While pharmacy personnel may encounter patients familiar with probiotics and prebiotics – usually due to doctor prescriptions – they might not fully understand their usage, purposes, and health benefits. Pharmacists can provide crucial information about the differences and benefits of probiotics and prebiotics. 

PROBIOTICS VS PREBIOTICS 

Probiotics are live microorganisms, known as "good bacteria," naturally found in the intestines.¹ They aid in digestion, nutrient absorption, disease prevention, and immune function. Poor diet, stress, and environmental factors can disrupt the balance between good and harmful bacteria in the gut, leading to health issues and immune dysfunction.² The human gut hosts about 100 trillion microorganisms, encompassing over 500 different species, typically without causing illness.¹ 

Probiotics are available in various forms, including foods, drugs, and dietary supplements. Fermented foods like sauerkraut, kimchi, kombucha, and Greek yogurt contain live microorganisms that enhance gut health and survive the digestive process. Patients should introduce these foods gradually to allow their gut to adjust to new bacterial strains.³ 

In contrast, prebiotics are dietary components that promote the growth and balance of healthy bacteria in the colon. Prebiotic fibres are non-digestible, fermented into short-chain fatty acids in the colon, providing energy for gut cells.⁵ Prebiotics naturally occur in foods such as asparagus, Jerusalem artichoke, garlic, and whole wheat. Due to their low concentrations in foods, they are also produced on a large industrial scale using raw materials like lactose, sucrose, and starch.⁴ 

HEALTH BENEFITS OF PROBIOTICS 

Probiotics offer various health benefits, including: 

• Antibiotic-associated diarrhoea: Probiotics help alleviate mild or severe diarrhoea caused by antibiotic treatments, which can disrupt normal gut microflora and promote the growth of pathogenic bacteria.⁵ 
• Infectious diarrhoea: Probiotics are effective in treating and preventing infectious diarrhoea, notably caused by rotavirus in infants, a significant cause of infant mortality. Probiotic supplementation in infant formulas aims to prevent such infections.⁵ 
• Inflammatory bowel disease (IBD): Probiotics can reduce symptoms of IBD, which includes conditions like Crohn's disease and ulcerative colitis, characterised by inflammation, ulceration, and gastrointestinal narrowing. Symptoms such as abdominal pain, diarrhoea, and gastrointestinal bleeding can be alleviated, and remission maintained through probiotic use.⁶ 
• Other potential benefits include immune system stimulation, protection against respiratory infections, cholesterol reduction, and anticancer effects. It's important to note that probiotic benefits are strain-specific, not species- or genus-specific.⁶ 

HEALTH BENEFITS OF PREBIOTICS 

Incorporating prebiotics into the diet provides multiple health benefits, such as: 

• Reducing low-density lipoprotein (LDL) cholesterol levels 
• Stimulating the immune system 
• Enhancing calcium absorption 
• Maintaining proper intestinal pH 
• Offering low caloric value 
• Alleviating symptoms of peptic ulcers and vaginal mycosis ⁷ 

Pharmacists can guide patients on the appropriate use of probiotics and prebiotics to maximise their health benefits and support overall well-being. 

REFERENCES 

1. Center for Applied Nutrition. (2019). ‘Probiotics vs Prebiotics.’ Available from: https://www.umassmed.edu/nutrition/blog/blog-posts/2019/4/probiotics-vs.-prebiotics/ 
2. NIB. (2019). ‘The Difference between Prebiotics and Probiotics.’ Available from: https://www.nib.com.au/the-checkup/healthy-living/difference-between-prebiotics-and-probiotics 
3. Colombia Surgery. ‘What You Need To Know About Probiotics.’ Available from: https://columbiasurgery.org/news/2017/02/09/what-you-need-know-about-prebiotics 
4. Davani-Davari, D at al. (2019). ‘Prebiotics: Definition, Types, Sources, Mechanisms and Clinical Applications. Available from: https://www.researchgate.net/publication/331677001_Prebiotics_Definition_Types_Sources_Mechanisms_and_Clinical_Applications 
5. Kechagia, K et al. (2013). ‘Health Benefits of Probiotics: A Review.’ Available from: https://www.researchgate.net/publication/258405079_Health_Benefits_of_Probiotics_A_Review 
6. Figueroa-Gonzalez et al. (2011). ‘The Benefits of Probiotics on Human Health.’ Available from: https://www.longdom.org/open-access/the-benefits-of-probiotics-on-human-health-1948-5948.S1-003.pdf 
7. NCBI. (2017). ‘Effects of Probiotics, Prebiotics and Synbiotics  on Human Health.’ Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622781/