen J, . . . Ehrenstein V. Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren: a prevalence study. International journal of obesity (2005). Oct 2015;39(10):1450-1455.

26.Morowitz MJ, Carlisle EM, Alverdy JC. Contributions of intestinal bacteria to nutrition and metabolism in the critically ill. The Surgical clinics of North America. Aug 2011;91(4):771-785, viii.

27.Festi D, Schiumerini R, Eusebi LH, Marasco G, Taddia M, Colecchia A (November 2014). "Gut microbiota and metabolic syndrome". World J. Gastroenterol. (Review). 20 (43): 16079–16094. doi:10.3748/wjg.v20.i43.16079. PMC4239493. PMID25473159.

28.Akobeng, AK; Elawad, M; Gordon, M (8 February 2016). "Glutamine for induction of remission in Crohn's disease" (PDF). The Cochrane Database of Systematic Reviews. 2: CD007348. doi:10.1002/14651858.CD007348.pub2. PMID26853855.

29.Kiefer, D; Ali-Akbarian, L (2004). "A brief evidence-based review of two gastrointestinal illnesses: Irritable bowel and leaky gut syndromes". Alternative Therapies in Health and Medicine. 10 (3): 22–30; quiz 31, 92. PMID15154150.

30.Heyman M, et al. (Sep 2012). "Intestinal permeability in coeliac disease: insight into mechanisms and relevance to pathogenesis". Gut (Review). 61 (9): 1355–64. doi:10.1136/gutjnl-2011-300327. PMID21890812. Changes in intestinal paracellular and transcellular permeability appear secondary to the abnormal immune reaction induced by gluten. Gliadin was suggested to increase junction permeability to small molecules through the release of prehaptoglobin-2. Environmental triggers of CD other than gliadin may also promote changes in permeability. Intestinal infection and iron deficiency can stimulate the expression of the transferrin receptor (TfR) CD71 in enterocytes. ... Once established, the alterations in intestinal permeability, notably the retro-transport of IgA-gliadin peptides, might self-sustain the inflammatory immune responses and perpetuate a vicious circle.

31.Khaleghi, Shahryar; Ju, Josephine M.; Lamba, Abhinav; Murray, Joseph A. (Jan 2016). "The potential utility of tight junction regulation in celiac disease: focus on larazotide acetate". Therapeutic Advances in Gastroenterology (Review. Research Support, N.I.H., Extramural). 9 (1): 37–49. doi:10.1177/1756283X15616576. ISSN1756-283X. PMC4699279. PMID26770266.

32.Fasano A (2012). "Intestinal permeability and its regulation by zonulin: diagnostic and therapeutic implications". Clin Gastroenterol Hepatol (Review). 10 (10): 1096–100. doi:10.1016/j.cgh.2012.08.012. PMC3458511. PMID22902773.

33.Slavin, Joanne (2013-04-22). "Fiber and Prebiotics: Mechanisms and Health Benefits". Nutrients. 5 (4): 1417–1435. doi:10.3390/nu5041417.

34.Pandey, Kavita R.; Naik, Suresh R.; Vakil, Babu V. (2015-12-01). "Probiotics, prebiotics and synbiotics- a review". Journal of Food Science and Technology. 52 (12): 7577–7587. doi:10.1007/s13197-015-1921-1. ISSN 0022-1155. PMC 4648921 .

35.C. K. Rajendran, Subin R.; Okolie, Chigozie Louis; Udenigwe, Chibuike C.; Mason, Beth (2017-10-01). "Structural features underlying prebiotic activity of conventional and potential prebiotic oligosaccharides in food and health". Journal of Food Biochemistry. 41 (5). doi:10.1111/jfbc.12389. ISSN 1745-4514.

36.Pokusaeva, Karina; Fitzgerald, Gerald F.; Sinderen, Douwe van (2011-08-01). "Carbohydrate metabolism in Bifidobacteria". Genes & Nutrition. 6 (3): 285–306. doi:10.1007/s12263-010-0206-6. ISSN 1555-8932. PMC 3145055 .

37.Lau K, Srivatsav V, Rizwan A, Nashed A, Liu R, Shen R, Akhtar M. Bridging the Gap between Gut Microbial Dysbiosis and Cardiovascular Diseases. Nutrients. Aug 10 2017;9(8).

38.Leclercq S, Matamoros S, Cani PD, Neyrinck AM, Jamar F, Starkel P, . . . Delzenne NM. Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity. Proceedings of the National Academy of Sciences of the United States of America. Oct 21 2014;111(42):E4485-4493.

39.Wilson, Bridgette; Whelan, Kevin (2017-03-01). "Prebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders". Journal of Gastroenterology and Hepatology. 32: 64–68. doi:10.1111/jgh.13700.

40.Hutkins RW; Krumbeck JA; Bindels LB; Cani PD; Fahey G Jr.; Goh YJ; Hamaker B; Martens EC; Mills DA; Rastal RA; Vaughan E; Sanders ME (2016). "Prebiotics: why definitions matter". Curr Opin Biotechnol. 37: 1–7. doi:10.1016/j.copbio.2015.09.001. PMC 4744122 . PMID 26431716.

41.Gibson GR, Roberfroid MB (Jun 1995). "Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics". J. Nutr. 125 (6): 1401–1412. PMID 7782892.

42.Gibson, Glenn R.; Hutkins, Robert; Sanders, Mary Ellen; Prescott, Susan L.; Reimer, Raylene A.; Salminen, Seppo J.; Scott, Karen; Stanton, Catherine; Swanson, Kelly S.; Cani, Patrice D.; Verbeke, Kristin; Reid, Gregor (2017). "Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics". Nature Reviews Gastroenterology & Hepatology. 14 (8). doi:10.1038/nrgastro.2017.75. ISSN 1759-5053.

43.Slavin, Joanne (2013-04-22). "Fiber and Prebiotics: Mechanisms and Health Benefits". Nutrients. 5 (4): 1417–1435. doi:10.3390/nu5041417.

44.Lamsal, Buddhi P (2012-08-15). "Production, health aspects and potential food uses of dairy prebiotic galactooligosaccharides". Journal of the Science of Food and Agriculture. 92 (10): 2020–2028. doi:10.1002/jsfa.5712. ISSN 1097-0010.

45.Ackerman DL, Craft KM, Doster RS, Weitkamp JH, Aronoff DM, Gaddy JA, Townsend SD. Antimicrobial and Antibiofilm Activity of Human Milk Oligosaccharides against Streptococcus agalactiae, Staphylococcus aureus, and Acinetobacter baumannii. ACS infectious diseases. Dec 8 2017.

46.Schlundt, Jorgen. "Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria" (PDF). Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria. FAO / WHO. Archived from the original (PDF) on October 22, 2012. Retrieved 17 December 2012.

47.Araujo JR, Tomas J, Brenner C, Sansonetti PJ. Impact of high-fat diet on the intestinal microbiota and small intestinal physiology before and after the onset of obesity. Biochimie. Oct 2017;141:97-106.

48.Fernandez M, Hudson JA, Korpela R, de los Reyes-Gavilan CG. Impact on human health of microorganisms present in fermented dairy products: an overview. Biomed Res Int. 2015;2015:412714.

49.Ferrario C, Statello R, Carnevali L, Mancabelli L, Milani C, Mangifesta M, . . . Turroni F. How to Feed the Mammalian Gut Microbiota: Bacterial and Metabolic Modulation by Dietary Fibers. Front Microbiol. 2017;8:1749.

50.He M, Shi B. Gut microbiota as a potential target of metabolic syndrome: the role of probiotics and prebiotics. Cell & bioscience. 2017;7:54.

51.Jones ML, Martoni CJ, Prakash S. Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial. European journal of clinical nutrition. Nov 2012;66(11):1234-1241.

52.Jones ML, Martoni CJ, Prakash S. Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. The Journal of clinical endocrinology and metabolism. Jul 2013;98(7):2944-2951.

53.David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, . . . Turnbaugh PJ. Diet rapidly and reproducibly alters the human gut microbiome. Nature. Jan 23 2014;505(7484):559-563.

54.Dubinkina VB, Tyakht AV, Odintsova VY, Yarygin KS, Kovarsky BA, Pavlenko AV, . . . Govorun VM. Links of gut microbiota composition with alcohol dependence syndrome and alcoholic liver disease. Microbiome. Oct 17 2017;5(1):141.

55.Clarke SF, Murphy EF, O'Sullivan O, Lucey AJ, Humphreys M, Hogan A, . . . Cotter PD. Exercise and associated dietary extremes impact on gut microbial diversity. Gut. Dec 2014;63(12):1913-1920.

56.Krajmalnik-Brown R, Ilhan ZE, Kang DW, DiBaise JK. Effects of gut microbes on nutrient absorption and energy regulation. Nutrition in clinical practice: official publication of the American Society for Parenteral and Enteral Nutrition. Apr 2012;27(2):201-214.

57.Candido FG, Valente FX, Grzeskowiak LM, Moreira APB, Rocha D, Alfenas RCG. Impact of dietary fat on gut microbiota and low-grade systemic inflammation: mechanisms and clinical implications on obesity. International journal of food sciences and nutrition. Jul 4 2017:1-19.

58.Capurso G, Lahner E. The interaction between smoking, alcohol and the gut microbiome. Best Pract Res Clin Gastroenterol. Oct 2017;31(5):579-588.

59.Cassidy-Bushrow AE, Burmeister C, Havstad S, Levin AM, Lynch SV, Ownby DR, . . . Wegienka G. Prenatal antimicrobial use and early-childhood body mass index. International journal of obesity (2005). Aug 17 2017.

60.Castanys-Munoz E, Martin MJ, Vazquez E. Building a Beneficial Microbiome from Birth. Adv Nutr. Mar 2016;7(2):323-330.

61.Lemas DJ, Yee S, Cacho N, Miller D, Cardel M, Gurka M, . . . Shenkman E. Exploring the contribution of maternal antibiotics and breastfeeding to development of the infant microbiome and pediatric obesity. Seminars in fetal & neonatal medicine. Dec 2016;21(6):406-409.

62.Gueimonde M, Collado MC (2012). "Metagenomics and probiotics". Clinical Microbiology and Infection. 18 Suppl 4: 32–4. doi:10.1111/j.1469-0691.2012.03873.x. PMID22647045.

63.Mach T (November 2006). "Clinical usefulness of probiotics against chronic inflammatory bowel diseases". Journal of Physiology and Pharmacology. 57 Suppl 9: 23–33. PMID17242485.

64.Derwa Y, Gracie DJ, Hamlin PJ, Ford AC. Systematic review with meta-analysis: the efficacy of probiotics in inflammatory bowel disease. Alimentary pharmacology & therapeutics. Aug 2017;46(4):389-400.

65.Di Stefano M, Miceli E, Armellini E, Missanelli A, Corazza GR. Probiotics and functional abdominal bloating. Journal of clinical gastroenterology. Jul 2004;38(6 Suppl):S102-103.

66.Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World journal of gastroenterology: WJG. Mar 14 2015;21(10):3072-3084.

67.Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. The American journal of clinical nutrition. Oct 2014;100(4):1075-1084.

68.Dimidi E, Christodoulides S, Scott SM, Whelan K. Mechanisms of Action of Probiotics and the Gastrointestinal Microbiota on Gut Motility and Constipation. Adv Nutr. May 2017;8(3):484-494.

69.Distrutti E, Monaldi L, Ricci P, Fiorucci S. Gut microbiota role in irritable bowel syndrome: New therapeutic strategies. World journal of gastroenterology. Feb 21 2016;22(7):2219-2241.

70.Dolin BJ. Effects of a proprietary Bacillus coagulans preparation on symptoms of diarrhea-predominant irritable bowel syndrome. Methods and findings in experimental and clinical pharmacology. Dec 2009;31(10):655-659.

71.Ghoshal UC, Shukla R, Ghoshal U. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut and liver. Mar 15 2017;11(2):196-208.

72.Giddings SL, Stevens AM, Leung DT. Traveler's Diarrhea. The Medical clinics of North America. Mar 2016;100(2):317-330.

73.Girard P, Coppe MC, Pansart Y, Gillardin JM. Gastroprotective effect of Saccharomyces boulardii in a rat model of ibuprofen-induced gastric ulcer. Pharmacology. 2010;85(3):188-193.

74.Goderska K, Agudo Pena S, Alarcon T. Helicobacter pylori treatment: antibiotics or probiotics. Appl Microbiol Biotechnol. Jan 2018;102(1):1-7.

75.Lau CS, Ward A, Chamberlain RS. Probiotics improve the efficacy of standard triple therapy in the eradication of Helicobacter pylori: a meta-analysis. Infection and drug resistance. 2016;9:275-289.

76.Lu M, Yu S, Deng J, Yan Q, Yang C, Xia G, Zhou X. Efficacy of Probiotic Supplementation Therapy for Helicobacter pylori Eradication: A Meta-Analysis of Randomized Controlled Trials. PloS one. 2016;11(10):e0163743.

77.Homan M, Orel R. Are probiotics useful in Helicobacter pylori eradication? World journal of gastroenterology. Oct 7 2015;21(37):10644-10653.

78.Bibiloni R, Fedorak RN, Tannock GW, Madsen KL, Gionchetti P, Campieri M, . . . Sartor RB. VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis. The American journal of gastroenterology. Jul 2005;100(7):1539-1546.

79.Blaabjerg S, Artzi DM, Aabenhus R. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients-A Systematic Review and Meta-Analysis. Antibiotics (Basel, Switzerland). Oct 12 2017;6(4).

80.Iovino P, Bucci C, Tremolaterra F, Santonicola A, Chiarioni G. Bloating and functional gastro-intestinal disorders: where are we and where are we going? World journal of gastroenterology: WJG. Oct 21 2014;20(39):14407-14419.

81.Kato S. Role of serotonin 5-HT(3) receptors in intestinal inflammation. Biological & pharmaceutical bulletin. 2013;36(9):1406-1409.

82.Kelesidis T, Pothoulakis C. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Therapeutic advances in gastroenterology. Mar 2012;5(2):111-125.

83.Majeed M, Nagabhushanam K, Natarajan S, Sivakumar A, Ali F, Pande A, . . . Karri SK. Bacillus coagulans MTCC 5856 supplementation in the management of diarrhea predominant Irritable Bowel Syndrome: a double blind randomized placebo controlled pilot clinical study. Nutr J. Feb 27 2016;15:21.

84.Morris G, Berk M, Carvalho AF, Caso JR, Sanz Y, Maes M. The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome. Curr Pharm Des. 2016;22(40):6058-6075.

85.Tiequn B, Guanqun C, Shuo Z. Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis. Intern Med. 2015;54(3):243-249.

86.Bennet SM, Ohman L, Simren M. Gut microbiota as potential orchestrators of irritable bowel syndrome. Gut and liver. May 23 2015;9(3):318-331.

87.Kruis W, Fric P, Pokrotnieks J, Lukas M, Fixa B, Kascak M, . . . Schulze J. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut. Nov 2004;53(11):1617-1623.

88.Fakhoury M, Negrulj R, Mooranian A, Al-Salami H. Inflammatory bowel disease: clinical aspects and treatments. J Inflamm Res. 2014;7:113-120.

89.Fakruddin M, Hossain MN, Ahmed MM. Antimicrobial and antioxidant activities of Saccharomyces cerevisiae IFST062013, a potential probiotic. BMC complementary and alternative medicine. Jan 21 2017;17(1):64.

90.Guslandi M, Giollo P, Testoni PA. A pilot trial of Saccharomyces boulardii in ulcerative colitis. European journal of gastroenterology & hepatology. Jun 2003;15(6):697-698.

91.Guslandi M, Mezzi G, Sorghi M, Testoni PA. Saccharomyces boulardii in maintenance treatment of Crohn's disease. Digestive diseases and sciences. Jul 2000;45(7):1462-1464.

92.Halfvarson J, Brislawn CJ, Lamendella R, Vazquez-Baeza Y, Walters WA, Bramer LM, . . . Jansson JK. Dynamics of the human gut microbiome in inflammatory bowel disease. Nature microbiology. Feb 13 2017;2:17004.

93.DeGruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current Understanding of Dysbiosis in Disease in Human and Animal Models. Inflamm Bowel Dis. May 2016;22(5):1137-1150.

94.Del Piano M, Anderloni A, Balzarini M, Ballare M, Carmagnola S, Montino F, . . . Mogna G. The innovative potential of Lactobacillus rhamnosus LR06, Lactobacillus pentosus LPS01, Lactobacillus plantarum LP01, and Lactobacillus delbrueckii Subsp. delbrueckii LDD01 to restore the "gastric barrier effect" in patients chronically treated with PPI: a pilot study. Journal of clinical gastroenterology. Oct 2012;46 Suppl:S18-26.

95.Hun L. Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS. Postgrad Med. Mar 2009;121(2):119-124.

96.Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clinical epidemiology. 2014;6:71-80.

97.Fashner J, Gitu AC. Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection. American family physician. Feb 15 2015;91(4):236-242.

98.Yan F, Polk DB (November 2006). "Probiotics as functional food in the treatment of diarrhea". Current Opinion in Clinical Nutrition and Metabolic Care. 9 (6): 717–21. doi:10.1097/01.mco.0000247477.02650.51. PMID17053425.

99.Amato KR, Yeoman CJ, Cerda G, Schmitt CA, Cramer JD, Miller ME, . . . Leigh SR. Variable responses of human and non-human primate gut microbiomes to a Western diet. Microbiome. Nov 16 2015;3:53.

100.Anderson JR, Carroll I, Azcarate-Peril MA, Rochette AD, Heinberg LJ, Peat C, . . . Gunstad J. A preliminary examination of gut microbiota, sleep, and cognitive flexibility in healthy older adults. Sleep Med. Oct 2017;38:104-107.

101.Alverdy JC, Luo JN. The Influence of Host Stress on the Mechanism of Infection: Lost Microbiomes, Emergent Pathobiomes, and the Role of Interkingdom Signaling. Front Microbiol. 2017;8:322.

102.Aoyagi Y, Park S, Matsubara S, Honda Y, Amamoto R, Kushiro A, . . . Shephard RJ. Habitual intake of fermented milk products containing Lactobacillus casei strain Shirota and a reduced risk of hypertension in older people. Benef Microbes. Feb 7 2017;8(1):23-29.

103.Belkaid Y, Hand TW. Role of the microbiota in immunity and inflammation. Cell. Mar 27 2014;157(1):121-141.

104.Bermon S, Petriz B, Kajeniene A, Prestes J, Castell L, Franco OL. The microbiota: an exercise immunology perspective. Exercise immunology review. 2015;21:70-79.

105.Ait-Belgnaoui A, Colom A, Braniste V, Ramalho L, Marrot A, Cartier C, . . . Tompkins T. Probiotic gut effect prevents the chronic psychological stress-induced brain activity abnormality in mice. Neurogastroenterology and motility: the official journal of the European Gastrointestinal Motility Society. Apr 2014;26(4):510-520.

106.Moya-Perez A, Luczynski P, Renes IB, Wang S, Borre Y, Anthony Ryan C, . . . Cryan JF. Intervention strategies for cesarean section-induced alterations in the microbiota-gut-brain axis. Nutrition reviews. Apr 1 2017;75(4):225-240.

107.Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology. Apr-Jun 2015;28(2):203-209.

108.Jenkins TA, Nguyen JC, Polglaze KE, Bertrand PP. Influence of Tryptophan and Serotonin on Mood and Cognition with a Possible Role of the Gut-Brain Axis. Nutrients. Jan 20 2016;8(1).

109.Mayer EA, Knight R, Mazmanian SK, Cryan JF, Tillisch K. Gut microbes and the brain: paradigm shift in neuroscience. The Journal of neuroscience: the official journal of the Society for Neuroscience. Nov 12 2014;34(46):15490-15496.

110.Messaoudi M, Violle N, Bisson JF, Desor D, Javelot H, Rougeot C. Beneficial psychological effects of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in healthy human volunteers. Gut microbes. Jul-Aug 2011;2(4):256-261.

111.Galland L. The gut microbiome and the brain. Journal of medicinal food. Dec 2014;17(12):1261-1272.

112.Chen Z, Li J, Gui S, Zhou C, Chen J, Yang C, . . . Xie P. Comparative metaproteomics analysis shows altered fecal microbiota signatures in patients with major depressive disorder. Neuroreport. Mar 21 2018;29(5):417-425.

113.Clapp M, Aurora N, Herrera L, Bhatia M, Wilen E, Wakefield S. Gut microbiota's effect on mental health: The gut-brain axis. Clinics and practice. Sep 15 2017;7(4):987.

114.Clark A, Mach N. Exercise-induced stress behavior, gut-microbiota-brain axis and diet: a systematic review for athletes. Journal of the International Society of Sports Nutrition. 2016;13:43.

115.Tamaki H, Nakase H, Inoue S, Kawanami C, Itani T, Ohana M, . . . Shibatouge M. Efficacy of probiotic treatment with Bifidobacterium longum 536 for induction of remission in active ulcerative colitis: A randomized, double-blinded, placebo-controlled multicenter trial. Digestive endoscopy: official journal of the Japan Gastroenterological Endoscopy Society. Jan 2016;28(1):67-74.

116.Allaker RP, Stephen AS. Use of Probiotics and Oral Health. Current oral health reports. 2017;4(4):309-318.

117.Burton JP, Drummond BK, Chilcott CN, Tagg JR, Thomson WM, Hale JD, Wescombe PA. Influence of the probiotic Streptococcus salivarius strain M18 on indices of dental health in children: a randomized double-blind, placebo-controlled trial. J Med Microbiol. Jun 2013;62(Pt 6):875-884.

118.Burton JP, Wescombe PA, Moore CJ, Chilcott CN, Tagg JR. Safety assessment of the oral cavity probiotic Streptococcus salivarius K12. Appl Environ Microbiol. Apr 2006;72(4):3050-3053.

119.Dewhirst FE, Chen T, Izard J, Paster BJ, Tanner AC, Yu WH, . . . Wade WG. The human oral microbiome. J Bacteriol. Oct 2010;192(19):5002-5017.

120.Di Pierro F, Colombo M, Giuliani MG, Danza ML, Basile I, Bollani T, . . . Rottoli AS. Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children. European review for medical and pharmacological sciences. Nov 2016;20(21):4601-4606.

121.Di Pierro F, Colombo M, Zanvit A, Risso P, Rottoli AS. Use of Streptococcus salivarius K12 in the prevention of streptococcal and viral pharyngotonsillitis in children. Drug Healthc Patient Saf. 2014;6:15-20.

122.Di Pierro F, Donato G, Fomia F, Adami T, Careddu D, Cassandro C, Albera R. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media. International journal of general medicine. 2012;5:991-997.

123.Iwasaki K, Maeda K, Hidaka K, Nemoto K, Hirose Y, Deguchi S. Daily Intake of Heat-killed Lactobacillus plantarum L-137 Decreases the Probing Depth in Patients Undergoing Supportive Periodontal Therapy. Oral health & preventive dentistry. 2016;14(3):207-214.

124.Janakiram C, Deepan Kumar CV, Joseph J. Xylitol in preventing dental caries: A systematic review and meta-analyses. Journal of natural science, biology, and medicine. Jan-Jun 2017;8(1):16-21.

125.Nayak PA, Nayak UA, Khandelwal V. The effect of xylitol on dental caries and oral flora. Clinical, cosmetic and investigational dentistry. 2014;6:89-94.

126.Szajewska H, Kolodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Alimentary pharmacology & therapeutics. Nov 2015a;42(10):1149-1157.

127.Szajewska H, Kolodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Alimentary pharmacology & therapeutics. Oct 2015b;42(7):793-801.

128.Di Pierro F, Zanvit A, Nobili P, Risso P, Fornaini C. Cariogram outcome after 90 days of oral treatment with Streptococcus salivarius M18 in children at high risk for dental caries: results of a randomized, controlled study. Clinical, cosmetic and investigational dentistry. 2015;7:107-113.

129.Di Pilato V, Freschi G, Ringressi MN, Pallecchi L, Rossolini GM, Bechi P. The esophageal microbiota in health and disease. Annals of the New York Academy of Sciences. Oct 2016;1381(1):21-33.

130.Di Pierro F, Colombo M, Zanvit A, Rottoli AS. Positive clinical outcomes derived from using Streptococcus salivarius K12 to prevent streptococcal pharyngotonsillitis in children: a pilot investigation. Drug Healthc Patient Saf. 2016;8:77-81.

131.Galland L. The gut microbiome and the brain. Journal of medicinal food. Dec 2014;17(12):1261-1272.

132.Di Pierro F, Di Pasquale D, Di Cicco M. Oral use of Streptococcus salivarius K12 in children with secretory otitis media: preliminary results of a pilot, uncontrolled study. International journal of general medicine. 2015;8:303-308.

133.Gupta ND, Sharma S, Sharma VK. Probiotic - An emerging therapy in recolonizing periodontal pocket. Journal of oral biology and craniofacial research. Jan-Apr 2017;7(1):72-73.

134.Haukioja A. Probiotics and oral health. European journal of dentistry. Jul 2010;4(3):348-355.

135.Hedayati-Hajikand T, Lundberg U, Eldh C, Twetman S. Effect of probiotic chewing tablets on early childhood caries--a randomized controlled trial. BMC oral health. 2015;15(1):112.

136.Jiao Y, Hasegawa M, Inohara N. The Role of Oral Pathobionts in Dysbiosis during Periodontitis Development. Journal of dental research. Jun 2014;93(6):539-546.

137.Meuric V, Le Gall-David S, Boyer E, Acuna-Amador L, Martin B, Fong SB, . . . Bonnaure-Mallet M. Signature of Microbial Dysbiosis in Periodontitis. Appl Environ Microbiol. Jul 15 2017;83(14).

138.Toiviainen A, Jalasvuori H, Lahti E, Gursoy U, Salminen S, Fontana M, . . . Soderling E. Impact of orally administered lozenges with Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 on the number of salivary mutans streptococci, amount of plaque, gingival inflammation and the oral microbiome in healthy adults. Clin Oral Investig. Jan 2015;19(1):77-83.

139.Tomas-Barberan FA, Selma MV, Espin JC. Interactions of gut microbiota with dietary polyphenols and consequences to human health. Current opinion in clinical nutrition and metabolic care. Nov 2016;19(6):471-476.

140.Torii S, Torii A, Itoh K, Urisu A, Terada A, Fujisawa T, . . . Fujiwara S. Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum markers of atopic dermatitis in children. Int Arch Allergy Immunol. 2011;154(3):236-245.

141.Arseneault-Breard J, Rondeau I, Gilbert K, Girard SA, Tompkins TA, Godbout R, Rousseau G. Combination of Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 reduces post-myocardial infarction depression symptoms and restores intestinal permeability in a rat model. The British journal of nutrition. Jun 2012;107(12):1793-1799.

142.Cribby S, Taylor M, Reid G. Vaginal microbiota and the use of probiotics. Interdisciplinary perspectives on infectious diseases. 2008;2008:256490.

143.Kirjavainen PV, Pautler S, Baroja ML, Anukam K, Crowley K, Carter K, Reid G. Abnormal immunological profile and vaginal microbiota in women prone to urinary tract infections. Clinical and vaccine immunology: CVI. Jan 2009;16(1):29-36.

144.Beerepoot MA, ter Riet G, Nys S, van der Wal WM, de Borgie CA, de Reijke TM, . . . Geerlings SE. Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninferiority trial in postmenopausal women. Archives of internal medicine. May 14 2012;172(9):704-712.

145.Bohbot JM, Cardot JM. Vaginal impact of the oral administration of total freeze-dried culture of LCR 35 in healthy women. Infectious diseases in obstetrics and gynecology. 2012;2012:503648.

146.De Seta F, Parazzini F, De Leo R, Banco R, Maso GP, De Santo D, . . . Restaino S. Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study. European journal of obstetrics, gynecology, and reproductive biology. Nov 2014;182:136-139.

147.Hanson L, VandeVusse L, Jerme M, Abad CL, Safdar N. Probiotics for Treatment and Prevention of Urogenital Infections in Women: A Systematic Review. Journal of midwifery & women's health. May 2016;61(3):339-355.

148.Deidda F, Amoruso A, Nicola S, Graziano T, Pane M, Allesina S, . . . Mogna L. The In Vitro Effectiveness of Lactobacillus fermentum Against Different Candida Species Compared With Broadly Used Azoles. Journal of clinical gastroenterology. Nov/Dec 2016;50 Suppl 2, Proceedings from the 8th Probiotics, Prebiotics & New Foods for Microbiota and Human Health meeting held in Rome, Italy on September 13-15, 2015:S171-s174.

149.Kohler GA, Assefa S, Reid G. Probiotic interference of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 with the opportunistic fungal pathogen Candida albicans. Infectious diseases in obstetrics and gynecology. 2012;2012:636474.

150.Kovachev SM, Vatcheva-Dobrevska RS. Local Probiotic Therapy for Vaginal Candida albicans Infections. Probiotics and antimicrobial proteins. Mar 2015;7(1):38-44.

151.Abdelmaksoud AA, Koparde VN, Sheth NU, Serrano MG, Glascock AL, Fettweis JM, . . . Jefferson KK. Comparison of Lactobacillus crispatus isolates from Lactobacillus-dominated vaginal microbiomes with isolates from microbiomes containing bacterial vaginosis-associated bacteria. Microbiology. Mar 2016;162(3):466-475.

152.Chew SY, Cheah YK, Seow HF, Sandai D, Than LT. Probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 exhibit strong antifungal effects against vulvovaginal candidiasis-causing Candida glabrata isolates. J Appl Microbiol. May 2015;118(5):1180-1190.

153.Huang R, Ning H, Shen M, Li J, Zhang J, Chen X. Probiotics for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in cellular and infection microbiology. 2017;7:392.

154.Marrs T, Flohr C. The role of skin and gut microbiota in the development of atopic eczema. Br J Dermatol. Oct 2016;175 Suppl 2:13-18.

155.Inoue Y, Kambara T, Murata N, Komori-Yamaguchi J, Matsukura S, Takahashi Y, . . . Aihara M. Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum cytokines of atopic dermatitis in Japanese adults: a double-blind, randomized, clinical trial. Int Arch Allergy Immunol. 2014;165(4):247-254.

156.Al-Ghazzewi FH, Tester RF. Impact of prebiotics and probiotics on skin health. Benef Microbes. Jun 1 2014;5(2):99-107.

157.Kober MM, Bowe WP. The effect of probiotics on immune regulation, acne, and photoaging. International journal of women's dermatology. Jun 2015;1(2):85-89.

158.Chang YS, Trivedi MK, Jha A, Lin YF, Dimaano L, Garcia-Romero MT. Synbiotics for Prevention and Treatment of Atopic Dermatitis: A Meta-analysis of Randomized Clinical Trials. JAMA pediatrics. Mar 2016;170(3):236-242.

159.Elazab N, Mendy A, Gasana J, Vieira ER, Quizon A, Forno E. Probiotic administration in early life, atopy, and asthma: a meta-analysis of clinical trials. Pediatrics. Sep 2013;132(3):e666-676.

160.Hirose Y, Yamamoto Y, Yoshikai Y, Murosaki S. Oral intake of heat-killed Lactobacillus plantarum L-137 decreases the incidence of upper respiratory tract infection in healthy subjects with high levels of psychological stress. Journal of nutritional science. 2013;2:e39.

161.Namba K, Hatano M, Yaeshima T, Takase M, Suzuki K. Effects of Bifidobacterium longum BB536 administration on influenza infection, influenza vaccine antibody titer, and cell-mediated immunity in the elderly. Bioscience, biotechnology, and biochemistry. 2010;74(5):939-945.

162.Miraglia Del Giudice M, Indolfi C, Capasso M, Maiello N, Decimo F, Ciprandi G. Bifidobacterium mixture (B longum BB536, B infantis M-63, B breve M-16V) treatment in children with seasonal allergic rhinitis and intermittent asthma. Italian journal of pediatrics. Mar 7 2017;43(1):25.

163.Jarde A, Lewis-Mikhael AM, Moayyedi P, Stearns JC, Collins SM, Beyene J, McDonald SD. Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis. BMC Pregnancy Childbirth. Jan 8 2018;18(1):14.

164.Jasarevic E, Howard CD, Misic AM, Beiting DP, Bale TL. Stress during pregnancy alters temporal and spatial dynamics of the maternal and offspring microbiome in a sex-specific manner. Sci Rep. Mar 7 2017;7:44182.

165.Kim SO, Ah YM, Yu YM, Choi KH, Shin WG, Lee JY. Effects of probiotics for the treatment of atopic dermatitis: a meta-analysis of randomized controlled trials. Ann Allergy Asthma Immunol. Aug 2014;113(2):217-226.

166.Jasarevic E, Howerton CL, Howard CD, Bale TL. Alterations in the Vaginal Microbiome by Maternal Stress Are Associated With Metabolic Reprogramming of the Offspring Gut and Brain. Endocrinology. Sep 2015;156(9):3265-3276.

167.Jasarevic E, Rodgers AB, Bale TL. A novel role for maternal stress and microbial transmission in early life programming and neurodevelopment. Neurobiology of stress. Jan 1 2015;1:81-88.

168.Chung KF. Airway microbial dysbiosis in asthmatic patients: A target for prevention and treatment? The Journal of allergy and clinical immunology. Apr 2017;139(4):1071-1081.

169.Ishida Y, Nakamura F, Kanzato H, Sawada D, Hirata H, Nishimura A, . . . Fujiwara S. Clinical effects of Lactobacillus acidophilus strain L-92 on perennial allergic rhinitis: a double-blind, placebo-controlled study. J Dairy Sci. Feb 2005;88(2):527-533.

170.Ishida Y, Nakamura F, Kanzato H, Sawada D, Yamamoto N, Kagata H, . . . Fujiwara S. Effect of milk fermented with Lactobacillus acidophilus strain L-92 on symptoms of Japanese cedar pollen allergy: a randomized placebo-controlled trial. Bioscience, biotechnology, and biochemistry. Sep 2005;69(9):1652-1660.

171.Jerzynska J, Stelmach W, Balcerak J, Woicka-Kolejwa K, Rychlik B, Blauz A, . . . Stelmach I. Effect of Lactobacillus rhamnosus GG and vitamin D supplementation on the immunologic effectiveness of grass-specific sublingual immunotherapy in children with allergy. Allergy and asthma proceedings: the official journal of regional and state allergy societies. Jul 2016;37(4):324-334.

172.Jespersen L, Tarnow I, Eskesen D, Morberg CM, Michelsen B, Bugel S, . . . Calder PC. Effect of Lactobacillus paracasei subsp. paracasei, L. casei 431 on immune response to influenza vaccination and upper respiratory tract infections in healthy adult volunteers: a randomized, double-blind, placebo-controlled, parallel-group study. The American journal of clinical nutrition. Jun 2015;101(6):1188-1196.

173.Marchisio P, Santagati M, Scillato M, Baggi E, Fattizzo M, Rosazza C, . . . Principi N. Streptococcus salivarius 24SMB administered by nasal spray for the prevention of acute otitis media in otitis-prone children. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology. Dec 2015;34(12):2377-2383.

174.Fujimura KE, Lynch SV. Microbiota in allergy and asthma and the emerging relationship with the gut microbiome. Cell Host Microbe. May 13 2015;17(5):592-602.

175.Gao Z, Kang Y, Yu J, Ren L. Human pharyngeal microbiome may play a protective role in respiratory tract infections. Genomics, proteomics & bioinformatics. Jun 2014;12(3):144-150.

176.Langkamp-Henken B, Rowe CC, Ford AL, Christman MC, Nieves C, Jr., Khouri L, . . . Dahl WJ. Bifidobacterium bifidum R0071 results in a greater proportion of healthy days and a lower percentage of academically stressed students reporting a day of cold/flu: a randomised, double-blind, placebo-controlled study. The British journal of nutrition. Feb 14 2015;113(3):426-434.

177.Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. The Cochrane database of systematic reviews. Feb 3 2015(2):Cd006895.

178.Hauptmann M, Schaible UE. Linking microbiota and respiratory disease. FEBS letters. Nov 2016;590(21):3721-3738.

179.Fujita R, Iimuro S, Shinozaki T, Sakamaki K, Uemura Y, Takeuchi A, . . . Ohashi Y. Decreased duration of acute upper respiratory tract infections with daily intake of fermented milk: a multicenter, double-blinded, randomized comparative study in users of day care facilities for the elderly population. American journal of infection control. Dec 2013;41(12):1231-1235.

180.Goodrich JK, Waters JL, Poole AC, Sutter JL, Koren O, Blekhman R, . . . Ley RE. Human genetics shape the gut microbiome. Cell. Nov 6 2014;159(4):789-799.

181.Graf D, Di Cagno R, Fak F, Flint HJ, Nyman M, Saarela M, Watzl B. Contribution of diet to the composition of the human gut microbiota. Microbial ecology in health and disease. 2015;26:26164.

182.Ho JT, Chan GC, Li JC. Systemic effects of gut microbiota and its relationship with disease and modulation. BMC immunology. Mar 26 2015;16:21.

183.Househam AM, Peterson CT, Mills PJ, Chopra D. The Effects of Stress and Meditation on the Immune System, Human Microbiota, and Epigenetics. Adv Mind Body Med. Fall 2017;31(4):10-25.

184.Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature. Jun 13 2012;486(7402):207-214.

185.Kau AL, Ahern PP, Griffin NW, Goodman AL, Gordon JI. Human nutrition, the gut microbiome and the immune system. Nature. Jun 15 2011;474(7351):327-336.

186.Khalighi A, Behdani R, Kouhestani S. Probiotics: A Comprehensive Review of Their Classification, Mode of Action and Role in Human Nutrition. In: Rao V, Rao LG, eds. Probiotics and Prebiotics in Human Nutrition and Health. Rijeka: InTech; 2016:Ch. 02.

187.Lloyd-Price J, Abu-Ali G, Huttenhower C. The healthy human microbiome. Genome medicine. Apr 27 2016;8(1):51.

188.Lopes EG, Moreira DA, Gullon P, Gullon B, Cardelle-Cobas A, Tavaria FK. Topical application of probiotics in skin: adhesion, antimicrobial and antibiofilm in vitro assays. J Appl Microbiol. Feb 2017;122(2):450-461.

189.Zupancic K, Kriksic V, Kovacevic I, Kovacevic D. Influence of Oral Probiotic Streptococcus salivarius K12 on Ear and Oral Cavity Health in Humans: Systematic Review. Probiotics and antimicrobial proteins. Jun 2017;9(2):102-110.

190.Zocco MA, dal Verme LZ, Cremonini F, Piscaglia AC, Nista EC, Candelli M, . . . Gasbarrini A. Efficacy of Lactobacillus GG in maintaining remission of ulcerative colitis. Alimentary pharmacology & therapeutics. Jun 1 2006;23(11):1567-1574.

191.Zhou L, Foster JA. Psychobiotics and the gut-brain axis: in the pursuit of happiness. Neuropsychiatr Dis Treat. 2015;11:715-723.

192.Yamazaki Y, Nakamura Y, Nunez G. Role of the microbiota in skin immunity and atopic dermatitis. Allergology international: official journal of the Japanese Society of Allergology. Oct 2017;66(4):539-544.

193.Xu Z, Knight R. Dietary effects on human gut microbiome diversity. The British journal of nutrition. Jan 2015;113 Suppl:S1-5.

194.Wischmeyer PE, McDonald D, Knight R. Role of the microbiome, probiotics, and 'dysbiosis therapy' in critical illness. Current opinion in critical care. Aug 2016;22(4):347-353.

195.West CE, Jenmalm MC, Kozyrskyj AL, Prescott SL. Probiotics for treatment and primary prevention of allergic diseases and asthma: looking back and moving forward. Expert review of clinical immunology. Jun 2016;12(6):625-639.

196.Wang Y, Kuang Z, Yu X, Ruhn KA, Kubo M, Hooper LV. The intestinal microbiota regulates body composition through NFIL3 and the circadian clock. Science (New York, N.Y.). Sep 1 2017;357(6354):912-916.

197.Wagner RD, Johnson SJ. Probiotic lactobacillus and estrogen effects on vaginal epithelial gene expression responses to Candida albicans. J Biomed Sci. Jun 20 2012;19:58.

198.Vivekananda MR, Vandana KL, Bhat KG. Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial. Journal of oral microbiology. Nov 2 2010;2.

199.Ursell LK, Metcalf JL, Parfrey LW, Knight R. Defining the Human Microbiome. Nutrition reviews. Aug 2012;70(Suppl 1):S38-44.

200.Teughels W, Durukan A, Ozcelik O, Pauwels M, Quirynen M, Haytac MC. Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol. Nov 2013;40(11):1025-1035.

201.Tursi A, Brandimarte G, Papa A, Giglio A, Elisei W, Giorgetti GM, . . . Gasbarrini A. Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment: a double-blind, randomized, placebo-controlled study. The American journal of gastroenterology. Oct 2010;105(10):2218-2227.

202. Tiequn B, Guanqun C, Shuo Z. Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis. Intern Med. 2015;54(3):243-249.

5th Aug 2018

Recent Posts