Do Probiotics Make It past the Stomach?

Do probiotics make it past the stomach?

Check out this answer from Consensus:

While the acidic environment of the stomach poses a significant challenge to the survival of probiotics, various strategies such as targeted delivery systems and microencapsulation have been developed to enhance their viability. Research has shown that with these protective measures, probiotics can indeed make it past the stomach and adhere to the intestinal mucosa, thereby potentially conferring health benefits to the host. Continued advancements in probiotic delivery technologies are likely to further improve the efficacy of these beneficial microorganisms.

Probiotics are live microorganisms that, when administered in adequate amounts, confer health benefits to the host. However, for probiotics to exert their beneficial effects, they must survive the harsh acidic environment of the stomach and reach the intestines in a viable state. This article explores whether probiotics can make it past the stomach and adhere to the intestinal mucosa, based on recent research findings.

Survival of Probiotics in the Stomach

The stomach’s acidic environment poses a significant challenge for the survival of orally administered probiotics. Studies have shown that many probiotic strains experience a substantial reduction in viability when exposed to gastric acid. For instance, a study assessing the viability of commercial probiotics and an in-house freeze-dried Lactobacillus acidophilus strain found that all tested probiotics demonstrated over 10^6 CFU reductions within 5 minutes of exposure to gastric acid2. This indicates that without protective measures, a large proportion of probiotic cells may not survive the passage through the stomach.

Strategies to Enhance Probiotic Survival

To overcome the harsh conditions of the stomach, various strategies have been developed to enhance the survival of probiotics. One such approach is the use of targeted delivery systems. For example, encapsulating probiotics in capsules designed for site-specific delivery into the colon has shown promising results. In the same study mentioned earlier, probiotics encapsulated with Phloral® coating technology exhibited approximately 90% viability after being exposed to gastric acid for 2 hours2. This suggests that targeted delivery systems can significantly improve the survival rate of probiotics as they transit through the stomach.

Another innovative method is microencapsulation, which involves immobilizing probiotic bacteria within a polymer matrix. This matrix remains intact in the stomach but degrades and dissolves in the intestine, thereby protecting the probiotics during gastric passage. This technique has been shown to reduce cell death and enhance the controlled release of probiotics across the intestinal tract3.

Adherence to the Intestinal Mucosa

For probiotics to confer their health benefits, it is crucial that they not only survive the stomach but also adhere to the intestinal mucosa. Research has demonstrated that certain probiotic strains can adhere to the gut mucosa even in challenging conditions. A study involving critically ill patients treated with broad-spectrum antibiotics found that Lactobacillus plantarum 299v (Lp 299v) was able to survive the passage from the stomach to the rectum and adhere to the rectal mucosa1. This adherence is essential for the probiotics to interact with the host’s intestinal cells and exert their beneficial effects.

Do probiotics make it past the stomach?

Hanne Tytgat has answered Near Certain

An expert from Wageningen University and Research Centre in Microbiology, Microbiome

There are two ways the survival of the probiotics till the large intestine is ascertained:

1. the selection of strains or mixtures of strains that display a high acid and bile tolerance, which are the main stressors on the way of the probiotic from mouth to gut
2. the formulation of strains: freeze drying, encapsulation… all can help protect the probiotics to survive the harsh conditions of the stomach

Do probiotics make it past the stomach?

Arthur C Ouwehand has answered Near Certain

An expert from DuPont Nutrition and Health in Microbiology

Most probiotics make it past the stomach and actually can be detected in the faeces. So, they make it all the way. While the use of protective delivery formats may help, in most cases it does not seem to be necessary. This may be, because most probiotic have been selected to be relatively acid and bile resistant.

Do probiotics make it past the stomach?

Mahmoud Ghannoum has answered Likely

An expert from Case Western Reserve University in Microbiology, Medicine

This is a good question: The concern here is the fact that the stomach has an acidic environment. Although the pH of the gut is generally considered to be highly acidic (i.e., pH<3.5-5), studies have shown that following a meal, the pH of the stomach can rise to a range of 4.0 – 6.0. Approximately 2 hours after eating, the pH then returns to pre-ingestion levels.  This indicates that taking your probiotic after a meal makes sense since the acidicity will decrease. We tested different strains of probiotics including Lactobacillus, Bifidobacteria and Saccharomyces boulardii and showed that they survive very well at ph 3 and above with some of them able to survive at a pH of 1.5. 

Do probiotics make it past the stomach?

Robert Rastall has answered Near Certain

An expert from University of Reading in Food Science

There is a lot of misinformation out there about this. We can feed volunteers probiotics and isolate them from their faeces so we know that they survive passage through the gastrointestinal tract. The evidence for this varies with respect to different probiotics, however, and the extent of survival is likely to be strain specific. There is, however abundant evidence of health benefits in many probiotic feeding studies, again illustrating that they can survive long enough to have an effect.

The majority of viable bacteria will die in the stomach, however good quality probiotic products contain a LOT of bacteria. The industry standard is 1×109 bacterial cells; even supposing that 99.9% of them die in the stomach that still leaves 1,000,000 viable bacterial cells entering the small intestine – enough to interact with the immune system there and to survive in the gut ecosystem as long as you consume the product.

Do probiotics make it past the stomach?

Claude P Champagne has answered Likely

An expert from Agriculture and Agri-Food Canada in Food Science

When the probiotic is microencapsulated and the caplet has enteric coating, a very high delivery rate of viable cells in the intestine occurs.

In foods it will vary as a function of strain, time of consumption (probably better if taken before the meal) of the type of food (better survival when in milk or cheese that in water).