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D Lactic Acidosis Probiotics

D-lactic Acid - Breaking The Vicious Cycle

D-lactic Acid - Breaking The Vicious Cycle

Since researching D-lactic acid, I have just received some enlightening news. To begin with, my book talks much in the Brain Connection and in the Autism Connection chapters about the effect on behavior of too much D-lactic acid being absorbed into the bloodstream as a result of bacterial growth - even good guy bacteria sometimes. I thought that, usually, when D-lactic is produced, equal amounts of L-lactic acid is also produced and this is the form we need not be concerned about because L-lactic is quickly metabolized by the liver, does not accumulate in the bloodstream and, therefore, does not threaten the brain cells. I found an authority on this, Dr Brian A. Nummer, Ph.D. and we have been dialoguing, here is my question to him and what he told me. So you are telling me that the terminology "whey" can be used correctly to describe the watery separation as in curd and whey (no fermentation) (as is accomplished by rennin) and also can be used to describe the watery formation after yogurt production. So, both can aptly be called" whey?" And now that I have your ear, could you please tell me if the lactic acid produced in making yogurt is D-lactic acid or L-lactic acid or is it a combination of both? Thanks so much. Yes, whey is used for the water phase after coagulation of milk casein regardless of method. Whether D- or L- lactic acid is produced will depend on the strains of lactic acid bacteria. Since the actual yogurt culture can vary there is no simple answer. You would have to look at the members of the culture used. Lactobacillus bulgaricus, L. helveticus, and L. delbrueckii will produce optically pure (99%) L+. If my memory serves correctly Streptococcus thermophilus will also produce only L+. Continue reading >>

Probiotics, Dlactic Acidosis, Oxidative Stress And Strain Specificity

Probiotics, Dlactic Acidosis, Oxidative Stress And Strain Specificity

Probiotics, DLactic acidosis, oxidative stress and strain specificity aSydney Medical School, The University of Sydney, Sydney, New South Wales, Australia bMedlab Clinical Ltd, Sydney, New South Wales, Australia aSydney Medical School, The University of Sydney, Sydney, New South Wales, Australia bMedlab Clinical Ltd, Sydney, New South Wales, Australia aSydney Medical School, The University of Sydney, Sydney, New South Wales, Australia bMedlab Clinical Ltd, Sydney, New South Wales, Australia CONTACT Professor Luis Vitetta [email protected]_siul ; [email protected] , Medlab Clinical Ltd and, The University of Sydney, Sydney, Australia. 2015 Received 2016 Aug 17; Revised 2016 Nov 8; Accepted 2016 Dec 29. The existence of an implicit living microscopic world, composed primarily of bacteria, has been known for centuries. The exact mechanisms that govern the contribution of bacteria to human health and disease have only recently become the subject of intense research efforts. Within this very evident shift in paradigms, the rational design of probiotic formulations has led to the creation of an industry that seeks to progress the engineering of probiotic bacteria that produce metabolites that may enhance human host health and prevent disease. The promotion of probiotics is often made in the absence of quality scientific and clinically plausible data. The latest incursions into the probiotic market of claims have posited the amelioration of oxidative stress via potent antioxidant attributes or limiting the administration of probiotics to those species that do not produce D-Lactic acid (i.e., claims that D-Lactic acid acidosis is linked to chronic health conditions) or are strain-specific (shaping an industry point of difference) for appraising a therapeutic effect. E Continue reading >>

D-lactic Acidosis: An Underrecognized Complication Of Short Bowel Syndrome

D-lactic Acidosis: An Underrecognized Complication Of Short Bowel Syndrome

D-Lactic Acidosis: An Underrecognized Complication of Short Bowel Syndrome Department of Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06102, USA Received 26 November 2014; Revised 28 March 2015; Accepted 8 April 2015 Copyright 2015 N. Gurukripa Kowlgi and Lovely Chhabra. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. D-lactic acidosis or D-lactate encephalopathy is a rare condition that occurs primarily in individuals who have a history of short bowel syndrome. The unabsorbed carbohydrates act as a substrate for colonic bacteria to form D-lactic acid among other organic acids. The acidic pH generated as a result of D-lactate production further propagates production of D-lactic acid, hence giving rise to a vicious cycle. D-lactic acid accumulation in the blood can cause neurologic symptoms such as delirium, ataxia, and slurred speech. Diagnosis is made by a combination of clinical and laboratory data including special assays for D-lactate. Treatment includes correcting the acidosis and decreasing substrate for D-lactate such as carbohydrates in meals. In addition, antibiotics can be used to clear colonic flora. Although newer techniques for diagnosis and treatment are being developed, clinical diagnosis still holds paramount importance, as there can be many confounders in the diagnosis as will be discussed subsequently. D-lactic acidosis (D-la) is a rare form of lactic acidosis seen mostly in patients with short bowel syndrome (SBS). Other conditions implicated are toxic ingestions of chemicals such as propylene glycol and rarely in patients with severe diabetic Continue reading >>

D-lactic Acidosis In A Ten Months Old Infant With Short Bowel Syndrome: Early Suspicion Equals Early Treatment | Anales De Pediatra (english Edition)

D-lactic Acidosis In A Ten Months Old Infant With Short Bowel Syndrome: Early Suspicion Equals Early Treatment | Anales De Pediatra (english Edition)

Vol. 84. Num. 1. 01 January 2016Pages 1-62 d-Lactic acidosis in a ten months old infant with short bowel syndrome: Early suspicion equals early treatment Acidosis d-lctica en un nio de diez meses afecto de un sndrome de intestino corto: la rpida sospecha equivale a un rpido tratamiento , V.M. Navas Lpez b , R. Yahyaoui Macas c , C. Sierra Salinas b a Unidad de Gestin Clnica de Pediatra, Hospital Materno Infantil, Hospital Regional Universitario de Mlaga, Spain b Unidad de Gastroenterologa y Nutricin Infantil, Unidad de Gestin Clnica de Pediatra, IBIMA, Hospital Materno Infantil, Hospital Regional Universitario de Mlaga, Spain c Laboratorio de Metabolopatas y Centro de Cribado Neonatal de Andaluca Oriental, Unidad de Gestin Clnica de Laboratorios, Hospital Materno Infantil, Hospital Regional Universitario de Mlaga, Spain Metabolic acidosis is a disorder of the acidbase balance which may be due to bicarbonate losses, deficient acid elimination by the kidney, exogenous intake of acids or an endogenous increased acid production. Within this last group, lactic acidosis should be noted, because of its frequency, morbidity and potential mortality. Lactic acidosis, which is generally caused by accumulation of the l-lactic isomer, can be congenital or secondary, the latter is in relation to tissue hypoxia (type A) or to hepatic, renal or oncologic diseases, intense exercise, seizures or toxics (type B). Less common are the situations where the cumulative isomer is the d-lactic, 13 which have occasionally been reported in patients suffering from short bowel syndrome (SBS), presenting with a metabolic acidosis, increased anion GAP and neurological symptoms. 4,5 We present a case of a ten month old infant with SBS secondary to gastroschisis and intestinal necrosis. He had undergon Continue reading >>

D-lactate Free Probiotics Frequently Asked Questions

D-lactate Free Probiotics Frequently Asked Questions

D-lactate free probiotics Frequently asked questions Q. I noticed that GutPro contains L. plantarum that is not D-lactate free. Why? A. GutPro contains L. plantarum for a very good reason. It has actually been proven to reverse acidosis.L. plantarum initially produces L(+)-lactate, and then switches to producing D(-)-lactate, allowing for equilibrium to be reached. The production of D(-)-lactate in L. plantarum is linked to the biosynthesis of the cell wall. Q. What about L. salavarius? Is this strain D-lactate free? A. L. salavarius primarily produces L-lactate and this is why it commonly referred to as d-lactate free. But, in reality it does produce a small amount of D-lactate. No studies have shown that this strain has ever caused acidosis. The case is similar withL. gasseri, which predominantly makes L(+)-lactate during the growth phase and switches to D(-)-lactate when the growth cycle plateaus. Q. I heard that probiotics that contain D-lactate producing strains cause acidosis. A. Just because a strain produces D-lactate does not mean that it will contribute to acidosis. GUTPro is formulated with L. plantarum which produces both D-lactate and L-lactate. L. plantarum has actually been proven to reverse acidosis. Q. Isnt it true that some probiotics can cause D-lactic acidosis? A. Yes. Several studies have shown that L. acidophilus has caused acidosis in individuals with compromised digestive systems. That is why GutPro was specifically designed without this popular strain of probiotic. A. D-lactic acidosis occurs when the body is unable to properly metabolize excess D(-)-lactate. Q. What are the symptoms of D-lactic acidosis? A. Impaired mental status is a universal feature in D-lactic acidosis. Some of the common neurological symptoms include: Aggressive or hostil Continue reading >>

D-lactic Acidosis In Children With Short Bowel Syndrome: A Relevant Clinical Condition

D-lactic Acidosis In Children With Short Bowel Syndrome: A Relevant Clinical Condition

1Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy; 2Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom; 3Department of Paediatric Surgery, Donauspital, Vienna, Austria. Introduction: D-lactic acidosis (D-LA) is an uncommon complication in children with Short Bowel Syndrome (SBS). This condition is related to excess of production of D-lactate by intestinal bacteria when carbohydrates (CHO) are not completely absorbed in the small bowel. We retrospectively analyze the presentation of D-LA in children with SBS treated at the Royal Manchester Childrens Hospital. Methods: Thirty-five short bowel patients underwent autologous bowel reconstruction from January 2010 to January 2017. Data collected included population demographics, bowel length, antibiotic treatment, CHO intake. Eight children (23%) developed 23 episodes of D-LA in total during the study period. They all presented with neurological symptoms, fatigue and lethargy or behavioral changes. Two further children although symptomatic did not have high level of D-lactate. Results: All children enjoyed free diet and were on oral cyclical gut decontamination when developed D-LA. No children were on long term probiotics or symbiotic. The number and the severity of the D-LA episodes were not related to the length of the bowel or the age of the patients. The management of D-LA consisted in 24 hour of starvation with only oral/IV fluid intake allowed, slow re introduction of CHO and change of gut decontamination antibiotics. Conclusions: D-lactic acidosis is a rare but serious complication of SBS, which should be suspected in presence of neurological symptoms and behavioral changes. The aetiology of D-LA is still Continue reading >>

Don't Overdose On Probiotics | Ask Dr. Maxwell

Don't Overdose On Probiotics | Ask Dr. Maxwell

Probiotics are the beneficial bacteria found in foods such as yogurt, kefir, sauerkraut, kombucha, and kimchi. If you have a compromised digestive system due to food allergies and/or inflammatory bowel disease, you may have heard that adding a probiotic supplement to your diet can greatly improve your health. In my 30 years of clinical experience, I have found this largely to be true. However, with the emergence of the new probiotic trend going around for the past decade or so, its important to offer a reminder never to overdose on probiotics (or any natural supplement). If youre currently supplementing with probiotics to treat a digestive disorder, especially short bowel syndrome or carbohydrate intolerance, I strongly caution you never to use more than what is directed by your doctor or the label on the bottle. Probiotics are Beneficial When Taken as Directed When taken as directed, probiotics have been shown to ease gastrointestinal distress, improve digestion, treat hay fever , ease depression, relieve the symptoms of allergic skin disorders, eliminate chronic candida, and even improve mental cognition. D-Lactic Acidosis Caused by Overdose on Probiotics Supplemental probiotics are generally well-tolerated by most. However, there are some conditions which make it difficult to properly metabolize excess D-lactate found in L. acidophilus. If you have short bowel syndrome, carbohydrate intolerance , or have had gastrointestinal surgery, you may develop D-lactic acidosis. Symptoms of this physiological condition include: Extremely painful muscle spasms (rigidity) Unfortunately, this condition often goes unnoticed by new probiotic users because they believe what they are experiencing are die-off symptoms; the worsening of symptoms in response to the die-off of bad bacter Continue reading >>

Lactic Acidosis – Fatigued, Confused, Grumpy? This Might Be Why.

Lactic Acidosis – Fatigued, Confused, Grumpy? This Might Be Why.

Many people with gut issues suffer from cogitative issues and body-wide symptoms, along with the gastrointestinal hell they’re going through. One of the reasons is often high levels of D-lactic acid. A few definitions acidosis – an abnormal decrease in pH levels. If systemic this is usually only a tenth of a pH level, or so, high. lactic acid (lactate) – an organic compound formed from fermentation, as well as by humans during normal metabolism and exercise. There are two main types discussed here D-lactic acid and L-lactic acid (two mirror-image isomers), DL-lactic acid is a mixture of the two in equal amounts. See Wikipedia for more information on D&L chirality prefixes. L-lactic acid – the type produced in the human body and the primary type found in the human diet. This form is easy for the body and rarely accumulates at a rate higher than the bodies ability to remove it. Short term acidosis is possible from l-lactic acid with extended strenuous exercise, but is usually cleared within a few hours. Acidosis can also occur with organ failure and other illness. D-lactic acid – this type is mostly foreign to the body and difficult to remove. It can easily build up, when it does this is called lactic acidosis. This article will refer it to as d-lactic acidosis to distinguish Lactate – In this context – the conjugate base of lactic acid, the two terms are used interchangeably. Lactic acid actually isn’t the real culprit that causes the fatigue, brain fog, etc. (see below for symptoms). When lactic acid is formed in the body (by us during exercise, or by bacteria) hydrogen ions are formed, hydrogen ions lower the pH (make it acidic), hydrogen is the true culprit. Excess hydrogen causes problems of its own, but the increased systemic acidity is what causes m Continue reading >>

D-lactate Producing Probiotic Strains In Chronic Fatigue Syndrome

D-lactate Producing Probiotic Strains In Chronic Fatigue Syndrome

D-Lactate producing probiotic strains in Chronic Fatigue Syndrome There appears to be a growing concern surrounding the use of probiotic species which produce some D-lactic acid , as opposed to solely L-lactic acid or other acid types (e.g. butyric, propionic, acetic and succinic acids). Limited human evidence exists on this topic, however a clear combination of symptoms do appear to be caused by the presence of excess D-lactic acid in the system. These symptoms tend to resemble those of chronic fatigue syndrome (CFS), with myalgia and mood and cognitive changes. Despite the most noted cases of acidosis occurring in individuals with short bowel syndrome, it has been hypothesised that this situation of acidity may arise in other circumstances, as a result of microbial imbalance within the gastrointestinal tract (GIT). Lactic acid can be produced by certain microorganisms as either L-lactic acid or its stereoisomer D-lactic acid. The theory behind the acidosis concern is that L-lactic acid can be metabolised and utilised by the mitochondria for energy production, whilst humans tend to lack sufficient levels of the enzyme D-lactate dehydrogenase required to utilise D-lactic acid. Instead, when high amounts of D-lactic acid accumulate in the gut, altering the pH, gut integrity may be compromised and the acid allowed passage into the body. When D-lactic acid then enters the cell, it can be preferentially taken up in the place of L-lactic acid, compromising mitochondrial function, leading to toxicity, acidity and resultant symptoms. Controversy still exists around this story, however, as research has revealed that despite this past hypothesis, most humans do produce D-lactate dehydrogenase and only a very small portion of the population are unable to.[1] Specific microbial s Continue reading >>

Popular Probiotic May Cause Neurotoxicity

Popular Probiotic May Cause Neurotoxicity

You Are Here: Mommypotamus Blog Everything Else Popular Probiotic May Cause Neurotoxicity Popular Probiotic May Cause Neurotoxicity Tipping at a restaurant in Iceland is considered an insult, camels have three eyelids, and what we thought we knew about L-acidophilus just might be all wrong. Okay, not ALL wrong, but what if certain probiotic strains sometimes canexacerbate chronic fatigue syndrome, autoimmune disorders and/or create brain fog and depression? Im not talking about die-off or a healing crisis, where an individual gets worse before they get better. In this post, Im going to share research that has caused me to conclude that sometimes probiotics themselves may be problematic. Lets jump in with a little Probiotic 101, shall we? [Warning: This section contains a fair amount of geek speak, but well move as quickly as possible to the Belly Button Biodiversity Project. Ready, Set, READ!] The two most common types of probiotics come from lactic-acid producing bacteria (LABs) and bifidobacteria. Of the LABs there are two categories: those that primarily produce L-lactic acid/L-lactate those that primarily produce D-lactic acid/D-lactate. L-Lactate, which is usually predominant in the body, is easily metabolized. For most people D-Lactate is not a problem, either, but in large amounts it may be difficult for those with impaired digestion to break down. This may be especially true for those who have difficulty digesting carbohydrates. Certain probiotics especially L. acidophilus are sometimes taken in huge quantities because theyre considered safe in any amount. However, L. acidophilus mainly produces D-lactic acid, and for those who cannot easily break this could create unintended consequences. D-lactic acidosis (or a sub-clinical form of the same) occurs when the b Continue reading >>

Safety Of D-lactate Producing Probiotics

Safety Of D-lactate Producing Probiotics

You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT01119170 Information provided by (Responsible Party): Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information In this study the investigators want to test the safety of D-lactate producing probiotics in babies from birth to 1 month of age. Previous data demonstrated no increase in urinary D-lactate in 4 month old infants supplemented with D-lactate producing probiotics. The primary purpose of this study is to evaluate the influence of D-lactate producing probiotics on D-lactate excretion in young infants during the neonatal period (days 0 - 28). Other: Starter formula Other: starter formula with D-lactate producing probiotics Lactate, in addition to being found in more common fermented foods of today, such as yogurt, lactate, in its two stereoisomer forms, known as the D (dextrorotary) or L (levorotary) is also produced in the colon through the normal fermentative process of lactic acid producing bacteria. Both D-lactate and L-lactate produced by these microbes are metabolized by enzymes within human cells and do not typically pose an acid-base risk by reducing pH to a threatening degree in healthy individuals. However, the specific dehydrogenase that converts D-lactate to pyruvate is far less active than that for L-lactate, and it has been suggested that very young infants may be a vulnerable group for D-lactic acidosis. Pre Continue reading >>

D-lactic Acidosis In Short-bowel Syndrome Managed With Antibiotics And Probiotics - Sciencedirect

D-lactic Acidosis In Short-bowel Syndrome Managed With Antibiotics And Probiotics - Sciencedirect

D-lactic acidosis in short-bowel syndrome managed with antibiotics and probiotics Author links open overlay panel HirooUchidaa HidekiYamamotoa YoshiyukiKisakia JunkoFujinoa YukiIshimarua HitoshiIkedaa Get rights and content D-lactic acidosis sometimes occurs in malabsorbed patients with short-bowel syndrome and is characterized by recurrent episodes of encephalopathy and metabolic acidosis. The characteristic neurologic abnormalities and the presence of metabolic acidosis raises a diagnostic suspicion, and the diagnosis is made when the serum level of D-lactic acid is greater than 3 mmol/L. Standard treatment consists of restricting oral carbohydrates or fasting, correction of metabolic acidosis, and a long-term suppression of pathogenic floras with antibiotics. The authors present a case of D-lactic acidosis in a 22-year-old patient with short-bowel syndrome, to whom intestinal bacterial agents (probiotics) were given in addition to oral kanamycin. Recolonization of the intestine with nonpathogenic floras should be a long-term treatment for D-lactic acidosis. Continue reading >>

Why Supplementing With Probiotics May Make You Ill Part 4: D-lactate

Why Supplementing With Probiotics May Make You Ill Part 4: D-lactate

Home Digestive Health Why Supplementing With Probiotics May Make You Ill Part 4: D-lactate Why Supplementing With Probiotics May Make You Ill Part 4: D-lactate Many people with digestive issues cannot tolerate probiotics. Some people mention that when they ingest probiotics, their brain fog worsens. Does the increase of cognitive issues from ingesting probiotics occur only from immune system up-regulation and die off, or could it be caused by something else? Increased D-lactate production maybe the issue. What is the Difference Between L-lactate and D-lactate? Lactic acid bacteria in our gut produce both forms of lactate from carbohydrate fermentation. L-lactate is produced in our body from lactic acid bacteria in our microbiome and is a natural byproduct produced during the Krebs cycle for metabolism. L-lactate is also up-regulated during exercise because of the increased need for mitochondrial energy and oxygen to support our muscles. L-lactate is oxidized back into glucose by our liver and is further used for energy production by our body. Finally, our brain can metabolize lactate for energy. 1 2 3 D-lactate is not produced by our body and is only produced by the lactic acid bacteria in our microbiome. There is usually no issue with the d-lactate that is produced by the lactic acid bacteria within our gut. Minute amounts are produced by these bacteria unless there is a significant overgrowth or severe carbohydrate malabsorption. Also, most microbiome produced d-lactate is metabolized by the liver (by the enzyme d-lactate dehydrogenase) and eliminated through our stool. 4 5 6 7 8 The Issue With Overproduction and Leaky Gut D-lactate acidosis does exist in medical literature but is a very rare occurrence. It is documented to occur in short bowel syndrome, a medical co Continue reading >>

Probiotics: A Guide For Those With Food Sensitivities

Probiotics: A Guide For Those With Food Sensitivities

Probiotics: A Guide For Those With Food Sensitivities Probiotics are valuable tools in helping to balance the bacterial communities found in our digestive system. Many chronic health conditions are slowly having their roots traced back this balance. Gut bacteria have been shown capable of physically altering the composition of our brain, influencing emotions, and have been connected to chronic health conditions such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). This systemic connection between gut bacteria and health has led many to use probiotic supplements . Some of the bestprobiotics will affect many people differently and, in some cases, those heralded as most-beneficial may actually make things worse. This article discusses some important considerations to make before deciding whether probiotics may offer you benefit, which types may be most-beneficial and why. Lactic acid is a compound produced naturally by the human body and is used in many processes such as energy production. This compound is found in nature in one of two isomer forms; D-Lactic Acid or L-Lactic acid. Both of these variations are found in the human body, but only L-Lactic acid is actually produced by the body naturally. D-Lactic acid is produced by many difference types of bacteria, and is considered an accurate biomarker for bacterial overgrowth when found in excess. Much of the data we have for bacteria and lactic acid levels produced by them come from the study of food preservation. Eggs, for example, are thought to be past their shelf life when 200mg/kg of L-Lactic acid is observed [2]. This type of science highlights that bacteria are commonly known to produce types of lactic acid, and that measurements of lactic acid can indicate amount of growth. Measuring the ratio betw Continue reading >>

A Stand-alone Synbiotic Treatment For The Prevention Of D-lactic Acidosis In Short Bowel Syndrome

A Stand-alone Synbiotic Treatment For The Prevention Of D-lactic Acidosis In Short Bowel Syndrome

A Stand-Alone Synbiotic Treatment for the Prevention of D-Lactic Acidosis in Short Bowel Syndrome Kazuhiro Takahashi , Hideo Terashima , Keisuke Kohno , and Nobuhiro Ohkohchi Organ Transplantation Gastroenterological and Hepatobiliary Surgery, Faculty of Medicine, Division of Clinical Medicine, Graduate School of the University of Tsukuba, Tsukuba, Japan Organ Transplantation Gastroenterological and Hepatobiliary Surgery, Faculty of Medicine, Division of Clinical Medicine, Graduate School of the University of Tsukuba, Tsukuba, Japan Organ Transplantation Gastroenterological and Hepatobiliary Surgery, Faculty of Medicine, Division of Clinical Medicine, Graduate School of the University of Tsukuba, Tsukuba, Japan Organ Transplantation Gastroenterological and Hepatobiliary Surgery, Faculty of Medicine, Division of Clinical Medicine, Graduate School of the University of Tsukuba, Tsukuba, Japan Organ Transplantation Gastroenterological and Hepatobiliary Surgery, Faculty of Medicine, Division of Clinical Medicine, Graduate School of the University of Tsukuba, Tsukuba, Japan Reprint requests: Hideo Terashima, MD, PhD, or Kazuhiro Takahashi, MD, Organ Transplantation Gastroenterological and Hepatobiliary Surgery, Faculty of Medicine, Division of Clinical Medicine, Graduate School of University of Tsukuba, 1-1-1, Tennoudai, Tsukuba-city, Ibaraki 305-8575, Japan. Tel. and Fax: +81 29 853 3221; E-mail: [email protected] or [email protected] Copyright 2013 by the International College of Surgeons This article has been cited by other articles in PMC. Synbiotics are combinations of probiotics and prebiotics that have recently been used in the context of various gastrointestinal diseases, including infectious enteritis, inflammatory bowel disease, and bowel obstruction. W Continue reading >>

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