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Oesophageal Patients Association
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Probiotics or not

I am 11 years post op and like most others that have had an Oesophagectomy still have problems with digestion and probably always will have. A few months ago I asked my GP would a daily probiotic supplement help she said with my digestive system it would probably help. My question are any other members taking daily probiotics and do they help or hinder and what brand. Your comments will be most appreciated. This question was also raised at one of our OPA meetings.

Regards

Phil

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I take them daily at breakfast time. I had the surgery 10.5 years ago. I do not remember ever not taking them since the surgery but they have never done me any harm. I have a family member with other digestive issues so they were the one that suggested that I take them.

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I had a total gastrectomy 5 years ago and have always had problems swallowing and digesting food, I take Creon tablets as the pancreas isn't functioning properly producing the enzymes to digest food and not unusual for me to regurgitate food. Some months back I started taking probiotics and take one with 50 billion live bacteria cant say with any certainty that it is helping or not as I continue with the swallowing issues including chest spasms that I am going to have to live with but like most things if one believes it helps it does? Whilst the issues I have are upsetting at times I am happy to have them and be here. Rob

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For probiotics, I try to eat unpasteurized sauerkraut each week. I feel it helps with acid reflux more than the probiotic supplements I've tried. I have not had an Oesophagectomy.

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A good quality pre/probiotic certainly won't do any harm and may help. I haven't had an oesophagectomy but I do suffer with IBS and low stomach acid and I take one with pre and probiotics in the same capsule (you really need both to be effective) However I have also been advised to try sauerkraut, it is supposed to be very good for the digestive system!

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This is a very complex subject and is neglected by researchers since it is regarded as not being 'serious hard science' &/or too difficult.

But consider this:- There are estimated to be about 35 trillion (give or take) human cells in the average body and coincidentally there are a similar number of bacteria living within us.

This co-habitation has existed since time began. Hence it is reasonable to suppose that the the two populations have evolved an high degree of inter-dependence.

The one thousand or so different species of bacteria each live in their own special niche, determined and defined by local conditions, progressing from the mouth along about 8 metres to the anus.

GI medical procedures surgery, chemo, antibiotics, etc have all contributed to changing and even destroying some or (temporarily) all of these niches; resulting in wholesale loss of species. This must have consequences.

A particularly dramatic factor is the reduction in hydrochloric acid, stemming from surgery and PPIs, which will alter pH along the length of the intestines.

Hence an imperative is to restore some sort of normality as broadly and as quickly as possible. How can this be achieved? It is known that newborns receive an inoculation from their Mothers, when in transit through the birth canal. Could this process be replicated in adults in order to re-establish a normal flora?

The solution being pioneered in many centres involves transplants from other, closely related humans, However any more readily available source such as one or more species cultured in mediums like Bio Yogurt, fermented cabbage, unpasteurized cheeses, etc is to be welcomed.

A further factor to bear in mind is that insoluble fibre in unrefined carbohydrates available from foodstuffs such as oats (porridge), raw vegetables and the like all act as large surface area substrates upon which bacteria can grow and multiply. In addition these fibres act as a resilient springy mass which resists over contraction by gut peristaltic contractions so slowing transit time, improving digestion and reducing diarrhea.

For me it's a no-brainer.

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