Can probiotics, supplements and faecal transplants help improve your gut microbiome?

Fermented foods contain beneficial microbes that promote gut health

Eleonora Grigorjeva/G​etty Images

If you have a condition like irritable bowel syndrome (IBS), a finnicky gut or just want to keep your microbiome in top condition, you might be tempted by products and treatments that offer a microbial tune-up. But what really works? Here are the main tools to engineer a better gut.

Probiotics

Probiotics are microbes that may help to restore healthy gut microbiota. If they also improve your mood, they are called psychobiotics. You can typically get them from eating naturally fermented foods like yogurt that contain beneficial bacteria, such as Lactobacillus or Bifidobacterium.

But as an adult, these microbes are unlikely to colonise your intestines. To the extent that they are helpful, their benefit comes while they are passing through. Such probiotics stimulate immune cells in the gut to reduce inflammation, increase mucus production and deter pathogens by producing lactic acid. But as mere visitors, they need daily top-ups.

Probiotic supplements have been used (with mixed success) for more than a century to help with the gut conditions of Crohn’s disease, colitis and IBS. They have also been shown to help with weight loss in people who are overweight and are increasingly being used for other conditions, including bacterial vaginosis and urinary tract infections. What’s more, they reduce the risk of antibiotic-associated diarrhoea.

As the gut microbiome can affect our mental health, it is perhaps unsurprising that psychobiotics are also being used to target our minds. Some studies suggest they may be able to help boost resilience to stress, reduce anxiety …

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