Rating of the best prebiotic drugs

*Review of the best according to the editors. About the selection criteria. This material is subjective, not an advertisement and does not serve as a guide to purchase. Consultation with a specialist is necessary before purchase.

If we consider the human body as a collection of cells, we may be surprised to find that we are not alone. In addition to our cells, there are a huge number of other living things in the body called normal gut microflora. The number of these permanent settlers is measured in the thousands and hundreds of thousands of trillions. The number of microbial species living in the intestine alone is up to 10,000.

If we remember that each species of microorganism can have several strains, that is, subspecies that differ in cultural and biochemical properties, we can safely multiply the number of species by a factor of 7 or 10. And almost all of this motley composition is localized in the large intestine. In the small intestine, there are few microorganisms, because the environment there is mostly acidic. But in an alkaline environment, the number of microorganisms increases by tens and hundreds of thousands of times. Most of all in the large intestine are anaerobic microorganisms, that is, those whose metabolism does not require oxygen. But can’t our bodies do without a population of microbes? No, it can’t. That’s what they’re for.

Why do we need microbes??

It may be recalled that the aggregate of microorganisms inhabiting our intestines is called the intestinal microbiota. Therefore, this term can sometimes be used loosely. So, the function of this microbiota is vast and varied. They:

1. help provide energy and nutrition (as strange as it may sound);
2. provide energy through some of their products;
3. stimulate the immune system and especially the local immune system;
4. stimulate the formation of antibodies;
5. control and regulate intestinal peristalsis, i.e. the quality of the contractions;
6. Microbes are involved in the detoxification and excretion of alien toxic substances;
7. Activate drugs that enter the intestine;
8. destroy substances that have mutational potential;
9. improve the ionic composition of the epithelium zone and the physico-chemical qualities of this zone;
10. Prevent carcinogens and the effects of poisonous substances on the intestinal epithelium;
11. prevent viruses from multiplying and eliminate them;
12. supply sources for fat and glucose formation;
13. synthesize B vitamins and pantothenic acid.

This list could go on and on. It is safe to say the following. A person with a completely sterile large intestine will not be viable.

Why the microbiota is disrupted?

Man lives in an aggressive world. And over the last century or two, a huge number of external physical and chemical factors have influenced its vital functions. There are also various internal factors, such as disease, and dietary habits. They also upset the balance of the intestinal microbiota.

What factors we are talking about? Here they are:

1. uncontrolled use of antibiotics as self-medication;
2. use of medications such as hormones, cytostatics and immunosuppressants, radiation and chemotherapy, surgery;
3. Disorder in the diet. First of all, it is an abundance of preservatives that protect the refined food from spoilage, and are very harmful to the life of gut microbes: it is dyes, lack of dietary fiber, fast food.
4. Stress and chronic neurosis;
5. Acute intestinal infections such as dysentery, salmonellosis, rotavirus infection;
6. Low immunity, due to frequent colds,
7. Disruption of the body’s biorhythms associated with frequent travel and flights (jetlag);
8. Various chronic diseases, and functional disorders, disorders of intestinal motor function.

An example of a classic diagnosis would be spastic or atonic constipation, biliary dyskinesia.

So how do you deal with this situation, after identifying and eliminating the risk factor? If competent – then the treatment of the pathology that led to dysbacteriosis is prescribed. The conditionally pathogenic flora, which has kneaded the normal microorganisms, is neutralized, then eubiosis is restored, that is, the gut is repopulated with normal microorganisms, and then this state is maintained. And here is the colossal importance of probiotics and prebiotics in eliminating dysbacteriosis and restoring gut health. You could say that without them there would be nothing: no health, no life.

Why do we need prebiotics??

On almost every healthy eating website, you can read the simple difference between prebiotics and probiotics. The difference is the same as between prebiotics and history: prebiotics prepare and probiotics inhabit.

Probiotics are live microorganisms, whose task is to multiply and colonize. And prebiotics are pre-populated food brought in for them. It is clear that humans and microbes require completely different foods, and prebiotics have no nutritional value for our body.

Prebiotics are mainly represented by different fibers. We don’t have the enzymes to digest them. We can give you an example of fiber that we regularly consume, but which leaves the intestine in its unchanged form: these are mushrooms.

As we know, a part of the fungal body consists of chitin, the same material that makes up the shells of insects. From mushrooms, our body takes everything except chitin, because we do not have the enzyme chitinase. Similarly, we cannot eat wood because wood is cellulose, and cellulose, as an enzyme, is absent in our bodies. But it is abundant in various beetles such as woodworms, sawflies, bark beetles and other arthropods.

But, nevertheless, such fibers, which reach the intestines in their unchanged form, “for a hurrah”, are met by newly populated microorganisms. Once they are fermented, various short-chain fatty acids are formed, and just these are very important for improving intestinal function. First of all, they support the acid-base state, improve the integrity of the walls, and reduce their permeability. As a result, numerous toxins do not penetrate into the bloodstream through the thin intestinal wall. It reduces the likelihood of developing allergies, autoimmune diseases and cancer.

For example, the short-chain fatty acid butyrate reliably reduces the incidence of colorectal cancer if maintained at normal concentrations.

What are referred to as prebiotics?

So what are the representatives of prebiotics known to modern science, which at first glance seem to be useless for humans, but very much in demand for its “tenants”?

There are many classifications of prebiotics, both by chemical structure and by origin. Here are some of them:

1. varieties of starches and starchy substances, inulin and other polysaccharides. Inulin is greatest in topinambour, onions and chicory, as well as asparagus and fresh garlic;
2. Fructooligosaccharides, found in oats and ripe tomatoes;
3. Galactosoligosaccharides are the result of the breakdown of milk sugar, or lactose;
4. They are abundant in soybeans, mangoes, berries, green stalks of dandelion, from which lettuce is made, in rye bran.

Separately, we should mention the oligosaccharides that the baby receives with breast milk, as well as lactulose.

We should not forget about monosaccharides, such as xylitol and sorbitol, about long-chain sugars such as cellulose, pectins, found in apples and marshmallows.

Even various amino acids, such as glutamic acid, valine, carotenoids, can exhibit prebiotic properties. Separately, there are various plant extracts: carrot, corn, pumpkin and others.

However, there are leaders in pronounced prebiotic properties. Of these, inulin, lactulose, and several other prebiotics in their pure form can be named. The leading prebiotic foods are: chicory, beans, artichoke, bananas, asparagus, peas, various cereals and onions, cornflakes.

Of course, some prebiotics are also saturated with medicines, as well as dietary supplements. How to choose from this variety what is most useful and indicated?

“Passport” of a prebiotic

If a person has a complete diet with all the proteins, fats, carbohydrates and vitamins, but no prebiotics – they will not have health. Even if it is literally “flooded” with bifidumbacterin and other probiotics, there will be nothing for the microbes, landing in the intestines to eat. Therefore, the diet should not work against the microbes of the normal microflora, but for it.

Before choosing a prebiotic, there are strict requirements to consider. Nutritionists know that:

1. these compounds should not be broken down in active gastric juice, and by pancreatic enzymes;
2. they should not be adsorbed in the upper gastrointestinal tract;
3. They should stimulate the reproduction of beneficial microorganisms.

Absolutely all of these requirements are satisfied by such polysaccharides of cereals, vegetables and fruits, such as inulin, artificial disaccharides such as lactulose, as well as calcium pantothenate.

It should be understood that prebiotics in their pure form should be prescribed when correcting dysbacteriosis, that is, to treat. In a healthy person prebiotics should not be in the medicine cabinet, and on the dinner table. Cabbage, garlic, bananas, onions, asparagus, pistachio nuts and cashews, are considered the best sources of such fiber. If these foods are added little by little to the daily diet, the gut microbiota will soon respond with gratitude. Immunity will be strengthened, as well as immunity to various infections.

Certain prebiotic preparations

In conclusion, let us look at some prebiotic products that you can buy in the pharmacy. As a rule, they are prescribed in the complex therapy of diseases of the gastrointestinal tract, as well as for the correction of dysbacteriosis.

We will move away from the usual scheme, and we will not describe separately the advantages and disadvantages, because prebiotics are not formally a drug. Therefore, the disadvantage can only be an individual intolerance, or, for example, the high price or difficulty in obtaining this product in pharmacies. It should also be said right away that acute intestinal obstruction can be a contraindication, since all prebiotics lead to an improvement in motility and the appearance of the physiological rhythm of defecation. After all, prebiotics are not so much medicine for us as they are for our friends, the microorganisms.

Rating of the best prebiotics

Lactulose (Duphalac, Portalac, Romphalac, Normase)

Prebiotic rating: 4.9

Although lactulose refers to prebiotics, but according to the anatomical and clinical classification it belongs to the group of laxatives. In addition to dysbacteriosis, it is indicated in rehabilitation treatment after acute intestinal infection, in constipation, as well as in liver failure. Lactulose is available as a syrup. These are 200 ml, 500 ml, or 1 liter bottles, or 15 milliliter single pack sachets. The box of 10 of these bags.

It is quite a viscous liquid, which may have a light yellow or brown color, and yet it is transparent. First of all, lactulose has an impact, being an osmotic laxative. By itself, without germs it can do nothing. Only thanks to them, it can stimulate peristalsis, contributes to the removal of ammonia, which alleviates the condition in patients with liver failure.

Lactulose is a prodrug. It is intensively consumed by the intestinal microflora, and the very low molecular weight acids we have already talked about above are formed. As a result, the osmotic pressure increases, the volume of the contents of the large intestine increases, and irritates specific intestinal receptors. It increases peristalsis, softens stools, and restores normal defecation rhythm. This is how lactulose deals with constipation.

In patients with severe hepatic impairment, and even with hepatic coma, lactulose, with the help of acidophilus bacilli, transforms ammonia into a soluble form, which reduces its toxic effects. Because we must remember that in chronic liver failure ammonia is not neutralized in the liver, and ammonia itself is the end product of protein metabolism. Therefore, patients with this severe pathology it is very worthwhile to limit the protein in the diet.

Naturally, there are also contraindications to the intake of lactulose, such as intestinal obstruction, or individual intolerance.

Lactulose is used in adults in an initial dose of 15 to 45 milliliters, and if the constipation resolved within 2 days, the dose is reduced. The maintenance dose is about 2/3 of the starting dose. In cases of hepatic coma and encephalopathy it is given in high doses, up to 45 milliliters three times a day, and then the dose is reduced, achieving regular stools 2-3 times a day. Produced by Solvay Pharmaceuticals, the Netherlands. The average cost of a bottle of 200 milliliters is 300 rubles.

Gastrointestinal Transit prebiotic

Prebiotic rating: 4.8

You can buy this medicine in the pharmacy, and its name perfectly reflects the essence of prebiotics: they transit through the gastrointestinal tract, benefiting the microbes. It is a powder in sachets, 10 sachets in a package. Each sachet contains: oligofructose, inulin, artichoke extract and green tea.

Prebiotic is produced by a home company ZAO Evalar, which specializes in various food supplements. The average cost of a pack is 182 rubles., Minimum – 153, maximum – 292 rubles. per package. The action of this drug is standard for prebiotics: stimulation of bacterial life, displacement of harmful microflora, improving the passage of food through the intestines, excretion of toxins.

This is not a therapeutic drug, but a dietary supplement that contains soluble dietary fiber, as well as fructose. The convenience of this remedy is that you can not look for artichoke extract and inulin separately, that is, topinambur powder, but buy it all together in a bag.

Hilac-Forte

Rating of prebiotic: 4.7

Finally, we should tell you about another, truly unique product: Hilac Forte drops. Why they are unique? Their task is to establish nutrition and improve colonization of the large intestine with newly introduced bifidobacteria and lactobacilli from probiotics. But dietary fiber, and none of the above types of prebiotics Hilac-Forte refers to. These are products of the vital activity of healthy intestinal microorganisms, which form a familiar environment for our friends.

According to its classification it again had to be squeezed into anti-diarrhea products, although in fact this clear solution with a sour odor in its pure form is a drug that normalizes intestinal microflora.

All other indications are secondary, and related to the activity of normal microflora. Thus, an expanded list of indications for the use of the drug Hilac forte will not only constipation. These are gastritis and salmonella infection, dyspepsia and functional diarrhea, dermatitis and urticaria, and so on.

The drug contains metabolic products of normal E. coli, fecal streptococcus, as well as several species of lactobacilli. It may come as a surprise that the life products stimulate the multiplication of new microorganisms. Imagine a room full of feces or garbage to encourage the continuation of the human species is hardly possible. But microorganisms have a different way of doing things. Their products, including lactic acid and its buffer salts, protect the proliferating colonies from the potential harmful effects of pathogens.

Thus, with the help of Hilac Forte, “greenhouse” conditions are created for newly emerged microorganisms, which have not yet taken roots in the intestines. First of all, Hilac Forte stimulates the growth of acidophilus and lactobacillus flora. It is harmless, it is perfectly tolerated by both adults and children, it can be prescribed to pregnant and lactating women, and again of all contraindications, only a rare individual intolerance is possible.

It should be taken either before a meal or with a meal, 3 times a day. Adults – an average of 50 drops per dose, children – 30 drops, and infants – 20 drops. It comes in the form of drops for ingestion, and a bottle of 100 milliliters will cost 500 rubles. It is produced by a German company, Ratiopharm.

In conclusion, we should turn to gardeners and vegetable growers. A great opportunity to get a high quality prebiotic inulin is available to almost everyone, from the Krasnodar region to Siberia. It is a cultivation on a homestead plot of earthen pear, or topinambur. In addition to extremely useful root vegetables, this plant also pleases with beautiful yellow flowers.

Topinambour is undemanding, has a powerful deep root system, where edible tubers are formed. The tubers are lumpy, and a bit like a turnip, or a cabbage sprout. Topinambour tubers are very juicy and are more nutritious than many vegetables. They do not have their own flavor, so they can be successfully added to almost any salad. It can be dried. If topinambour is fried, it may taste like fried potatoes, only sweetish. You can also make chips from topinambour, dried topinambour grinded can be added to coffee drinks, you can make your own chicory drink. For example, this is what they do in the United States. Topinambour is used to make a coffee substitute for diabetics.