For five decades, scientists have debated what exactly they are. probiotics. However, in 2002, a consensus was finally found, thanks to which World organization healthcare was able to accept the definition of probiotics. So, according to WHO, probiotics are microorganisms that are non-pathogenic for humans, which are capable of restoring the normal microflora of organs, as well as having a detrimental effect on pathogenic and opportunistic bacteria. In other words, probiotics are microbes that normally make up the microflora of various human organs.

Currently, probiotics include the following microorganisms:

• Lactobacilli (L. acidophilus, L. plantarum, L. casei, L. bulgaricus, L. lactis, L. reuteri, L. rhamnosus, L. fermentum, L. jonsonii, L. gassed);
• Bifidobacteria (B. bifidum, B. infantis, B. longum, B. breve, B. adolescents);
• Non-pathogenic Escherichia Coli species;
• Non-pathogenic species of Bacillus (B. subtilis);
• Non-pathogenic species of Enterococcus (Enterococci faecium, E. salivarius);
• Lactic acid streptococcus (Str. thermophylus);
• Yeast fungi Saccharomyces boulardii.

The listed microorganisms are included in various drugs in various combinations. Some drugs from the probiotic group contain only one type of microorganisms of normal microflora, while other drugs contain several. Depending on the type of microbes contained in a particular probiotic, its therapeutic activity and scope of application are determined.

Probiotics can be found both in food and in specially created and developed medications or dietary supplements. For example, traditional probiotic products used by people for many centuries are kefir, fermented baked milk, cheeses, yogurt, matsoni, ricotta and other lactic acid products. Currently, there are numerous dairy products on the market that are specially fortified with one or another probiotic, for example, Activia, Actimel, Bifidokefir, ice cream with bifidobacteria, etc. In principle, both food products, dietary supplements, and medicines, containing microorganisms that are representatives of the normal human microflora, are called probiotics. In the further part of the article we will consider only drugs and, accordingly, by the term “probiotic” we will mean drugs.

That is, prebiotics, unlike probiotics, are chemical substances that are found in quite wide range food products. Largest quantity prebiotics are found in dairy products, corn, cereals, bread, onions, garlic, beans, peas, artichokes, asparagus, bananas, etc. In addition, many commercially available products (porridge, biscuits, dairy products, etc.) are fortified prebiotics, which is always indicated on the label.

Prebiotics actually include the following organic compounds and food components:

• Oligofructose;
• Inulin;
• Galactooligosaccharides;
• Para-aminobenzoic acid;
• Calcium pantothenate;
• Lactulose;
• Lactitol;
• Breast milk oligosaccharides;
• Dietary fiber (fiber);
• Extracts of algae, yeast, carrots, potatoes, corn, rice, pumpkin and garlic;
• Xylitol;
• Raffinose;
• Sorbitol;
• Xylobiosis;
• Pectins;
• Dextrin;
• Chitosan;
• Valin;
• Arginine;
• Glutamic acid;
• Glutathione;
• Ubiquinone;
• Carotenoids;
• Vitamins A, E and C;
• Selenium;
• Eicosapentaenoic acid;
• Lectins.

The listed substances are used for the manufacture of biologically active food additives or medicines. In addition, prebiotics can be added to prepared foods. Currently, there are isolated or chemically synthesized prebiotic substances that are marketed in the form of dietary supplements or medications. In the following article we will consider only medications and dietary supplements that are prebiotics.

Probiotics and prebiotics - what are the differences (what is the difference)

The difference between prebiotics and probiotics is that they are fundamentally different biological structures, simply complementing each other's therapeutic effects and having similar names. The similarities between prebiotics and probiotics are that they both have beneficial effect on the human body due to the normalization of intestinal microflora. Thanks to this positive influence prebiotics and probiotics are widely used in complex therapy intestinal diseases characterized by the presence of dysbiosis, discomfort, flatulence, bloating, diarrhea, painful spasms, etc.

Returning to the differences between probiotics and prebiotics, it must be said that the former are living microorganisms, and the latter are chemical organic compounds. That is, the difference between probiotics and prebiotics is the same as between any living creature, such as a dog or cat, and some organic chemical compound, for example, ethyl alcohol or glycerin. Moreover, probiotics are microorganisms that make up normal microflora human intestines. Prebiotics are organic compounds that provide the most favorable conditions for the growth and reproduction of bacteria of normal microflora, while simultaneously inhibiting pathogenic and opportunistic microorganisms.

To summarize, we can say that probiotics are microorganisms of normal intestinal microflora. And prebiotics are substances that provide optimal conditions for the growth and development of normal microflora. Both prebiotics and probiotics have beneficial effects on the human condition.

The reason for the confusion between probiotics and prebiotics is the similar names that differ from each other by only one letter, and general area therapeutic use. After all, both are used for treatment various violations digestion and intestinal diseases.

Positive effects of probiotics and prebiotics on the human body

Probiotics have the following beneficial effects on physiological functions And general condition person:

• Colonization of the large intestine by representatives of normal microflora, which take root, begin to grow and multiply, suppressing, and subsequently preventing pathogenic or conditionally pathogenic bacteria, viruses, yeast or fungi from becoming active. In fact, thanks to the colonization of the intestines with representatives of normal microflora, dysbiosis is cured;
• Improving the balance between representatives of normal microflora and pathogenic or opportunistic pathogenic microorganisms in favor of the former, which prevents relapse of dysbacteriosis;
• Bacteria of normal microflora, breaking down food components in the colon, produce vitamin K, biotin, niacin and folic acid;
• Probiotics promote the breakdown of bile salts, which helps lower the concentration of cholesterol in the blood;
• Improving digestion, as well as normalizing intestinal motor function, eliminating bloating, flatulence, colic, etc.;
• Optimization of the time of passage of the food bolus through the large intestine;
• Elimination of intoxication by activating components of the local immune system;
• Stimulation and improvement of the functions of local immunity (Peyer's patches of the intestine);
• Detrimental effect on bacteria Helicobacter pylori which provokes the development of peptic ulcers and chronic gastritis;
• Reduces the amount and severity side effects antibiotics used in the treatment of stomach ulcers;
• Restore intestinal microflora after antibiotic therapy;
• Relieves diarrhea caused by acute intestinal infection.

The described effects are, to a greater or lesser extent, characteristic of all microorganisms related to probiotics. However, the mechanisms of these effects have not yet been fully elucidated.

Prebiotics have the following beneficial effects on functioning digestive tract and general condition of the person:

• Promote a 10-fold increase in the number of representatives of normal microflora (bifidobacteria, lactobacilli, E. coli, etc.) while simultaneously reducing the number of opportunistic microbes (staphylococci, non-lactic acid streptococci, etc.);
• Suppression of the growth and reproduction of pathogenic microbes in the intestines, such as salmonella, listeria, campylobacter, shigella or vibrio cholerae;
• Eliminate excess mucus from the walls and lumen of the large intestine;
• Accelerate the healing process of the colon wall;
• Maintain optimal acidity (pH) for the life of bacteria of normal microflora;
• Increase volume feces, stimulating intestinal motility and thereby eliminating constipation;
• Reduce gas formation in the intestines, relieving a person of bloating;
• Stimulates the synthesis of vitamins B and K;
• Have a moderate antibacterial effect on representatives of pathogenic microflora due to stimulation of local immunity mechanisms;
• Restore normal intestinal microflora.

As you can see, probiotics and prebiotics have similar therapeutic effects on the human body, improving the functioning of the intestines and normalizing the processes of food digestion. However, probiotics and prebiotics are often used together because their effects are complementary rather than mutually exclusive.

Effects of probiotics and prebiotics - video

Are probiotics beneficial - video

Classification of probiotics and prebiotics

Prebiotics are classified depending on the composition of the drug into two large groups:
1. Pure prebiotics. These preparations contain only prebiotics as active ingredients. Examples of such drugs are lactulose syrups, produced under various commercial names, for example, Duphalac, Normaze, Lactusan, etc.;
2. Prebiotics combined with enterosorbents that bind and retain various toxic substances in the intestinal lumen. These toxic substances are excreted from the body along with feces and the sorbent that securely bound them. An example of combined prebiotics are Laktofiltrum, Laktofiltrum-Eco, Maxilak, etc.

There are currently no other classifications of prebiotics. Prebiotic medications are available in various forms - syrups, tablets, powders, granules, etc. Each drug usually indicates which prebiotics it contains.

Depending on their state of aggregation, probiotics are divided into two large groups - liquid and dry. Liquid Probiotics– these are solutions or suspensions that were not initially subjected to the lyophilization (drying) process. These solutions contain a certain number of living bacteria, as well as the substrate on which they feed. In addition, liquid probiotics may contain additional ingredients (vitamins, microelements, amino acids, etc.), as well as various substances, produced by bacteria in the course of their life, such as lactic acid. Bacteria from the liquid form of probiotics begin to act immediately after entering the human body. In addition, an additional benefit of the liquid form of probiotics is that you can not only take it orally, but also insert it into the vagina, rectum, nose, mouth, throat, ears, or apply it to the skin and hair.

Dry probiotics– these are specially dried (lyophilized) cultures of microorganisms, which are a fine powder. Dry probiotics can be sold in the form of tablets, capsules, or powders for suspension. After taking such dry probiotics, it takes 1 to 4 hours for the microorganisms to emerge and activate, so their effect does not begin immediately after use.

Depending on which bacteria are contained in the preparation, probiotics are classified into the following groups:

• Lactic acid strains - probiotics contain L. acidophilus, L. plantarum, L. bulgaricum, L. casei, L. fermentum, B. lactis;
• Donor strains - probiotics contain B. bifidum, B. longum, B. infantis, B. adolescents, L. rhamnosus, E. faecium, L. salivarius;
• Antagonists – B. subtilus, S. boulardii.

Lactic acid strains are bacteria that normally produce lactic acid and, thereby, create the acidity of the intestinal environment necessary for the normal growth and life of the main microorganisms. Normally, lactic acid strains make up from 5 to 7% of the total intestinal microflora.

Donor strains are bacteria that make up the normal intestinal microflora. Normally, such strains make up from 90 to 93% of the total intestinal microflora.

Antagonists are bacteria that do not normally live in the human intestine, but have useful action when taken orally. These bacteria are completely removed from the intestines within about a day after the last dose. While antagonist bacteria are in the intestines, they inhibit the growth of pathogenic microbes such as viruses, Shigella, Salmonella, Vibrio cholerae, etc. Due to this action, these probiotics are often used to treat diarrhea caused by intestinal infections.

This classification of probiotics is necessary for selecting the optimal drug for the treatment of various types of intestinal microflora disorders.

Depending on the composition of the drug, all probiotics are divided into the following groups:

• Monocomponent - contain only one strain of bacteria (for example, Bifidumbacterin, Lactobacterin, Colibacterin, etc.);
• Multicomponent - contain several varieties of bacteria (usually 2 - 3). Examples of multicomponent probiotics are Bifilong (2 types of bacteria), Bifinorm (3 types), Acylact (3 types), Acipol (2 types), Bifidin (2 types), Linex (3 types), Bifiform (3 types), Polybacterin (3 type);
• Combined (synbiotics) - contain bacteria of normal microflora and any substances that create optimal conditions for these microorganisms, for example, Kipacid (lactobacillus + immunoglobulins), Bifilis (bifidobacteria + lysozyme), Bioflor (Escherichia coli + soybean and propolis extract);
• Sorptive – contain bacteria of normal microflora in combination with enterosorbents, for example, Bifidobacterin-forte, Probiofor, Bificol forte, Ecoflor;
• Recombinant - contain genetically modified bacteria into which a gene with certain characteristics has been implanted, for example, Subalin.

Various types of probiotics are successfully used in the treatment of various types of dysfunction and intestinal diseases.

In addition, there is a classification of probiotics based on the time of their creation:
1. The 1st generation includes drugs containing only one type of bacteria (for example, Bifidobacterin, Lactobacterin, Colibacterin, etc.);
2. The 2nd generation includes self-excreting antagonists (for example, Enterol, Baktisubtil, Biosporin, Sporobacterin, etc.), which are bacteria that do not normally live in the human intestine, but are capable of suppressing the growth and reproduction of pathogenic microbes;
3. The 3rd generation includes drugs containing several types of bacteria (for example, Bifilong, Linex, Bifikol, Acipol, Acilact);
4. The 4th generation includes combination preparations containing bacteria and substances that promote their growth (for example, Bifiliz, Kipacid);
5. The 5th generation includes multicomponent preparations containing several types of bacteria and substances that promote their growth (Bifiform).

In addition, all probiotics are divided not only by the quantity and quality of components, but also by the genus of the bacteria included:

• Probiotics containing bifidobacteria (bifido-containing), such as Bifidumbacterin, Bifidumbacterin-forte, Bifiliz, Bifiform, Bifikol, Probifor, etc.;
• Probiotics containing lactobacilli (lacto-containing), such as Lactobacterin, Acipol, Acylact, Linex, Biobakton, Gastrofarm, etc.;
• Probiotics with E. coli (coli-containing), for example, Colibacterin, Bifikol, Bioflor, etc.;
• Probiotics containing bacilli, saccharomyces or enterococci, for example, Bactisubtil, Bactisporin, Sporobacterin, Biosporin, Enterol, etc.

Enterococci are contained only in imported probiotics Linex and Bifiform. The above classification is used by practicing doctors in Russia and the CIS countries.

Probiotics, prebiotics, eubiotics - definition and differences

Currently, the term "eubiotics" is used as a synonym for "probiotics". However, it was previously believed that eubiotics include only those strains and varieties of bacteria that live in the human large intestine, making up the normal microflora. The concept of probiotics is somewhat broader, since they include all microorganisms that can have a positive effect on the functioning of the intestines and the general condition of a person. That is, probiotics also include those strains of microbes that normally do not live in the human intestines, but when taken orally they bring tangible benefits. An example of such probiotics are the yeast fungi Saccharomyces boulardii or representatives of the bacilli - Bacilus subtilus, which effectively suppress the growth of pathogenic microflora, quickly stopping diarrhea caused by acute intestinal infection. That is, using the old meanings of the terms, we can say that eubiotics are representatives of a large group of probiotics.

However, at present, no one puts the same meaning into the old terms, and doctors, when they say “eubiotics,” mean probiotics. That is, both terms are used as synonyms. The presence of two options for designating the same thing is due to the fact that on the territory of the countries former USSR doctors have traditionally used the term “eubiotics,” and their foreign colleagues have used probiotics. However, with the advent of contacts, doctors began to use both terms, each of which remained in the lexicon.

Thus, eubiotics and probiotics are the same thing, and they differ from prebiotics in that they are living cultures of microorganisms. And prebiotics are organic compounds that create the best conditions for the growth and reproduction of bacteria from probiotic groups.

Probiotics, prebiotics and symbiotics - definition and differences

Symbiotics are medications that contain several types of probiotic microorganisms or several strains of the same type of bacteria. For example, any drug containing 2 - 3 types of lactobacilli or bifidobacteria and lactic streptococci will be a symbiotic.

Thus, a symbiotic is several probiotics in one preparation. This means that it differs from a probiotic in the quantitative and species composition of microorganisms. And both of them - a symbiotic and a probiotic - differ from a prebiotic in that they contain living microorganisms.

Probiotics, prebiotics and synbiotics - definition and differences

Synbiotics are medications that contain a combination of probiotics and prebiotics. That is, synbiotics are complex preparations that combine both probiotics and prebiotics in one capsule.

In addition, there are also probiotic complexes that contain probiotics, prebiotics, sorbents, vitamins, minerals, amino acids and other substances that are beneficial for intestinal function.

Probiotics and prebiotics - medications (list)

Here is a list of probiotics - medications and standardized dietary supplements available for sale on the market in Russia and the CIS countries. We will include in the lists only those dietary supplements that have been standardized and are produced in strict accordance with technology and production regulations medicines. In principle, in essence, these dietary supplements are medicinal products, but due to the difficulties of registering and introducing a new drug into circulation, manufacturers prefer a simpler path - including them in the registers of dietary supplements.

To avoid a long list and maintain systematization of probiotics, we will divide them into four large groups:
1. Probiotics that contain only one type of bacteria (monocomponent);
2. Probiotics, which contain several types of bacteria (symbiotics);
3. Preparations that contain probiotics and prebiotics at the same time (synbiotics);
4. Preparations that contain probiotics and sorbents simultaneously (probiotic complexes).

Monocomponent probiotics

So, probiotics that contain only one type of microorganism (monocomponent) include the following:

• Acylact (lactobacteria);
• Bactisporin (Bacilus subtilus);
• Bactisubtil (Bacilus chereus);
• Biobakton (lactobacteria);
• Biovestin (bifidobacteria);
• Biosporin (Bacilus licheniformus and subtilus);
• Bifidumbacterin (bifidobacteria);
• Bifinorm (bifidobacteria);
• Colibacterin (non-pathogenic types of Escherichia coli);
• Lactobacterin (lactobacteria);
• Narine (lactobacteria);
• Primadophilus (lactobacillus);
• Probiform (bifidobacteria);
• Regulin (lactobacillus);
• Rela Life (lactobacteria);
• Sporobacterin (Bacilus subtilus);
• Flonivin BS (Bacilus chereus);
• Euflorin-L (lactobacteria);
• Euflorin-B (bifidobacteria);
• Effidigest (lactic acid bacteria).

The name of the microorganism that contains this probiotic is given in parentheses.

Symbiotics

Probiotics containing several types of beneficial bacteria (symbiotics) include the following drugs:

• Acidobac (9 types of lactobacilli);
• Acipol (lactobacteria, kefir fungi);
• Bacterial balance (bifidobacteria, lactobacilli);
• Biovestin-Lacto (bifidobacteria, lactobacilli);
• Bifidin (bifidobacteria, lactobacilli);
• Bifidobacterium (bifidobacteria, lactic acid streptococci);
• Bifidobacterin-Multi 1 (5 types of bifidobacteria);
• Bifidobacterin-Multi 2 (6 species of bifidobacteria);
• Bifidobacterin-Multi 3 (6 species of bifidobacteria);
• Bifidum-BAG (bifidibacteria, lactobacilli);
• Bifikol (non-pathogenic types of Escherichia coli, bifidobacteria);
• Bifilong (2 types of bifidobacteria);
• Bifiform (bifidobacteria, enterococci);
• Bifiform baby (bifidobacteria, lactic acid streptococci);
• Bonolact Pro+Biotik (bifidobacteria, lactobacilli);
• Bonolact Re+General (bifidobacteria, lactobacilli);
• Darm-Symbioten Pasco (bifidobacteria, lactobacilli);
• Yogulact and Yogulact forte (lactobacteria and lactic acid streptococcus);
• Linex (lactobacteria, bifidobacteria, enterococci);
• Polybacterin (bifidobacteria, lactobacilli);
• Primadophylus Bifidus (bifidobacteria, lactobacilli);
• Protozymes (bifidobacteria, lactobacilli);
• Santa-Rus-B (lactobacteria, bifidobacteria);
• Symbiolact (bifidobacteria and lactobacilli);
• Trilact (3 types of lactobacilli);
• Florin forte (bifidobacteria, lactobacilli);
• Enterol (Saccharomyces boulardii).

Synbiotics

Preparations containing both probiotics and prebiotics (synbiotics) include the following:

• Algibif (bifidobacteria and sodium alginate);
• Algilac (lactobacillus and sodium alginate);
• Bion – 3 (lactobacteria, bifidobacteria, vitamins and microelements);
• Bioflor (Escherichia coli + soybean and propolis extract);
• Bifidumbacterin 1000 (bifidobacteria + lactulose);
• Bifilar (bifidobacteria, lactobacilli, fructooligosaccharides);
• Biphilis (bifidobacteria + lysozyme);
• Bifistim (bifidobacteria, vitamins, pectin, MCC, fructose) separate forms for children and adults;
• Bifainol (bifidobacteria, eicosapentaenoic, docosahexaenoic fatty acids, vitamins A, D, E);
• Vitabs Bio (Lactobacilli, bromelain, rutin, sea buckthorn fiber);
• Vitabs Bio (Bifidobacteria, bromelain, rutin, sea buckthorn fiber);
• Calsis (lactobacillus, selenium, vitamins E and C, oat bran, citrus fiber);
• Kipacid (lactobacillus + immunoglobulins);
• Maxilac (bifidobacteria, lactobacilli, fructooligosaccharides);
• Narine forte (bifidobacteria, vitamins C, PP and B, amino acids);
• Normobact (bifidobacteria, lactobacilli, fructooligosaccharides);
• Normoflorin-B (bifidobacteria, lactitol);
• Normoflorin-D (bifidobacteria, lactobacilli, lactitol);
• Normoflorin-L (lactobacteria, lactitol);
• Senior (bifidobacteria, vitamins, microelements);
• Flora-Dophilus+FOS (lactobacteria, bifidobacteria, fructooligosaccharides);
• Evitalia (lactobacteria, lactic acid streptococcus, propionobacteria);
• Eubicor (Saccharomyces cerevisiae, dietary fiber and vitamins).

Probiotic complexes

Preparations containing probiotics and sorbents simultaneously (probiotic complexes) include the following:

• Bifidumbacterin-forte (bifidobacteria and activated carbon);
• Bifikol forte (bifidobacteria, non-pathogenic types of Escherichia coli, sorbent);
• Probiofor (bifidobacteria, activated carbon);
• Ecoflor (bifidobacteria, lactobacilli and SUMS-1 sorbent).

All of the listed probiotics are produced and used currently.

Below is a list of prebiotics that are available in the form of medications and standardized dietary supplements. Numerous non-standardized and untested supplements containing probiotics are not included in the list, since their effect on the condition of the human body, as well as methods for obtaining raw materials and components, are not known.

So, the following drugs are classified as prebiotics:

• Goodluck (lactulose);
• Duphalac (lactulose);
• Importal N (lactitol);
• Inulin (inulin);
• Lactulose syrup (lactulose);
• Lactusan (lactulose);
• Lactofiltrum and Lactofiltrum-Eco (lactulose and lignin sorbent);
• Livoluk PB (lactulose);
• Normaze (lactulose);
• Portalac (lactulose);
• Prelax (lactulose);
• Romphalac (lactulose);
• Stimbifid (oligofructose, inulin, vitamins E, C, PP, B, trace elements selenium and zinc);
• Transulose gel (lactulose);
• Hilak forte (substances produced in the process of life by E. coli, lactobacilli and non-pathogenic streptococci);
• Exportal (lactitol);
• Eubicore (fiber).

As can be seen from the above list, the most common “pharmacy” prebiotic is lactulose, which is associated with high efficiency of this substance, the relative ease of obtaining, purifying and standardizing ready-made dosage forms. In addition to the listed medications, prebiotics include numerous options for fiber and bran, sold in stores or pharmacies. Additionally, remember that sources of prebiotics include fresh dairy products, fruits, vegetables, and unrefined grains.

Mixtures with probiotics and prebiotics for baby food

There are also probiotic and prebiotic blends available for baby food, which reduce the frequency of diarrhea, flatulence, digestive disorders and regurgitation in infants. Prebiotic mixtures include the following:

• Agusha-1;
• Agusha-2;
• Agusha gold;
• Grandma's basket;
• Lactofidus "Danone";
• Baby with dietary fiber and nucleotides;
• MD cute goat;
• NAS fermented milk "Nestlé";
• NAS 6-12 months with bifidobacteria "Nestlé";
• Nestozen prebio;
• Nutrilak premium;
• Nanny with prebiotics;
• Similac with probiotics;
• Similak Premium;
• Frisolac Gold;
• Hipp Combiotic;
• Humana with prebiotics.

Infant formulas with various probiotics are shown in the table.

Mixtures with live lactobacilli (NAN Premium, Similak Premium, Agusha Gold) also contain prebiotics.

Hilak forte, Bifiform and Linex are prebiotics or probiotics

Bifiform and Linex are probiotics containing several types of microorganisms. Bifiform contains two types of probiotic microorganisms - Bifidobacterium longum (bifidobacteria) and Enterococcus faecium (enterococci). And Linex contains three types of probiotic microorganisms - Lactobacillus acidophilus (lactobacteria), Bifidobacterium infantis (bifidobacteria) and Enterococcus faecium (enterococci).

Probiotics for the treatment of chronic conditions are usually taken 3 - 4 times a day, 20 - 60 minutes before meals, for 14 - 21 days. If probiotics are taken to treat an acute intestinal infection (diarrhea), then they are taken 4–6 times a day for 2–4 days until stool normalizes. If a probiotic powder is used, then before ingestion it is diluted in warm water, capsules and tablets are simply swallowed with a small amount of liquid. If a person suffers increased acidity gastric juice, then before taking probiotics he needs to drink alkaline mineral water or antacid medications (for example, Maalox, Almagel, Gastal, etc.).

It is very important to choose the right probiotic to treat a given condition. To select a probiotic, you can use the following simple rules:

• If you suspect a viral infection of the intestines (acute or chronic), it is recommended to take medications containing lactobacilli (for example, Lactobacterin, Narine, Biobakton, Primadophilus, etc.);
• If bacterial intestinal damage is suspected (acute or chronic), it is recommended to take complex preparations containing lactobacilli and bifidobacteria simultaneously (for example, Bacteriobalance, Bifidin, Linex, etc.);
• If you suspect fungal infection intestines and genitals (intestinal and vaginal candidiasis), it is recommended to take medications containing bifidobacteria (for example, Probiform, Biovestin, Bifidumbacterin, etc.).

When treating dysbiosis, it is recommended to first take drugs with lactobacilli, then with bifidobacteria, and only after that with colibacteria (for example, Colibacterin). You can immediately start taking complex medications that simultaneously contain bifidobacteria and lactobacilli.

Probiotics and prebiotics can be used either individually or as part of complex therapy for the following diseases, the presence of which is considered an indication for use:
1. Colon cancer (it is recommended to take prebiotics and 4 types of probiotics);
2. Acute infectious diarrhea (lactobacillus and enterococcus); enterocolitis

The world around us is populated different bacteria, some of them are pathogenic, while others are beneficial. The latter inhabit our gastrointestinal tract and mucous membranes, protecting the body from the invasion of “pests” and actively participating in the digestion and absorption of food.

A newborn, when born, essentially does not have its own microflora. The first bacteria and enzymes that help him digest and break down food enter his body along with colostrum and continue to be supplied with milk. The baby's microflora is very delicate, and the balance of microorganisms can shift at any time due to hypothermia, a change in diet, inflammation or taking antibiotics.

For any problems associated with intestinal microflora, pediatricians prescribe beneficial bacteria for newborns. What is their mechanism of action and how to take them correctly? What contraindications does Bifidumbacterin have?

Composition of microflora

Microflora healthy intestines consists of various kinds bacteria that are in perfect balance.

1. Bifidobacteria.
2. Lactobacilli.
3. Mushrooms.
4. Escherichia coli.
5. Klebsiella.

Proportion of beneficial bacteria in the intestines healthy baby makes up 95%, the rest are pathogenic bacteria. They begin to actively multiply at the slightest imbalance, when the percentage of bifidobacteria decreases for some reason.

Dysbacteriosis

The proliferation of pathogenic flora leads to true dysbacteriosis. Such an imbalance is not an independent disease, but is a consequence of inflammatory processes or antibacterial therapy. During true dysbacteriosis in children the following is observed:

• inadequate breakdown of food;
• the occurrence of colic and bloating;
• persistent regurgitation;
• insufficient weight gain;
• whims during feeding or breast refusal.

Dysbacteriosis can not only accompany illness, but also be a temporary phenomenon during the transition period until the baby’s intestines are filled with the required amount of bifidobacteria. Such dysbiosis is characterized by:

• frequent regurgitation;
• loose or, conversely, infrequent stools;
• tummy soreness.

Breastfed babies stop worrying about temporary dysbiosis by 3 months. In artificial babies, the period of colonization of the intestines with microflora lasts longer than in children on breastfeeding, because there are no bifidobacteria in regular formulas, and the baby has nowhere else to get them from. This is why children on IV suffer from colic, bloating and other manifestations of dysbacteriosis more often.

When is taking bifidobacteria indicated?

Your pediatrician may prescribe bifidobacteria if:

• the baby experiences persistent bloating;
• the baby suffers from intestinal colic;
• the baby is not gaining weight well;
• the child burps profusely and frequently;
• the baby has intestinal problems, expressed in diarrhea or constipation;
• Mom is diagnosed with diabetes;
• the pregnancy was complicated;
• after intestinal infections and inflammations;
• to eliminate dysbiosis after taking antibiotics.

Also, mandatory intake of bifidobacteria is indicated for infants and babies who have switched from breastfeeding to formula. If the former have a completely understandable lack of enzymes and bacteria due to dietary habits, then the latter experience colic and digestive problems due to a change in the method of feeding. This is also a temporary dysbacteriosis, which requires some therapeutic support from parents.

Drugs

At the pharmacy you can find a lot of products that will help you restore the baby’s microflora after treatment or populate the newborn’s intestines with the necessary bacteria. They are divided into two groups:

1. Prebiotics are a ready-made “set” of beneficial bacteria. After passing through the gastrointestinal tract, they settle in the intestines and begin to multiply there.
2. Probiotics are substances that stimulate the growth of existing bifidobacteria and suppress the development of pathogenic flora.

Based on the baby’s health condition, identified negative reactions to substances and the results of a stool analysis, the pediatrician will select the appropriate drug for you.

Acylact effectively supports the body of children during and after intestinal infections. It is ideal for babies with lactase deficiency as it does not contain lactose. Acylact contains only lactobacilli, so if you have a deficiency of bifidobacteria, this remedy will not work.

The popular drugs Linex and Laktomun contain both bifidobacteria and lactobacilli and are successfully used to colonize the intestines and restore microflora. They will help babies with colic and bloating. As a rule, they are in mandatory prescribed to children after antibacterial therapy, and also if the baby has long time there was loose stool, which washed out the microflora from the intestines. These products are not recommended for children with diabetes because they contain lactose.

Most often, pediatricians prescribe domestic Bifidumbacterin. It is believed that it is ideal for babies in the first year of life, has virtually no contraindications and has proven itself to be an effective remedy for relieving colic, bloating and other signs of dysbiosis. In addition, Bifidumbacterin, compared to foreign products, is not very expensive and is affordable for everyone.

Compound

Bifidumbacterin contains bifidobacteria and lactose, due to which, when crumbs enter the body, beneficial bacteria actively multiply. Because of this, the drug in vials is not recommended for children with true lactase deficiency. For such babies, bacteria grown in a dairy environment are purified from impurities and in pure form Available in foil bags.

Forms

Bifidumbacterin is available in 4 forms: liquid solution, tablets, powder and suppositories. Newborns can be given the powder after diluting it in boiled water or use ready-made remedy. One sachet or liquid Bifidumbacterin in a bottle is designed for 5 “doses” for an infant. This volume is enough for the baby to populate his intestines with the necessary microflora or recover after antibacterial therapy. Bifidumbacterin is a very concentrated drug; 1/5 of the dose contains about 50 million bacteria.

Taking the drug

• The baby should be given Bifidumbacterin as prescribed by the pediatrician twice a day, half an hour before meals;
• It is advisable to dilute the powder in warm water, the temperature of which is not higher than 35 degrees, since otherwise living bacteria may die, and the drug will not bring the desired result, without relieving the baby of colic and bloating;
• Store the powder and liquid preparation in the refrigerator;
• it is better to give the baby Bifidumbacterin from a spoon, so the entire dose of beneficial bacteria will enter his body and will not remain on the walls of the bottle or mug;
• the course of treatment to restore the microflora is about a week, at the end of this period you will notice positive dynamics: stool will improve, bloating will disappear, the volume of gas and the pain of colic will decrease;
• For artificial babies, Bifidumbacterin is prescribed for longer periods, until tests show that their intestines are sufficiently populated.

Immediately after birth, the baby enters a world inhabited by many microorganisms. Many of them are considered pathogenic, but there are also beneficial bacteria. To ensure immune defense The gastrointestinal tract of a newborn must be populated with beneficial microorganisms. But in some situations (taking antibiotics, inflammatory processes) “harmful” bacteria begin to develop in the baby’s body. All this leads to dysbiosis, which can be dealt with using various drugs containing bifidobacteria.

Do babies need bifidobacteria?

Bifidobacteria, lactobacilli and Escherichia coli are the main microorganisms inhabiting the gastrointestinal tract of a newborn, their share is 95%. Also in the baby’s body there are so-called conditionally pathogenic microorganisms, which include:

• mushrooms of the genus Candida;
• Klebsiella;
• clostridia.

Such bacteria begin to multiply if the number of bifidobacteria decreases, and provoke infectious processes in the body of the crumbs.

It is important to remember that the newborn's intestines are colonized beneficial bacteria gradually, and therefore temporary dysbiosis can often occur. It is expressed by frequent regurgitation, loose stools and tummy problems. This condition of the baby’s body does not require treatment.

True dysbiosis occurs when the proportion of pathogenic bacteria begins to exceed the number of beneficial microorganisms. Remember that dysbiosis (another name for the disease) is not independent disease, it accompanies various inflammatory processes in the child’s body.

In what cases does a baby need help in the form of taking medications with bifidobacteria? This can confidently include:

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• constantly emerging;
• bloating;
• frequent regurgitation ();
• poor weight gain();
• the child suffers from diarrhea or constipation (see o/);
• diabetes mellitus or infectious diseases in the mother;
• premature or complicated birth;
• gestosis during pregnancy;
• artificial feeding (or mixed).

Breastfed babies get everything beneficial microorganisms through mother's milk, and therefore rarely need to take such drugs (more on drugs below).

How to choose the right drug?

Of course, any drug must be used as prescribed by a doctor, especially for newborns. But any loving parent should at least at a minimum level know the types of preparations containing beneficial bacteria and their beneficial properties.

So, there are two types of medicines containing beneficial microorganisms:

1. prebiotics – preparations that contain a ready-made set of beneficial bacteria;
2. probiotics are medications that can stimulate the growth of bifidobacteria in the intestines of a newborn and suppress pathogenic microorganisms.

The following medications are used for infants:

• Bifidumbactrin. It is used to treat acute intestinal infections. It is also shown when transitioning from natural feeding to artificial. The drug contains live bifidobacteria and lactose, so caution should be exercised if the child has allergies. Analogues of this remedy are Bifiform Bifidumbacterin-forte;
• Acylact. It is used for intestinal infections and in the complex therapy of atopic dermatitis. The drug does not contain lactose, and therefore is recommended for use in children with lactase deficiency. The product contains lactobacilli;
• Linux. The drug is complex, contains bifidobacteria and lactobacilli, lactose and potato starch. Used in the treatment of dysbiosis. An analogue of the product is Laktomun.

Probiotics that come in liquid form are preferable because they begin to act immediately after entering the body.

Preparations containing bifidobacteria can be given to infants for preventive purposes. There will be no harm from this. But if there is any disorder in the baby’s gastrointestinal tract, then such medications should be taken on a regular basis. It is advisable to give the drug to the child approximately half an hour before meals in the dosage prescribed by the attending physician. Medicines released in the form of dry powders are pre-diluted boiled water according to the instructions.

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Mom mistakenly gave her child 5 ampoules of bifidumbacterin, what should I do?

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Microflora disturbance is a common problem among children. To combat it, pediatricians prescribe special drugs– prebiotics and probiotics for children that can quickly restore normal composition bacteria, eliminate unpleasant symptoms and prevent the development of complications.

Probiotics are effective remedies for disorders of the gastrointestinal tract in children and adults

Probiotics and prebiotics: differences and similarities

Probiotics are non-pathogenic and non-toxic living microorganisms, substances of microbial and other origin that are used for medicinal purposes to restore normal and suppress the growth of pathogenic and opportunistic microflora. These include representatives of the genus Lactobacilli, Bifidobacteria, Enterococci and Bacillus, non-pathogenic strains of Escherichia coli, and some yeast fungi that are residents of the intestines. Probiotics are contained in specially developed medications, supplements and food products (kefir, fermented baked milk, yogurt, cheeses, etc.).

Fermented milk products – best sources probiotics for children

Prebiotics are food components that are not digested or absorbed into the body. upper sections Gastrointestinal tract, but are fermented by the microflora of the large intestine and selectively stimulate the growth and activity of bacteria living in it. In essence, they provide food for beneficial natural microflora or create conditions favorable for their development.

Prebiotics are present in foods (dairy, cereals, bran, legumes, raw vegetables and fruits) and are produced in the form of medicines.

Depending on the structure, the following groups of prebiotics are distinguished:

• monosaccharides (xylitol, sorbitol);
• disaccharides (lactulose);
• oligosaccharides (fructose and galactooligosaccharides);
• polysaccharides (cellulose, fiber, inulin, pectins, dextrin, chitosan);
• organic acids (citric, acetic, para-aminobenzoic, glutamic);
• peptides;
• amino acids, etc.

Foods rich in prebiotics

The common properties of probiotics and prebiotics is their final result of action - the normalization of intestinal microflora, and the differences lie in the mechanism for achieving it. They can be prescribed to children individually or in combination, as they complement the therapeutic effects.

Effect on the body

The activity of the immune system, the process of food digestion, and absorption depend on the state of the intestinal microflora. nutrients and even the child’s mood. The balance of beneficial and pathogenic bacteria is important for maintaining normal child health and preventing a number of diseases, including infectious ones.

When they enter the intestines, they not only increase the number of beneficial bacteria, but also:

• participate in the synthesis of antibacterial substances, organic acids, enzymes that inhibit the growth of pathogenic intestinal flora;
• compete with bacteria for attachment sites on the intestinal mucosa;
• stimulate the immune response, increase the production of antibodies, T-killers, increase the production of interferon;
• reduce the permeability of the intestinal mucosa;
• have a positive effect on exchange;
• participate in the synthesis of B vitamins (biotin, cyanocobalamin, folic acid).

Mechanism of action of the probiotic

Prebiotics also perform important functions in the gastrointestinal tract:

• create in the intestines optimal for development beneficial microflora pH level;
• activate local immunity;
• prevent rotting, reduce the formation of gases and facilitate their removal;
• suppress the growth of pathogenic microflora (clostridium, shigella, listeria, candida, etc.), bind the toxins produced by it;
• improve calcium absorption;
• enhance intestinal motility, increase the volume of feces, eliminate constipation;
• help remove mucus from the large intestine;
• contribute speedy recovery the mucous membrane of the large intestine when it is damaged.

Indications

The main indication for prescribing probiotics or prebiotics for children is dysbiosis, that is, an imbalance of intestinal microflora. According to the famous pediatrician E. O. Komarovsky, the cause of the development of intestinal dysbiosis is a violation of the diet, overfeeding, snacking, therefore, to eliminate it, you should feed the child according to his appetite and give healthy foods.

Symptoms of dysbiosis in children

Pro- and prebiotics for children are often prescribed for acute respiratory infections, weakened immunity, and as part of complex therapy for gastrointestinal dysfunctions:

• irritable bowel syndrome;
• tendency to constipation;
• necrotizing enterocolitis;
• inflammatory processes (Crohn's disease, ulcerative colitis);
• skin allergies;
• diarrhea of ​​infectious origin;
• antibiotic-associated diarrhea;
• tumor diseases of the large intestine;
• hepatic encephalopathy.

Advice: Probiotics and prebiotics have a complex effect on the child’s body, so they should only be prescribed by a pediatrician if indicated. But parents can independently enrich their children’s diet with foods containing these substances in large quantities.

The role of probiotics for infants

During intrauterine development, the child's gastrointestinal tract is sterile. The colonization of bacteria begins at the time of birth during passage and subsequent attachment to the breast. The first inhabitants of the baby's gastrointestinal tract are representatives of Escherichia coli and streptococci, and then, as a result of contact with the mother, loved ones, and household objects, strains of Bifidobacteria, Lactobacilli, Bacteroides and other colonies, both useful and not so useful, appear.

The main reasons for the development of dysbiosis in infants are considered to be late attachment to the mother's breast, poor nutrition of the woman if the child consumes breast milk, and transfer to artificial feeding. It contains the prebiotic lactose (milk sugar), which promotes the development of microflora, antibodies, enzymes, vitamins and many other useful biologically active components that ensure the formation of immunity and normal work Gastrointestinal tract. If impossible breastfeeding choose milk formulas containing Lacto- and Bifidobacteria for newborns and children up to 6 months.

Mixtures with pro- and prebiotics reduce the frequency of regurgitation, diarrhea, constipation, and colic attacks in infants

Beneficial intestinal microflora is important for health and normal development newborns, it helps:

• combat vitamin deficiencies and enzymatic disorders;
• synthesize essential amino acids, peptides and nucleotides;
• regulate the process of adaptation to new conditions;
• reduce the risk of intestinal infections;
• form a protective barrier on the intestinal mucosa.

Interesting: In children born through caesarean section and located on artificial feeding, in the intestines there is a smaller number of Bifidobacteria and Lactobacilli than in babies born in a natural way.

If it is necessary to correct the composition of the intestinal microflora in children infancy pro- and prebiotics are prescribed. One of the indications for taking such drugs in the first months is intestinal colic, caused by the adaptation of the gastrointestinal tract to new food and living conditions. Lactobacilli are especially important for eliminating painful symptoms. Probiotics for babies in the first year of life are prescribed in complex treatment and for prevention infectious diseases, allergies, constipation, lactase deficiency.

Bifiform is a probiotic approved for children from the first day of life

Probiotics

The list of medications with probiotics presented on pharmacy shelves today is quite wide. The drugs differ in their qualitative composition, release form, cost, shelf life and storage conditions.

Probiotics are used for children different composition. The first were monocomponent products containing only one type of bacteria.

They are used when a deficiency is identified certain type bacteria:

• Bifidumbacterin (Bifidobacterium bifidum), from birth;
• Colibacterin (Escherichia coli), from 6 months;
• Acylact and Biobakton (Lactobacillus acidophilus), from birth;
• Lactobacterin (Lactobacillus plantarum and fermentum), from birth;
• Bactisporin (Bacillus subtilis), from 1 month;
• Sporobacterin (Bacillus subtilis), from 6 months;
• Enterol (Saccharomyces boulardii), from birth;
• Biosporin (Bacillus Subtilis and Licheniformis), from birth.

Bifidumbacterin

Most commercially available probiotics for children are multicomponent, meaning they contain several types of beneficial bacteria at the same time. They are effective in combating the predominance of pathogenic microflora in the intestines.

These include drugs with the following names:

• Bifiform (Bifidobacteria and Enterococci), from 2 months;
• Bifikol (Bifidobacteria and Escherichia coli bacteria), from 6 months;
• Linex (Lacto-, Bifidobacteria and Entrococci), from birth;
• Acipol (Lactobacillus and kefir grains), from 3 months;
• Polybacterin (Bifidobacteria and Lactobacilli), from 3 years;
• Symbiolact (Bifidobacteria and Lactobacilli), from birth;
• Lactomune (Bifidobacteria and Lactococcus), from birth.

Linex for children is available in the form of sachets with powder

Modern drugs latest generation are sorbed probiotics, in which beneficial bacteria are immobilized on tiny particles of activated carbon or other enterosorbents. They have a pronounced protective and detoxifying effect and are highly bioavailable.

In sorbed probiotics, bacteria are protected from the destructive effects of gastric juice and are more firmly attached to the inner wall of the intestine:

• Probifor (Bifidobacteria), from birth;
• Florin Forte (Lacto- and Bifidobacteria), from birth;
• Ecoflor (Lacto- and Bifidobacteria), from 3 years;
• Bifidumbacterin Forte (Bifidobacteria), from birth.

Probifor is a preparation containing Bifidobacteria sorbed on activated carbon

When detected in children congenital intolerance lactose and cow's milk protein, it is necessary to select probiotics for newborns that do not contain these components: Bifiform Baby, Narine, Liveo Baby, Biovestin.

Probiotics should be given to children in age-appropriate dosages, following the instructions or recommendations of the doctor. Medicines in powder form are pre-diluted in warm water, tablets and capsules are swallowed whole with a small amount. Capsules and tablets from 3 years. For younger children, the capsules are opened and their contents are diluted in water. It is preferable to give probiotics in liquid form to a young child. They contain high concentrations of viable, non-dried bacterial cultures and a nutrient medium for them, begin to act within a couple of hours after administration, and are easily dosed.

Prebiotics

Prebiotics are available in the form of syrups, drops, granules, tablets, and powders.

In pediatrics they use:

• lactulose-based syrups (Duphalac, Normaze, Romphalac, Portalac and Goodluck) from birth;
• Hilak-Forte drops containing germ-free aqueous substrates of metabolic products of beneficial intestinal microflora, from 2 years;
• Lactusan and Prelax Baby syrups with prebiotics lactulose, lactose and galactose, from birth;
• Importal N and Exportal powders containing lactitol, from 1 year.

Syrups with lactulose are often used as laxatives for infants.

Some products contain prebiotics in combination with other active ingredients:

• Lactofiltrum and Lactofiltrum-Eco, tablets with lactulose and lignin sorbent, are allowed from 1 year;
• Stimbifide, tablets with vitamins (groups B, E, PP, C), minerals, inulin and oligofructose, from 6 months;
• Pikovit Prebiotic, vitamins B, A, E, C, K, D with oligofructose, from 3 years.

Recommendation: To prevent dysbiosis and correct mild forms of intestinal dysfunction, it is better to first increase the amount of food products containing prebiotics in the child’s diet, and then, if necessary.

Pikovit – vitamins with prebiotics for children over 3 years old

Combination drugs

IN separate group secrete preparations containing both pro- and prebiotics.

The products increase the survival rate of bacterial supplements taken in the intestines, creating favorable conditions for beneficial microflora and improving metabolic processes:

• emulsion Biovestin-Lacto, contains the bacteria Bifidobacterium adolescentis and Lactobacillus plantarum, bifidogenic factors and metabolic products of Bifidobacterium and Lactobacilli, from 1 year;
• Normospectrum capsules contain Bifidobacteria and Lactobacilli, vitamins, minerals, prebiotics oligofructose and inulin, from 1.5 years;
• symbiotic complexes Normoflorin, containing Lactobacilli or a mixture thereof, in combination with organic acids, amino acids, bacterial metabolic products, minerals, vitamins and the prebiotic lactitol, from birth;
• Maxilac powder, includes a complex of Lacto- and Bifidobacteria in combination with fructo-oligosaccharides, from 4 months.

Complexes Normoflorin

Precautions

Probiotics and prebiotics are considered safe medications, which is why most of them are approved for use from birth. However, this does not mean that they should be given to children for any reason and prescribed independently, since their long-term consequences long-term use have not yet been fully studied.

Contraindications for their use include:

• allergic reactions to any components of the drug, including excipients;
• intestinal obstruction;
• the presence of blood in the stool;
• pathologies affecting the state of the immune system.

When using probiotics, especially in liquid form, it is important to check the expiration date and strictly follow the storage conditions, otherwise the product may quickly deteriorate and have no effect.

Probiotics are medications that contain strains of live bacteria. The product is sold in various forms of release and with different compositions. There are not only single-component probiotics, where only one type of microorganism is present, but also multicomponent ones. The unique properties of the drug help achieve the following results:

• strengthening the immune system;
• restoration of microflora and intestinal mucosa after taking antibiotics;
• lowering blood cholesterol;
• rapid removal of toxins and allergens from the body;
• normalization of Ph balance in the colon;
• improving the absorption of vitamins and microelements.

Below are the best probiotics according to doctors and patient reviews. Please note that the information provided is for informational purposes only and is not a guide to purchase. For any advice you should contact specialists!

There are contraindications. Consult your doctor.

The best monocomponent probiotics

Mono-ingredient probiotics contain only one strain of bacteria. These could be: bifidobacteria, lactobacilli, E. coli or bacilli. Such drugs are classified as first generation probiotics. That is, this was exactly the composition of the very first products for improving intestinal microflora. Despite the fact that probiotics are modified every year and have more complex formulas, monocomponent preparations do not reduce their popularity.

2 Lactobacterin

Best for newborns
Country: Russia
Average price: 140 rub.
Rating (2019): 4.6

The first generation probiotic "Lactobacterin" is created on the basis of one component - live lactobacilli. After entering the intestines, they produce lactic acid, creating favorable conditions for the formation of beneficial bacteria. The active component fights staphylococcus, Proteus and E. coli. Lactobacterin is allowed for babies from the first day of life. The probiotic has virtually no contraindications and side effects, therefore, is not capable of harming the fragile intestines of newborns.

The drug is available in the form of a powder, hermetically packaged in bottles. Each pack contains 10 such bottles. The product can be used for no more than 10 days. The product is resistant to antibiotics, so it can be used simultaneously with antibacterial drugs.

Indications for use:

• diarrhea;
• impaired intestinal function in newborns.

Contraindications:

• vulvovaginitis.

1 Bifidumbacterin

For the whole family
Country: Russia
Average price: 232 rub.
Rating (2019): 4.8

A prominent representative of the first generation of probiotics is Bifidumbacterin. The one-component drug is available in the form of tablets, drops, powder and suppositories. The product improves metabolic processes, increases immunity and normalizes intestinal function in both adults and children from 6 months. It is worth noting that six-month-old babies can only take “Bifidumbacterin” in powder; other forms of release are approved for use from 3 years of age. If infants refuse to take the drug, then it is possible to prepare a solution based on breast milk.

The active ingredient of the drug is bifidobacteria, which are active against strains of Escherichia coli, yeast-like fungi and staphylococcus. The course of treatment should not exceed 14 days. Only the attending physician can extend the period of admission.

Indications for use:

• dysbacteriosis;
• intestinal infections;
• colic.

Contraindications:

• individual intolerance;
• allergy to probiotic.

The best multi-component probiotics

Multicomponent probiotics are called symbiotics, since they contain from 2 to 30 strains or several types of living bacteria. That is, the symbiotic formula includes more than two probiotics. For example, one preparation may contain four types of lactobacilli or a mixture of bifidobacteria and lactic acid streptococci. Thanks to more complex composition than in first-generation probiotics, symbiotics have a complex effect on the intestinal microflora. Below are the three best multi-ingredient probiotics based on customer reviews and medical recommendations.

3 Bifiform

Best for kids
Country: Denmark
Average price: 472 rub.
Rating (2019): 4.5

The composition of the symbiotic "Bifiform" includes enterococci and strains of bifidobacteria. Active substances normalize work digestive system Therefore, the probiotic is used for the treatment and prevention of dysbiosis in children and adults. The product also effectively combats constipation and diarrhea. The medication strengthens the immune system and serves as a prevention of infectious diseases.

For adults, the drug is sold in the form of tablets or capsules. For children The release form is more varied. "Bifiform Malysh" is presented in the form of a powder for preparing a solution with an orange-raspberry flavor. With the same taste there is chewable tablets"Bifiform Kids". And for very young patients it is produced oil solution"Bifiform Baby"

Indications for use:

• prevention and treatment of dysbacteriosis;
• constipation and diarrhea.

Contraindications:

2 Acipol

Maximum benefits – minimum contraindications
Country: Russia
Average price: 337 rub.
Rating (2019): 4.7

"Acipol" is produced in capsules containing kefir grains and acidophilus lactobacilli. Since the shell is gelatinous, before taking the symbiotic for small children, it is recommended to open the capsule and mix the contents in one teaspoon of water or milk. The probiotic is approved for use by babies older than three months.

The action of the active substances of the drug is similar to antibiotics. The product creates unfavorable conditions for pathogenic microbes, so it easily normalizes the balance of intestinal microflora. The probiotic is used for the prevention and treatment of dysbiosis resulting from poor nutrition or taking antibiotics. It is often included in the course complex treatment Gastrointestinal tract, for example, with colitis and enterocolitis.

Indications for use:

• intestinal infections and dysbacteriosis;
• reducing intoxication during food poisoning;
• chronic enterocolitis and colitis.

Contraindications:

• sensitivity to components.

1 Enterol

Best after taking antibiotics
Country: France
Average price: 450 rub.
Rating (2019): 4.9

The multicomponent probiotic "Enterol" was developed by French scientists. The symbiotic composition includes Saccharomyces boulardii - these are lyophilized live bacteria, and as excipient acts as lactose monohydrate. Having fulfilled its main function, yeast fungi are naturally eliminated from the body. The drug is available in capsules or sachets of powder.

Most often, Enterol is prescribed after a course of antibiotics. The probiotic fights the causes of diarrhea that could arise due to food poisoning or against the background of dysbacteriosis. The product should not be taken by children under 1 year of age without a doctor's prescription.

Indications for use:

• diarrhea;
• rotavirus infection;
• irritable bowel syndrome.

Contraindications:

• allergic reactions or high sensitivity to the components included;
• pregnancy and lactation period.

The best sorption probiotics

This category presents the best probiotic complexes, which in addition to living microorganisms include a sorbent. In the preparation, bacteria are united into small colonies (20-180 living cells), which are fixed on sorbents, most often activated carbon. This increases the survival rate of microorganisms in the stomach. A product with this composition gently and effectively cleanses the intestines, restores colonies of beneficial bacteria, and prevents poisoning and other stomach problems.

3 Linux

Produces B vitamins
Country: Slovenia
Average price: 263 rub.
Rating (2019): 4.4

The active ingredient of the drug "Linex" is libenin, which contains strains of live lactobacilli, bifidobacteria and enterococci. Once in the intestines, beneficial microorganisms not only begin to actively multiply, but also synthesize vitamins B1, B2, B6, B12 and K. Lactic acid bacteria increase the acidity of the intestinal microflora, which leads to inhibition of the growth and development of pathogenic microorganisms. Active substances do not give pathogenic bacteria attach to the intestinal wall.

The release form of the drug is capsules. Linex is safe for health if the dosage is taken correctly. The product is prescribed even to infants, but it is first recommended to carefully remove the contents of the capsule and mix with breast milk or a mixture.

Indications for use:

• treatment and prevention of dysbacteriosis;
• gas or heartburn;
• diarrhea or constipation.

Contraindication:

• hypersensitivity to components.

2 Probifor

Best for poisoning
Country: Russia
Average price: 730 rub.
Rating (2019): 4.6

The release form of Probifor is capsules or powder in sealed bags. The drug does not have age restrictions, so even newborns can take it from the first day of life. The probiotic consists of live bifidobacteria sorbed on activated carbon, lactose acts as an auxiliary substance.

The product perfectly fights diarrhea, since bifidobacteria not only destroy pathogenic microorganisms, but produce antibacterial substances. Thanks to his unique composition probiotic in short terms restores the structure of the intestinal mucosa, and fights poisoning and toxicity without the help of antibiotics. The drug can be prescribed in postoperative period or in preparation for surgery, childbirth, or caesarean section. Often used in complex courses of treatment of ARVI or influenza.

Indications for use:

• eczema and allergic reactions;
• irritable bowel syndrome;
• chronic colitis and pancreatitis;
• bacterial vaginosis and colpitis (external use).

Contraindications:

• intolerance to probiotic components.

1 Bifidumbacterin Forte

Quickly removes toxins from the body
Country: Russia
Average price: 215 rub.
Rating (2019): 4.9

The probiotic complex is available in capsule or powder form. Live bifidobacteria sorbed on activated carbon evenly populate the intestinal microflora. Active components normalize microflora, and charcoal eliminates intoxication. The drug very quickly rids the digestive organs of waste products of harmful bacteria, removes toxic substances and restores colonies of beneficial microorganisms.

A probiotic is prescribed not only for indigestion, but also before a planned operation or after surgery. The drug easily eliminates poisoning, constipation and diarrhea. Newborns are prescribed the drug from the first day of life only in powder; capsules are allowed from three years of age.

Indications for use:

• poisoning and allergies;
• constipation or diarrhea;
• intestinal infections.

Contraindications:

• lactase deficiency;
• Individual intolerance to the components of the drug.

The best synbiotics

Synbiotics are preparations that contain probiotics and prebiotics. Probiotics are live bacteria that are part of the normal intestinal microflora. Prebiotics are organic chemicals that create ideal conditions for normalizing intestinal microflora. Complex drugs They cope well with indigestion, since one capsule contains not only beneficial microorganisms, but also a nutrient medium for them.

3 Normoflorin

The most natural composition, suitable for newborns
Country: Russia
Average price: 400 rub.
Rating (2019): 4.7

"Normoflorin" is an effective biocomplex against intestinal dysbiosis. It improves peristalsis, restores microflora, and reduces cholesterol. It is based on three components: metabolites, lactitol and bacteria (bifido and lacto). Together they have an active positive impact on the gastrointestinal tract. The drug is suitable even for people intolerant to lactose and cow's milk protein. An important feature is the completely natural composition.

The manufacturer produces three types of “Normoflorin”, which differ slightly in composition. But most often they are advised to be taken in combination. The probiotic has been on the market for over 20 years. It is a complex of useful substances that can help even with chronic diseases Gastrointestinal tract (ulcers, gastritis, etc.). The kit includes a measuring cup. The product is used for the prevention and treatment of dysbiosis in children and adults. Does not contain dyes or preservatives.

Indications for use:

• stomach ulcer, chronic gastritis etc.;
• lactase deficiency;
• dysbacteriosis;
• disturbed microbiocenosis.

Contraindications:

• individual intolerance to components.

2 Narine Forte

Dietary fermented milk product
Country: Russia
Average price: 350 rub.
Rating (2019): 4.7

The liquid probiotic contains a specially created strain of acidobacteria “Narine TNSi”, which takes root well on the mucous membranes of the gastrointestinal tract. The product fights all known pathogenic microorganisms. Together, bifidobacteria and acidobacteria remain viable for a long time, which means the effect of normalizing the intestinal microflora is longer.

The drink is recommended for use by adults and children with dysbacteriosis and intestinal infections. "Narine Forte" is prescribed after long reception antibiotics or hormonal drugs, as well as after radiation or chemotherapy. The product normalizes intestinal function after climate change. It can be taken by expectant mothers, women during lactation, as well as newborn or premature babies.

Indications for use:

• vitamin deficiency;
• alcohol intoxication;
• prevention of dysbacteriosis.

Contraindications:

• individual intolerance.

1 Maxilac

Best by popularity
Country: Poland
Average price: 440 rub.
Rating (2019): 4.8

The dietary supplement "Maxilak" is one of the most popular according to doctors and patient reviews. The drug contains live lactobacilli (4 species), bifidobacteria (3 species), lactococci and streptococci, and to create comfortable conditions the prebiotic oligofructose is used. This combination effectively suppresses the activity of harmful bacteria and stops their reproduction.

The drug can be taken not only by adults, but also by children aged 3 to 14 years, subject to compliance with all prescriptions of the attending physician. The synbiotic is available in the form of capsules with an innovative patented Multi Resistant Encapsulation (MURE) coating. Capsules retain the viability of microorganisms even under aggressive environmental influences, so the product can be stored at high temperatures.

Indications for use:

• long-term treatment with antibiotics;
• diarrhea or constipation;
• dysbiosis.

Contraindications:

• hypersensitivity to synbiotic components.