The Importance of Supplementing With Probiotics In CF

We are taught how to manage pancreatic insufficiency with enzymes. Then given laxatives, food diaries, and stool charts to help manage other gut issues. But, where is the prescription for probiotics?

What are probiotics?

Probiotics are live bacteria - think of them as friendly flora. The whole body is thriving on all types of bacteria and yeast – some good and some bad. It is key we keep that different bacteria in check as their primary function is to maintain balance and harmony.

Things probiotics can help with in cystic fibrosis are:^1,2

• Digesting our food
• Diarrhea
• Gas
• Reflux
• Poor digestion
• Bloating
• Preventing upper respiratory tract infections

They are naturally found in yogurts or kefir and made into supplemental forms such as; powders, pills and liquid form.

Probiotics in cystic fibrosis care

It has been well documented that in CF, the microbial imbalance is disrupted around age one. As we grow, the friendly gut bacteria moves further away from a normal, healthy range. This stops the growth and stability of a thriving mixture of good bacteria surviving in our digestive tract.¹

Why this occurs in CF is not fully understood. However, the use of antibiotics plays a leading role as they kill healthy bacteria which then develops into small intestinal bacterial overgrowth (SIBO) and, C. difficile diarrhoea. CF research speculates there is a link between the bacteria in the lungs being present in the digestive tract.¹

Other evidence has suggested that these decreases in good gut bacteria can have an impact on:¹

• Intestinal inflammation
• Digestive issues
• CF liver disease
• The gut-brain axis
• Growth and CF-related diabetes
• Lung function decline

What should you be looking for in a probiotic?

Always consult with your doctor first!

Once you have the green light, look for medical grade probiotics. Most probiotics contain strains of Lactabacillus or Bifidobacterium which have both proven beneficial when targeting cystic fibrosis gut microbe dysfunction. Other bacterial strains specific to CF to look for are Saccharomyces and Streptococcus. When looking for a good probiotic always look out for 10 different strains of bacteria and, at least 20 CFU’s per pill.^1,2

The probiotic takeaway

Probiotics are still classified as a health food product and, in some cases they are undermined as an essential supplement. However, evidence suggests there is a dysfunction in the structure of good gut bacteria in CF which manifests in the early years. This dysfunction increases overall inflammation alongside increasing other issues associated with CF.¹

In my opinion, it should be deemed essential we enable optimal digestion and absorption of nutrition with a high calorie/high protein diet, targeted interventions of vitamins and, probiotics from the onset of treatment in early childhood.