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Synbiotics – Definition, Effects and Applications

Synbiotics are combination supplements containing both probiotics and prebiotics that work together to promote gut health and support a balanced intestinal microbiome.

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Things worth knowing about "Synbiotics"

Synbiotics are combination supplements containing both probiotics and prebiotics that work together to promote gut health and support a balanced intestinal microbiome.

What Are Synbiotics?

Synbiotics are dietary supplements or functional foods that contain both probiotics (live, health-promoting microorganisms) and prebiotics (non-digestible dietary fibers that stimulate the growth of beneficial bacteria). The term is derived from synergy and biotics, reflecting the combined and mutually reinforcing action of both components in the gastrointestinal tract. The goal is to enhance the colonization of the gut with beneficial bacteria while simultaneously ensuring their survival and metabolic activity.

Mechanism of Action

Synbiotics work through two complementary mechanisms:

Probiotic component: Live microorganisms such as Lactobacillus or Bifidobacterium strains reach the intestine and colonize it. They compete with harmful bacteria for nutrients and adhesion sites on the intestinal mucosa, produce short-chain fatty acids, and strengthen the natural gut barrier.
Prebiotic component: Dietary fibers such as inulin, fructooligosaccharides (FOS), or galactooligosaccharides (GOS) serve as a selective food source for the probiotic bacteria. This targeted nourishment significantly improves the survival, growth, and activity of the administered microorganisms in the gut.

The synergistic interaction of both components results in more effective modulation of the gut microbiome compared to the use of probiotics or prebiotics alone.

Medical Applications

Synbiotics are used in a variety of medical and health-related areas:

Gut health: Support for irritable bowel syndrome, constipation, diarrhea, and inflammatory bowel disease.
Antibiotic-associated complaints: Restoration of disrupted gut flora following antibiotic therapy.
Immune system: Strengthening of immune defenses through positive modulation of the gut-associated lymphoid tissue (GALT).
Metabolic disorders: Supportive use in obesity, type 2 diabetes, and metabolic syndrome.
Intensive care: Use to reduce infection risk and improve bowel function in critically ill patients.
Infant and pediatric nutrition: Incorporation into adapted infant formula to support healthy gut colonization.

Composition and Examples

Typical combinations found in synbiotic products include:

Lactobacillus acidophilus + inulin
Bifidobacterium longum + fructooligosaccharides (FOS)
Lactobacillus rhamnosus + galactooligosaccharides (GOS)

Synbiotics are available as capsules, powders, drinkable ampoules, and in functional foods such as yogurt and fermented dairy products.

Dosage and Usage Notes

The optimal dosage varies depending on the product, indication, and individual tolerance. General recommendations include:

Products should be taken according to the manufacturer's instructions or as directed by a healthcare professional.
Administration is often recommended on an empty stomach or with meals to optimize the survival of microorganisms through the gastrointestinal tract.
During antibiotic therapy, a gap of at least two hours between the antibiotic and the synbiotic should be maintained.

Side Effects and Tolerability

Synbiotics are generally well tolerated by most people. In rare cases, mild complaints may occur at the beginning of use:

Bloating and a feeling of fullness
Mild abdominal cramps
Changes in stool consistency

Individuals with weakened immune systems, severe underlying conditions, or indwelling central venous catheters should only take synbiotic products after consulting a physician, as a slightly increased risk of infection has been described in rare cases.

References

Gibson, G.R. et al. (2017): Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nature Reviews Gastroenterology and Hepatology, 14(8), 491–502.
Markowiak, P. & Slizewska, K. (2017): Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients, 9(9), 1021. doi:10.3390/nu9091021.
World Gastroenterology Organisation (WGO) (2023): Probiotics and Prebiotics – Global Guidelines. Available at: www.worldgastroenterology.org

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