Bacteria contained in stool samples are cultured to identify the presence and relative abundance of specific beneficial, imbalanced and dysbiotic bacteria. When dysbiotic bacteria are present, further testing is performed to determine which natural and pharmaceutical agents might eradicate the patient’s specific bacteria. This test is typically performed as a follow up to a CSAP to determine the efficacy of therapeutic treatment.
A good balance of beneficial microflora has been known to be associated with health benefits since the turn of the century. At that time Metchnikoff drew attention to the adverse effects of dysbiotic gut microflora on the host and suggested that ingestion of fermented milks ameliorated what he called “autointoxication”. He proposed that the consumption of large quantities of Lactobacillus species would reduce the number of toxin-producing bacteria and result in better health and increased lifespan. 1
Over the past 90 plus years there has been extensive scientific research demonstrating that a good balance of Lactobacilli, Bifidobacteria and beneficial E. coli bacteria are important to the functional health of the gut, and as a consequence, to the whole organism. The benefits identified include inhibition of microbial pathogens, 2 prevention and treatment of antibiotic associated diarrhea, 3 prevention of travelers’ diarrhea, 4 reduction of lactose intolerance symptoms, 5 reduction in serum cholesterol levels, 6,7 enhancement of the immune system, 8 and inhibition of the proliferation of Candida albicans. 9,10 Research has shown that improved biological value of food can be achieved through the activity of Lactobacilli and Bifidobacteria which have been reported to produce folic acid, niacin, thiamin, riboflavin, pyridoxine, biotin and vitamin K. 11
The mechanisms by which these benefits are derived are not yet fully understood. However, research suggests that some of the beneficial effects may be due to the following activities of beneficial bacteria:
Release of substances antagonistic to enteropathogenic microorganisms such as lactocidin, lactobicillin, and acidolin
Competition with pathogens for adhesion receptors
Production of lactase
Production of short chain fatty acids (SCFAs) such as butyrate, propionate, and acetate
In a healthy balanced state of intestinal flora the beneficial bacteria make up a significant proportion of the total microflora. However, in many individuals we see an imbalance of beneficial bacteria and an overgrowth of non-beneficial or even pathogenic microorganisms (dysbiosis). This can be due to a variety of factors including: daily exposure to chemicals in our drinking water that are toxic to friendly bacteria; the use of antibiotics; chronic consumption of highly processed foods (low in fiber, high in sugar) and high stress levels. Patients may present with chronic symptoms such as irritable bowel syndrome, autoimmune diseases (e.g. rheumatoid arthritis), fatigue, chronic headaches, and allergies to a variety of foods.
1 Metchnikoff, E. The Prolongation of Life. 1907, Heinemann
2 Fuller R. Probiotics in human medicine. GUT, 1991;32:439-442
3 Sittonen S, Vapaatalo H, Salminen S, et al. Effect of Lactobacilli GG yogurt in prevention of antibiotic associated diarrhea. Ann Med. 1990;22:57-59
4 Oksanen P, Salminen S, Saxelin M, et al. Prevention of travellers’ diarrhea by Lactobacillus GG. Ann med 1990;22:53-56
5 Kim H and Gilliland S. Lactobacillus acidophilus as a dietary adjunct for milk to aid lactose digestion in humans. J Dairy Sci. 1983;66:959-966
6 Tahri K, Crociani J, Ballongue J and Schneider F. Effects of three strains of bifidobacterial on cholesterol. Letters Applied Microbiology. 1995;21:149-151
7 Klaver F and Van Der Meer R. The assumed assimilation of cholesterol by Lactobacilli and Bifidobacterium bifidum is due to their bile salt- deconjugating activity. Applied and Envir. Micro. 1993;1120-1124
8 Peridgon G, Alvarez M, et al. The oral administration of lactic acid bacteria increases the mucosal intestinal immunity in response to enteropathogens J. Food Prot. 1990;53:404-410
9 Elmer G, Surawicz C, and McFarland L. Biotherapeutic agents – a neglected modality for the treatment and prevention of intestinal and vaginal infections. JAMA 1996; 275(11):870-876.
10 Fitzsimmons N and Berry D. Inhibition of Candida albicans by Lactobacillus acidophilus: evidence for involvement of a peroxidase system. Microbios. 1994; 80:125-133
11Noda H, Akasaka N and Ohsugi M. Biotin production by Bifidobacteria.J Nutr. Sci. Vitaminol. 1994; 40:181-188.