Probiotic Therapy in Traditional Medicine

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Common strains include Lactobacillus species (rhamnosus, acidophilus, plantarum, casei), Bifidobacterium species (breve, longum, lactis), Saccharomyces boulardii and combination products. Selection should be strain-specific because clinical effects vary by strain.

Mechanisms include competitive exclusion of pathogens at the intestinal mucosa, production of antimicrobial substances (bacteriocins, organic acids, hydrogen peroxide), strengthening of intestinal barrier integrity through tight junction modulation, immunomodulation via dendritic cell and T-regulatory cell activation and metabolite production (short-chain fatty acids, vitamin K, B vitamins).

Clinical evidence supports use in antibiotic-associated diarrhea, Clostridioides difficile infection prevention, infectious diarrhea, irritable bowel syndrome, inflammatory bowel disease (pouchitis, ulcerative colitis maintenance), atopic dermatitis prevention, recurrent vaginal candidiasis and lactose intolerance. In traditional medicine probiotics are integrated with prebiotics, symbiotics and dietary modifications; they are generally safe but caution is warranted in immunocompromised, critically ill or central venous catheter patients.