Human intestinal microflora. Intestinal dysbacteriosis: diagnosis, causes and treatment. The main functions of microflora

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Proper functioning of the intestines is the key to human health. It is in the large intestine that the largest number microflora. These microorganisms are involved in most of the processes occurring in the body. With their help, nutrients are absorbed, vitamins are synthesized. They are also involved in the regulation of the functions of the immune system. The normal intestinal microflora is an independent system that helps to protect, cleanse and proper nutrition organism.

In this article you will learn:

Function of microflora

The role of the intestinal microflora is in the following functions:

• Protective. The intestinal microflora normally counteracts foreign microorganisms that regularly enter the gastrointestinal tract. Beneficial bacteria impede development infectious diseases, not letting pathogens further into the body. If the microflora deteriorates, then the process of reproduction of dangerous microorganisms begins in the gastrointestinal tract. In this case, mucous membranes are affected by bacteria, purulent and inflammatory processes. Therefore, it is extremely important to prevent such a situation.
• Digestive. The intestinal flora takes part in the process of digestion of carbohydrates, fats and proteins. Its important function is the production of enzymes that are able to digest fiber. With normal microflora, it is fermented and broken down in the intestine.
• Synthesis of vitamins. With a normal microflora, beneficial bacteria in the colon synthesize vitamins (pantothenic acid, as well as folic acid, riboflavin, biotin, vitamins B12, B6, K, E). However, they are not able to be absorbed into the blood. bacteria small intestine produce vitamins that enter the bloodstream. Normal intestinal flora promotes the absorption of calcium, iron, prevents the development of certain diseases, such as rickets or anemia.

• Removal of toxins. This function involves the quantitative reduction and elimination of harmful substances in a natural way. With feces, nitrites, xenobiotics, mutagens, as well as salts of some metals are removed. Thanks to this function, harmful compounds are removed from the body, and beneficial bacteria eliminate their adverse effects.
• Immune. In the intestines, special proteins (immunoglobulins) are synthesized, which help to increase protective functions organism. They prevent the development of dangerous infectious diseases. Beneficial bacteria are able to absorb, destroy harmful microbes.

Members of the intestinal flora

The intestinal microflora is very heterogeneous in composition, the bacteria included in it are presented in the table.

All these representatives, most of which are also present in the microflora of the small intestine, can be divided into two types - aerobes, anaerobes. The nature of their existence is different. Aerobes only live when they have access to oxygen. Anaerobes are divided into obligate and facultative. Both of these species live without access to air.

Oxygen has a detrimental effect on obligate microorganisms, while facultative ones can carry out their vital activity in its presence.

Normal microflora

Gram-positive/negative anaerobes are found in the constant intestinal microflora. The former include lacto-, eu- and bifidobacteria, as well as peptostreptococci. To gram-negative - veillonella (immobile coccoid organisms) fusobacteria, bacteroids.

There is a beneficial microflora in the intestines

The name of these anaerobes comes from the surname of Gram (a bacteriologist from Denmark). He came up with a method in which he stained smears with iodine, dye (aniline) and alcohol. Moreover, if we consider the bacteria under a microscope, then some of them have a violet-blue color. They are Gram positive. If the microorganism is discolored, then it is gram-negative anaerobes. To see them better, a dye is used - fuchsin. It stains the bacteria in a pinkish hue.

The representatives listed above make up 95% intestinal microflora. These bacteria are also called beneficial because they produce substances similar to antibiotics that help eliminate pathogens of various infections. Such microorganisms create a special zone with a pH of 4.0 to 5.0 in the intestine, thereby forming a surface film on the mucosa that protects the organ.

Conditionally pathogenic

This microflora contains Gram-positive/negative facultative anaerobes. Such bacteria are considered opportunistic, because in a healthy body they have an extremely positive effect. However, when exposed to negative factors, they begin to multiply excessively and become pathogens. In this case, a person's health worsens and a stool disorder occurs, in which mucus impurities, and in some cases blood or even pus, may appear.

Candida fungus may be opportunistic

The increased reproduction of opportunistic bacteria leads to an imbalance in the microflora. This is usually associated with pathologies of the digestive system of an inflammatory nature, weak immunity, malnutrition, or long-term use certain medications, such as hormones, antibiotics, or analgesics.

Among opportunistic pathogens, there are Candida mushrooms. These representatives are rarely found in humans. However, if they were found even in small quantities in the masses of feces, it is urgent to consult a doctor to rule out candidiasis.

These fungi cause the development of gastritis and stomach ulcers.

pathogenic

Pathogenic bacteria enter the body from outside. They cause acute intestinal infections. The bacteria can enter the human body through contaminated fruits or vegetables, water, or through contact with an already infected person. Another route of infection is poor personal hygiene.

Among the dangerous ones, salmonella can be distinguished, which causes a serious intestinal infection.

Pathogenic microorganisms include pathogens of various infections, such as salmonellosis, dysentery or pseudotuberculosis. Some bacteria are commonly found in healthcare workers. These include Pseudomonas aeruginosa and Staphylococcus aureus.

Types of beneficial bacteria in the gut

Thousands of varieties of microorganisms are constantly in the intestines of humans. It largely depends on the bacteria whether he will be thin or full, depressive or cheerful, as well as how resistant his body will be to many diseases. The main representatives of the permanent intestinal microflora, which provide extremely useful functions, are some strict (otherwise called obligate) anaerobes. Such a name as "strict" they received because of the ability to live and reproduce only in the absence of oxygen in the environment. This element is detrimental to them. In the large intestine of a completely healthy person, anaerobic microorganisms are present to a greater extent, and aerobes - no more than 10%. These include E. coli, enterococci with staphylococci, as well as yeast-like fungi and lactose-negative enterobacteria.

Gram-positive anaerobic microorganisms:

• Bifidobacteria. They belong to the main microflora and are present in a healthy organ throughout human life. Their number prevails over the content of other microorganisms. Bifidobacteria protect the lining of the stomach from the pathological effects of organisms entering from outside, and also prevent their penetration into other parts of the gastrointestinal tract. This feature is especially relevant for newborns and toddlers up to a year. Bacteria produce both acetic and lactic acid. These compounds help absorb calcium as well as calciferols (vitamin D) along with iron. In addition, they have a stimulating effect on protective functions and are involved in the production of both amino acids and proteins with other vitamins. They do not respond to antimicrobial agents such as Penicillin or Streptomycin.

Bifidobacteria have a beneficial effect on the immune system

• Lactobacilli. These are rod-shaped microorganisms. They can be found in any part of the digestive system, and in newborns they are detected within a few days after birth. These bacteria exhibit antibacterial activity against pyogenic and putrefactive microbes. They are resistant to some antibiotics. In vegetarians, the number of lactobacilli in the digestive tract is higher than normal.
• Eubacteria. These microorganisms have an intermediate shape (they are not spherical, but not spherical). Quite often they are detected in artificial babies, despite the fact that eubacteria are rare in breastfed babies. Most of these microorganisms are saccharolytic, indicating their ability to ferment carbohydrates. Some of the eubacteria are able to synthesize vitamins and amino acids, break down cellulose, or participate in metabolic process steroid hormones and cholesterol.
• Peptostreptococci. These non-spore-forming bacteria are spherical in shape. For movement, cilia are usually used. In infants who feed on mother's milk, they are rarely detected, but in artificers almost always. These microorganisms grow slowly, to antibacterial drugs, except for beta-lactam antibiotics, have increased resistance. They live not only in the intestines. Since these bacteria are opportunistic pathogens, they are responsible for septic complications in immunosuppression or trauma.

It is very important to maintain a balance between different bacteria in the intestines.

Gram-negative anaerobic bacteria:

• Bacteroids. Due to the fact that they have different not only sizes, but also shapes, they are called polymorphic. Newborns appear after a week of life. Microorganisms are participants in digestion, break down bile acids.
• Fusobacteria. These are polymorphic rods. They live in the intestines and respiratory tract of an adult. Butyric acid is produced as the main metabolite, and acetic acid is produced as an additional metabolite.
• Waylonelles. They are coccoid, immobile bacteria. The meaning of their life is the processing of lactic acid into carbon dioxide, acetic acid and other metabolites.

Despite the fact that veillonella is an integral part of the normal environment, some types of this microorganism can become causative agents of purulent infections.

The quantitative content of representatives of normal microflora may change periodically. However, these fluctuations in values ​​should always remain normal. According to this criterion, it is determined whether the content of beneficial bacteria is sufficient for the body.

AT different ages in humans, the norm will be a different content of bacteria in the microflora

The main amount of bifidobacteria is found in the large intestine and is the basis of both parietal and luminal microflora. The content of this microorganism (as well as other bacteria) is determined in colony-forming units or in the reduction of CFU found in one gram of intestinal contents or feces (when considering fecal analysis). This figure reaches 400 million. At the same time, there are certain age gradations. For children under one year old, the number of bifidobacteria should not exceed the value of ten to the eleventh degree. However, the rate changes with age. In adults, it decreases to the tenth degree, and in the elderly - already to the ninth.

The norm of lactobacilli is 10⁷ for one-year-old children and 10⁸ for adults. A bacterium such as veillonella may not always be detected, so its quantitative content can range from zero to 10⁸. Each microorganism has its own norm. In an adult and completely healthy person, the quantitative content of fusobacteria ranges from tens of millions to billions of CFU.

This video will tell you how to restore the balance of microflora:

How can I check the intestinal microflora

To determine the microflora in humans (normal or not), it is necessary to take a stool test, which detects dysbacteriosis. This is a special research technique that allows you to accurately determine the number of certain microbes that inhabit the intestines.

In patients with polyposis of the large intestine, an increased content of eubacteria is detected in the feces.

If the microflora is disturbed in the small intestine, then this can lead to bloating and flatulence. A breath test helps to determine the failure of the intestines, during which an increase in the concentration of hydrogen is detected. This happens if anaerobic bacteria are overactive.

In cases where there are signs indicating an intestinal infection, a smear is taken from the rectum. For several days, it is grown on a nutrient medium, after which it is examined under a microscope to identify the type of pathogenic microbe that provoked the disease.

Hello, my name is Vasily. For 7 years now I have been helping people with intestinal problems, working in the first private clinic in Brno. I will be glad to answer your questions about the article in the comments, you can ask our doctors other questions on this page.

Microorganisms living in the human gastrointestinal tract are in a certain balance, and when it is disturbed, intestinal bacteriosis occurs. It is impossible to calculate how many bacteria live inside a person, but science identifies over 400 species. These are conditionally called “beneficial” microbes that do not harm the health of the body, but, on the contrary, maintain immunity and microflora in order. They are playing important role in digestion - help to break down proteins, fats and carbohydrates, produce vitamins and amino acids, support normal bowel function. A person coexists with bacteria on mutually beneficial terms - they support their vital activity with the help of wholesome and healthy food, in return they help health.

What are beneficial bacteria and what are the benefits?

The leaders among microorganisms are bifidobacteria (Bifidobacterium - lat.), The norm of which is the colonization of up to 90% of the total intestinal microflora. Bifidobacteria are actively involved in the digestion and absorption of food; protect the human body from pathogens and contribute to the production of immunoglobulin responsible for immunity. Bifidobacteria increase the body's resistance to allergens and promote the absorption of vitamins.

Lactobacilli (Lactobacillus plantarum - lat.) - hardworking microbes, representatives of a separate group (lactic acid bacteria). The role of lactobacilli is to fight pathogens. They prevent the development of gastrointestinal diseases, reduce the risk of cancer and improve metabolism. Like other lactic acid bacteria, they perform important functions in the process of digestion - they process complex carbohydrates and secrete lactic acid.

E. coli (Escherichia coli - lat.) - Another kind of friendly microbes. Their function is the synthesis of B and K vitamins. But these bacteria are beneficial only when they are in the intestines. In other organs of the human body, they can provoke many diseases. More often, pathogenic Escherichia coli cause acute poisoning, entering the human body along with unwashed vegetables and fruits, when drinking contaminated water or not following the rules of personal hygiene.

Types of bad bacteria and how they affect human health and intestines?

In the rich world of bacteria, there are as many bad organisms as there are good ones. Pathogenic microbes (in the process of settling the gastrointestinal tract) displace beneficial bacteria from there. The lack of the latter provokes the development of diseases. Helicobacter pylori (Helicobacter pylori - lat.) - the cause of the development of gastritis, ulcers and even stomach cancer. The only bacterium that is able to fully develop, live and multiply in an acidic environment. Extremely addictive and contagious - in some countries, the number of infected Helicobacter pylori is 30% of the population.

Salmonella (Salmonella - lat.) - bacteria that live in dairy products, raw meat and fish. Cause acute poisoning, salmonellosis and typhoid fever. They are characterized by survivability - outside the human body they remain active for 4 months, and in excrement they are able to live conditionally up to 4 years. Resistant to cold and die only when high temperatures. Lack of hygiene can lead to salmonella infections, so it's important to boil milk, avoid eating raw meat, and wash your hands after going to the toilet.

Bacteroides (Bacteroides - lat.) - bacteria that are responsible for colonizing the intestines. Can cause purulent and inflammatory diseases. Due to the fault of bacteroids, the appearance of peritonitis, colitis, sepsis and abscesses is possible. Lack of treatment leads to severe phlebitis, ulcerative skin lesions and inflammation of the inner membranes of the heart.

What are the causes of intestinal microflora disorders?

Conventionally, there are several main reasons for which the bacterial environment is disturbed:

What are the symptoms of intestinal microflora disorders?

Dysbacteriosis is characterized by stool disorders - diarrhea or constipation. Patients constantly complain of bloating and pain in the abdomen, flatulence, loss of appetite. There is an unpleasant aftertaste in the mouth, especially in the morning. Nausea and vomiting are possible. If you do not attach importance to these symptoms, the pathogenic flora will continue to actively multiply and almost completely replace the beneficial bacteria. In such cases, anemia and beriberi may develop. Insomnia, apathy, chronic fatigue are added to the already existing symptoms. In the future, infectious diseases of the intestine may develop.

How to avoid dysbacteriosis?

To prevent violations of the intestinal microflora, it is important to follow some rules:

• Do not overuse antibiotics. It is better to treat diseases with drugs of this group under the supervision of a doctor. During the cycle, you can play it safe and take probiotic supplements at the same time.
• Follow a balanced diet. Regularly consume kefir and yogurt containing lactic acid bacteria.
• Drink fresh juices and water (the norm is at least 1.5 liters of water per day).
• Diagnose health problems in a timely manner, since dysbacteriosis may indicate the presence of more serious diseases.
• Move more, exercise more. An active lifestyle has a beneficial effect on digestion and metabolism.
• Adhere to the rules of hygiene. Wash hands, vegetables and fruits thoroughly. Observe hygiene standards while cooking.

How to restore the intestinal microflora?

In the treatment of dysbacteriosis, the main thing is to suppress putrefactive pathogens and populate the human intestines with beneficial bacteria. If violations are caused short-term causes, for example, a course of taking antibiotics, seasonal changes or getting used to new food and water - the flora normalizes on its own. In some cases, bacteriophages are prescribed - viruses grown in special conditions that infect specific types of harmful bacteria. Treatment for dysbiosis may include antibiotics. But usually, the bacterial flora is restored with the help of probiotics or prebiotics, which, as a result of colonizing the intestines with beneficial bacteria, effectively fight pathogens.

is a combination of microorganisms that live in the small and large intestine, and form a single ecosystem with the human body. In 1861, the Dutch biologist Leeuwenhoek, who invented the microscope, first discovered bacteria in stool samples. More than three hundred years have passed, and scientists continue to explore the interaction between humans and single-celled living beings.

Scientists have described more than 400 types of microorganisms that live in the intestines. Their number reaches 50 trillion, which is 1.3 times the number of all cells in the human body. The total mass of all inhabitants of the intestine reaches 2.5-3 kg. Bacteria make up to 60% of dry feces. To maintain the vital activity of the intestinal microflora, up to 20% of the nutrients that enter the body with food are consumed daily.

Most of the microorganisms are concentrated in the large intestine. The number of bacteria in 1 g of its contents exceeds the population of our planet. The seeding of the small intestine is prevented by the antibacterial action of bile, the motor activity of the intestine and the valve on the border of the ileum and the caecum.

What are the functions of microorganisms?

• Protective - representatives of the normal microflora prevent the colonization of the digestive tract by pathogenic microbes. They are better adapted to living conditions in the intestines, absorb nutrients more easily, secrete components that inhibit the growth of pathogens of infectious diseases.
• digestive - participate in the breakdown of proteins, carbohydrates and fats, activate the work of enzymes.
• Detox - neutralize toxic substances that are formed during the digestion of food or come from outside.
• Restorative - stimulate the regeneration of intestinal cells.
• Synthetic - synthesize vitamins of groups B, C, K, hormones and biologically active substances.
• Regulatory – bifido- and lactobacilli regulate the metabolism of cholesterol and oxalates.
• immune - form substances that stimulate the immune system (see more).

Did you know that gut microbes have their own genetic potential?

The influence of microorganisms living in the intestine on human health depends on the hereditary information that is encoded in their DNA. All bacteria of the intestinal microbiocenosis contain 150 times more genes than are found in the human genome. It is thanks to the genetic potential that bacteria are able to perform various functions.

Scientists have discovered and isolated a bacterial gene that is responsible for the formation of antitumor substances from the soy substrate. Therefore, people in whose bodies live microorganisms - carriers of such a gene, practically do not suffer from bone and prostate cancer.

Can a person influence the state of his intestinal microflora?

Every year, scientists describe new diseases and conditions associated with impaired intestinal biocenosis. It's not just problems gastrointestinal tract, but also allergies, atherosclerosis, arterial hypertension, urolithiasis and even depression.

An unbalanced diet leads to a change in qualitative and quantitative. It has been proven that with a deficiency in the diet of dietary fiber, the intestinal biocenosis is disturbed in 34.8% of cases, with a low protein content - in 18.8%. Dairy products, on the contrary, stimulate the growth of beneficial microflora.

Eating foods containing dyes, stabilizers and preservatives negatively affects the condition of intestinal bacteria. Therefore, try to cook food from environmentally friendly products.

Violation of the rules of personal hygiene in digestive tract can penetrate - pathogens of intestinal infections - and helminth eggs. They multiply, release toxins and inhibit the vital activity of normal microflora. As a result, post-infectious dysbacteriosis develops.

Scientists have proven the relationship between intestinal biocenosis and lifestyle. For example, with physical inactivity in the colon, Proteus and E. coli are activated.

How do antibiotics affect the intestinal microflora?

Antibiotics are a powerful weapon in the fight against pathogens of dangerous infectious diseases. However, they destroy and. After a course of antibiotic treatment, its qualitative and quantitative composition changes. The consequences of taking antibiotics are abdominal pain, increased gas formation, upset stool, decreased immunity.

Therefore, uncontrolled intake of drugs of this group is unacceptable. Prescription of antibiotics should be carried out only according to strict indications, and not "just in case".

How to get an idea of ​​a person by the intestinal microflora?

Scientists have found that the composition of the intestinal microflora can be determined:

• Approximate age - in the elderly, the number of bacteria that help resist stress decreases.
• Type of constitution - in people who are prone to overweight, there are more bacteria in the intestines involved in the digestion of carbohydrates.
• Diet - passion for meat leads to the growth of microorganisms that break down proteins. In people who prefer fatty foods, the number of bacteroids and enterococci increases. In lovers of carbohydrates, aerobic opportunistic bacteria are activated.
• Place of residence - microscopic organisms that break down seaweed were found in the intestines of the Japanese.

Due to the variety of functions and role in maintaining homeostasis, scientists have proposed isolate the intestinal microflora into an independent organ. A change in the intestinal microbiocenosis disrupts the coordinated work of the body and leads to the development of diseases.

Microorganisms live in the human intestine, which make up a total mass of up to two kilograms. They form the local flora. The ratio is strictly maintained according to the principle of expediency.

The bacterial content is heterogeneous in function and significance for the host organism: some bacteria in all conditions provide support through the proper functioning of the intestines, therefore they are called beneficial. Others are just waiting for the slightest breakdown in control and weakening of the body in order to turn into a source of infection. They are called opportunistic pathogens.

The introduction of foreign bacteria into the intestines that can cause disease is accompanied by a violation of the optimal balance, even if a person is not sick, but is a carrier of the infection.

Treatment of the disease with medicines, especially antibacterial action, has a detrimental effect not only on the causative agents of the disease, but also on beneficial bacteria. The problem is how to eliminate the consequences of therapy. Therefore, scientists have created a large group of new drugs that supply live bacteria for the intestines.

What bacteria form the intestinal flora?

About half a thousand species of microorganisms live in the human digestive tract. They perform the following functions:

• help with their enzymes to break down the substances that have got with the products to normal absorption, absorption through the intestinal wall into the bloodstream;
• produce the destruction of unnecessary residues of digestion of food, toxins, toxic substances, gases to prevent decay processes;
• produce for the body special enzymes, biologically active substances (biotin), vitamin K and folic acid, which are necessary for life;
• participate in the synthesis of immune components.

Studies have shown that some bacteria (bifidobacteria) protect the body from cancer.

Probiotics gradually crowd out pathogenic microbes, depriving them of nutrition and directing immune cells to them.

The main beneficial microorganisms include: bifidobacteria (make up 95% of the entire flora), lactobacilli (almost 5% by weight), Escherichia. Conditionally pathogenic are:

• staphylococci and enterococci;
• mushrooms of the genus Candida;
• clostridia.

They become dangerous when a person's immunity falls, a change in the acid-base balance in the body. An example of harmful or pathogenic microorganisms are shigella, salmonella - the causative agents of typhoid fever, dysentery.

Beneficial live bacteria for the gut are also called probiotics. So, they began to call specially created substitutes for normal intestinal flora. Another name is eubiotics.
Now they are effectively used to treat digestive pathologies and consequences. negative impact medicines.

Types of Probiotics

Preparations with live bacteria were gradually improved and updated in terms of properties and composition. In pharmacology, they are usually divided into generations. The first generation are medicines containing only one strain of microorganisms: Lactobacterin, Bifidumbacterin, Colibacterin.

The second generation is formed by antagonist preparations containing an unusual flora that can resist pathogenic bacteria and support digestion: Bactistatin, Sporobacterin, Biosporin.

The third generation includes multicomponent drugs. They contain several strains of bacteria with bioadditives. The group includes: Lineks, Atsilakt, Acipol, Bifiliz, Bifiform. The fourth generation consists only of preparations from bifidobacteria: Florin Forte, Bifidumbacterin Forte, Probifor.

According to the bacterial composition, probiotics can be divided into those containing as the main component:

• bifidobacteria - Bifidumbacterin (forte or powder), Bifiliz, Bifikol, Bifiform, Probifor, Biovestin, Lifepack Probiotics;
• lactobacilli - Linex, Lactobacterin, Atsilact, Acipol, Biobacton, Lebenin, Gastrofarm;
• colibacteria - Colibacterin, Bioflor, Bifikol;
• enterococci - Linex, Bifiform, dietary supplements of domestic production;
• yeast-like fungi - Biosporin, Baktisporin, Enterol, Baktisubtil, Sporobacterin.

What should be considered when buying probiotics?

Under different names, pharmacological firms in Russia and abroad can produce the same drugs-analogues. Imported, of course, much more expensive. Studies have shown that people living in Russia are more adapted to local strains of bacteria.

Still better to buy your own drugs

Another negative - as it turned out, imported probiotics contain only a fifth of the declared volume of living microorganisms and do not settle in the intestines of patients for a long time. Before purchasing, you need to consult a specialist. This is caused by serious complications from the misuse of drugs. Patients reported:

• exacerbation of cholelithiasis and urolithiasis;
• obesity;
• allergic reactions.

Live bacteria should not be confused with prebiotics. These are also medicines, but do not contain microorganisms. Prebiotics contain enzymes, vitamins to improve digestion, stimulate the growth of beneficial microflora. They are often prescribed for constipation in children and adults.

The group includes known to practitioners: Lactulose, pantothenic acid, Hilak forte, Lysozyme, preparations from inulin. Experts believe that it is necessary to combine prebiotics with probiotic preparations for maximum results. For this created combined preparations(synbiotics).

Characterization of first generation probiotics

Preparations from the group of probiotics of the first generation are prescribed to young children when first-degree dysbacteriosis is detected, and also if prevention is necessary, if the patient is prescribed a course of antibiotics.

Primadophilus is an analogue of drugs with two types of lactobacilli, much more expensive than the others, since it is produced in the USA

The pediatrician chooses Bifidumbacterin, Lactobacterin for babies (include bifido- and lactobacilli). They are diluted in warm boiled water and given 30 minutes before breastfeeding. Older children and adults are suitable drugs in capsules, tablets.

Colibacterin - contains dried bacteria of Escherichia coli, is used for prolonged colitis in adults. A more modern monopreparation Biobacton contains an acidophilus bacillus, indicated from the neonatal period.

Narine, Narine Forte, Narine in milk concentrate - contains an acidophilic form of lactobacilli. Comes from Armenia.

Purpose and Description of Second Generation Probiotics

Unlike the first group, second-generation probiotics do not contain beneficial live bacteria, but include other microorganisms that can suppress and destroy pathogenic microflora - yeast-like fungi and spores of bacilli.

Mainly used for the treatment of children with mild form dysbacteriosis and intestinal infections. The duration of the course should be observed for no more than seven days, then switch to live bacteria of the first group. Baktisubtil (French drug) and Flonivin BS contain bacillus spores with a wide range antibacterial action.

Inside the stomach, spores are not destroyed by hydrochloric acid and enzymes, they reach the small intestine intact

Baktisporin and Sporobacterin are made from hay bacillus, antagonistic properties to pathogenic pathogens, resistance to the action of the antibiotic Rifampicin are preserved.

Enterol contains yeast-like fungi (saccharomycetes). Comes from France. Used in the treatment of diarrhea associated with antibiotics. Active against clostridia. Biosporin includes two types of saprophyte bacteria.

Features of third generation probiotics

Live bacteria collected in combination or several of their strains act more actively. They are used to treat acute intestinal disorders of moderate severity.

Linex - contains bifidobacteria, lactobacilli and enterococci, is produced in Slovakia in a special powder for children (Linex Baby), capsules, sachets. Bifiform is a Danish drug, several varieties are known (Baby drops, chewable tablets, complex). Bifiliz - contains bifidobacteria and lysozyme. Available in suspension (lyophilizate), rectal suppositories.

As part of the drug bifidobacteria, enterococci, lactulose, vitamins B 1, B 6

How are 4th generation probiotics different?

In the production of preparations with bifidobacteria of this group, the need for additional protection of the digestive tract and the removal of intoxication was taken into account. Means are called "sorbed" because the active bacteria are located on activated carbon particles.

Indicated for respiratory infections, diseases of the stomach and intestines, dysbacteriosis. The most popular drugs in this group. Bifidumbacterin Forte - contains live bifidobacteria sorbed on activated carbon, is available in capsules and powders.

Effectively protects and restores the intestinal flora after respiratory infections, with acute gastroenterological pathology, dysbacteriosis. The drug is contraindicated in people with congenital deficiency of the lactase enzyme, with rotavirus infection.

Probifor - differs from Bifidumbacterin Forte in the number of bifidobacteria, it is 10 times higher than the previous drug. Therefore, the treatment is much more effective. It is prescribed in severe forms of intestinal infection, with diseases of the large intestine, dysbacteriosis.

It has been proven that the effectiveness is equated in diseases caused by shigella to antibiotics of the fluoroquinolone series. Able to replace the combination of Enterol and Bifiliz. Florin Forte - includes a lacto- and bifidobacterium composition sorbed on coal. Available in capsule and powder form.

The use of synbiotics

Synbiotics are a completely new proposal in the treatment of intestinal flora disorders. They provide a double action: on the one hand, they necessarily contain a probiotic, on the other hand, they include a prebiotic that creates favorable conditions for the growth of beneficial bacteria.

The fact is that the action of probiotics is not long-lasting. After the restoration of the intestinal microflora, they can die, which again causes a worsening of the situation. Accompanying prebiotics nourish beneficial bacteria, provide active growth and protection.

Many synbiotics are classified as dietary supplements, not medicinal substances. Only a specialist can make the right choice. It is not recommended to make a decision about treatment on your own. The drugs in this series include the following.

Lb17

Many authors refer to the most the best drugs today. It combines useful action 17 types of live bacteria with extracts of algae, mushrooms, vegetables, herbs, fruits, cereals (more than 70 components). Recommended for course use, you need to take from 6 to 10 capsules per day.

The production does not involve sublimation and drying, therefore the viability of all bacteria is preserved. The drug is obtained by natural fermentation for three years. Strains of bacteria work in different parts of digestion. Suitable for people with lactose intolerance, does not contain gluten and gelatin. Comes to the pharmacy chain from Canada.

Multidophilus plus

Includes three strains of lactobacilli, one - bifidobacteria, maltodextrin. Produced in the USA. Available in capsules for adults. The Polish remedy Maxilak in its composition contains: as a prebiotic oligofructose, as a probiotic - live cultures of beneficial bacteria (three strains from bifidobacteria, five from lactobacilli, streptococcus). Indicated in diseases of the gastrointestinal tract, respiratory system, impaired immunity.

Assigned to children from the age of three and adults 1 capsule in the evening with meals

Which probiotics have targeted indications?

With an abundance of information about bacterial preparations with live microorganisms, some people rush to extremes: they either do not believe in the expediency of using them, or, conversely, spend money on products of little use. It is necessary to consult a specialist about the use of probiotics in a particular situation.

Children with diarrhea during breastfeeding(especially those born prematurely) prescribe liquid probiotics. They also help with irregular stools, constipation, lagging physical development.

Babies in such situations are shown:

• Bifidumbacterin Forte;
• Linex;
• Acipol;
• Lactobacterin;
• Bifiliz;
• Probifor.

If diarrhea in a child is associated with a past respiratory disease, pneumonia, infectious mononucleosis, false croup, then these funds are prescribed in a short course for 5 days. At viral hepatitis treatment lasts from a week to a month. Allergic dermatitis is treated with courses from 7 days (Probifor) to three weeks. Sick with diabetes it is recommended to conduct courses of probiotics of different groups for 6 weeks.

For prophylactic administration, Bifidumbacterin Forte, Bifiliz are most suitable during the season of increased incidence.

What is better to take with dysbacteriosis?

It is necessary to be sure of the violation of the intestinal flora to pass a stool test for dysbacteriosis. The doctor must determine which specific bacteria the body lacks, how severe the violations are.

With an established deficiency of lactobacilli, it is not necessary to use drugs only. containing them. Because it is bifidobacteria that are decisive in the imbalance and form the rest of the microflora.

Monopreparations, in which there are only the same type of bacteria, are recommended by the doctor only when mild degree violations

In severe cases, it is necessary combined means third and fourth generations. The most indicated Probifor (infectious enterocolitis, colitis). For children, it is always necessary to select combinations of drugs with lacto- and bifidobacteria.

Means with colibacilli are prescribed very carefully. When identifying ulcers in the intestines and stomach, acute gastroenteritis, probiotics with lactobacilli are more indicated.

Usually, the doctor determines the duration of treatment by the generation of the probiotic:

• I - a monthly course is required.
• II - from 5 to 10 days.
• III - IV - up to seven days.

In the absence of effectiveness, the specialist changes the treatment regimen, adds antifungals, antiseptics. The use of probiotics - modern approach to the treatment of many diseases. This is especially important for parents of young children. It is necessary to distinguish medicines from biological food supplements. Existing dietary supplements with intestinal bacteria can only be used healthy person for the purpose of prevention.

Normal gut microbes- These are colonies of bacteria that inhabit the lumen of the lower parts of the digestive tract and the surface of the mucous membrane. They are needed for high-quality digestion of chyme (food bolus), metabolism and activation of local protection against infectious pathogens, as well as toxic products.

Normal intestinal microflora is the balance of various microbes of the lower divisions digestive system, that is, their quantitative and qualitative ratio, necessary to maintain the biochemical, metabolic, immunological balance of the body and maintain human health.

• protective function. Normal microflora has a pronounced resistance against pathogenic and opportunistic microorganisms. Beneficial bacteria prevent the colonization of the intestines by other infectious pathogens that are not characteristic of it. In the event of a decrease in the amount of normal microflora, potentially dangerous microorganisms begin to multiply. Purulent-inflammatory processes develop, bacterial infection of the blood (septicemia) occurs. Therefore, it is important not to allow a decrease in the amount of normal microflora.
• digestive function. The intestinal microflora is involved in the fermentation of proteins, fats, high molecular weight carbohydrates. Beneficial bacteria destroy the main mass of fiber and chyme residues under the action of water, maintain the necessary level of acidity (pH) in the intestines. The microflora inactivates (alkaline phosphatase, enterokinase), participates in the formation of protein breakdown products (phenol, indole, skatole) and stimulates peristalsis. Also, the microorganisms of the digestive tract regulate the metabolism and bile acids. Contribute to the transformation of bilirubin (bile pigment) into stercobilin and urobilin. Beneficial bacteria play an important role in the final stages of cholesterol conversion. It produces coprosterol, which is not absorbed in the large intestine and is excreted in the feces. Normoflora is able to reduce the production of bile acids by the liver and control the normal level of cholesterol in the body.
• Synthetic (metabolic) function. Beneficial bacteria of the digestive tract produce vitamins (C, K, H, PP, E, group B) and essential amino acids. Intestinal microflora promotes better absorption of iron and calcium, and therefore prevents the development of diseases such as anemia and rickets. Due to the action of beneficial bacteria, there is an active absorption of vitamins (D 3, B 12 and folic acid) that regulate the hematopoietic system. The metabolic function of the intestinal microflora is also manifested in their ability to synthesize antibiotic-like substances (acidophilus, lactocidin, colicin, and others) and biologically active compounds (histamine, dimethylamine, tyramine, etc.), which prevent the growth and reproduction of pathogenic microorganisms.
• detoxification function. This function is associated with the ability of the intestinal microflora to reduce the amount and remove dangerous toxic products with feces: salts of heavy metals, nitrites, mutagens, xenobiotics, and others. Harmful compounds do not linger in body tissues. Beneficial bacteria prevent their toxic effects.
• immune function. The normoflora of the intestine stimulates the synthesis of immunoglobulins - special proteins that increase the body's defenses against dangerous infections. Also, beneficial bacteria contribute to the maturation of a system of phagocytic cells (nonspecific immunity), capable of absorbing and destroying pathogenic microbes (see).

Members of the intestinal microflora

The entire intestinal microflora is divided into:

1. normal (basic);
2. conditionally pathogenic;
3. pathogenic.

Among all representatives there are anaerobes and aerobes. Their difference from each other lies in the features of existence and life activity. Aerobes are microorganisms that can live and reproduce only in conditions of constant oxygen supply. Representatives of the other group are divided into 2 types: obligate (strict) and facultative (conditional) anaerobes. Both those and others receive energy for their existence in the absence of oxygen. For obligate anaerobes, it is destructive, but not for facultative ones, that is, microorganisms can exist in its presence.

Normal microorganisms

These include gram-positive (bifidobacteria, lactobacilli, eubacteria, peptostreptococci) and gram-negative (bacteroids, fusobacteria, veillonella) anaerobes. This name is associated with the name of the Danish bacteriologist - Gram. He developed a special method for staining smears using aniline dye, iodine and alcohol. Under microscopy, some of the bacteria have a blue-violet color and are Gram-positive. Other microorganisms are discolored. To better visualize these bacteria, a contrast dye (magenta) is used, which stains them pink. These are Gram-negative organisms.

All representatives of this group are strict anaerobes. They form the basis of the entire intestinal microflora (92-95%). Beneficial bacteria produce antibiotic-like substances that help to expel pathogens of dangerous infections from the habitat. Also, normal microorganisms create a zone of "acidification" (pH=4.0-5.0) inside the intestine and form a protective film on the surface of its mucous membrane. Thus, a barrier is formed that prevents the colonization of foreign bacteria that have entered from the outside. Beneficial microorganisms regulate the balance of opportunistic flora, preventing its excessive growth. Participate in the synthesis of vitamins.

These include gram-positive (clostridia, staphylococci, streptococci, bacilli) and gram-negative (escherichia - Escherichia coli and other members of the enterobacteria family: Proteus, Klebsiella, Enterobacter, Citrobacter, etc.) facultative anaerobes.

These microorganisms are opportunistic pathogens. That is, with well-being in the body, their influence is only positive, as in normal microflora. The impact of adverse factors leads to their excessive reproduction and transformation into pathogens. It develops with diarrhea, a change in the nature of the stool (liquid mixed with mucus, blood or pus) and a deterioration in general well-being. The quantitative growth of opportunistic microflora may be associated with weakened immunity, inflammatory diseases digestive system, malnutrition and use medicines(antibiotics, hormones, cytostatics, analgesics and other agents).

The main representative of enterobacteria is with typical biological properties. It is able to activate the synthesis of immunoglobulins. Specific proteins interact with pathogenic microorganisms from the Enterobacteriaceae family and prevent their penetration into the mucous membrane. In addition, E. coli produces substances - colicins with antibacterial activity. That is, normal Escherichia are able to inhibit the growth and reproduction of putrefactive and pathogenic microorganisms from the Enterobacteriaceae family - Escherichia coli with altered biological properties (hemolyzing strains), Klebsiella, Proteus and others. Escherichia are involved in the synthesis of vitamin K.

The conditionally pathogenic microflora also includes yeast-like fungi of the genus Candida. They are rarely found in healthy children and adults. Their detection in the feces, even in small quantities, should be accompanied by a clinical examination of the patient in order to exclude (excessive growth and reproduction of yeast-like fungi). This is especially true in children younger age and patients with reduced immunity.

pathogenic microorganisms

These are bacteria that enter the digestive tract from the outside and cause acute intestinal infections. Infection with pathogenic microorganisms can occur when eating contaminated food (vegetables, fruits, etc.) and water, in violation of the rules of personal hygiene and contact with the patient. Normally, they are not found in the intestine. These include pathogenic pathogens of dangerous infections - pseudotuberculosis and other diseases. The most common representatives of this group are shigella, salmonella, yersinia, etc. Some pathogens (Staphylococcus aureus, Pseudomonas aeruginosa, atypical E. coli) can occur among medical personnel (carriers of a pathogenic strain) and in hospitals. They cause serious nosocomial infections.

All pathogenic bacteria provoke the development intestinal inflammation by type or with a disorder of the stool (diarrhea, mucus in the feces, blood, pus) and the development of intoxication of the body. Beneficial microflora is suppressed.

Bacteria content in the intestines

Beneficial bacteria

CFU/g is the number of colony forming units of microbes in 1 gram of feces.

Opportunistic bacteria

Beneficial gut bacteria

Gram-positive strict anaerobes:

Gram-negative strict anaerobes:

• Bacteroids- polymorphic (having a different size and shape) sticks. Together with bifidobacteria, they colonize the intestines of newborns by the 6-7th day of life. When breastfeeding, bacteroids are detected in 50% of children. With artificial nutrition, they are sown in most cases. Bacteroides are involved in digestion and the breakdown of bile acids.
• Fusobacteria- polymorphic rod-shaped microorganisms. Characteristic of the intestinal microflora of adults. Often they are sown from pathological material with purulent complications of various localization. Able to secrete leukotoxin (a biological substance with a toxic effect on leukocytes) and platelet aggregation factor, which is responsible for thromboembolism in severe septicemia.
• Waylonelles- coccal microorganisms. In children who are breastfed, they are detected in less than 50% of cases. In babies on artificial nutrition, mixtures are sown in high concentrations. Waylonellas are capable of large gas production. With their excessive reproduction, this distinctive feature can lead to dyspeptic disorders (flatulence, belching and diarrhea).

How to check the normal microflora?

A bacteriological examination of feces should be carried out by inoculation on special nutrient media. The material is taken with a sterile spatula from the last portion of the feces. The required amount of feces is 20 grams. The material for research is placed in a sterile dish without preservatives. It is necessary to take into account the fact that microorganisms - anaerobes must be reliably protected from the action of oxygen from the moment of fecal sampling to its sowing. It is recommended to use test tubes filled with a special gas mixture (carbon dioxide (5%) + hydrogen (10%) + nitrogen (85%)) with a tightly ground lid. From the moment of material sampling to the beginning of bacteriological examination, no more than 2 hours should pass.

This analysis of feces allows you to detect a wide range of microorganisms, calculate their ratio and diagnose visible disorders - dysbacteriosis. Violations in the composition of the intestinal microflora are characterized by a decrease in the proportion of beneficial bacteria, an increase in the number of opportunistic flora with a change in its normal biological properties, as well as the appearance of pathogens.

Low content of normal microflora - what to do?

The imbalance of microorganisms is corrected with the help of special preparations:

1. contribute to the colonization of the intestine by the main microflora due to the selective stimulation of the growth and metabolic activity of one or more groups of bacteria. These drugs are not medicines. These include undigested food ingredients that are a substrate for beneficial bacteria and are not affected by digestive enzymes. Preparations: “Hilak forte”, “Duphalak” (“Normaze”), “Calcium Pantothenate”, “Lysozyme” and others.
2. – These are living microorganisms that normalize the balance of intestinal bacteria and compete with conditionally pathogenic flora. Beneficial effect on human health. They contain useful bifidobacteria, lactobacilli, lactic streptococcus, etc. Preparations: “Acilact”, “Linex”, “Bactisubtil”, “Enterol”, “Colibacterin”, “Lactobacterin”, “Bifidumbacterin”, “Bifikol”, “Primadophilus " other.
3. Immunostimulating agents. They are used to maintain normal intestinal microbiocenosis and increase the body's defenses. Preparations: “KIP”, “Immunal”, “Echinacea”, etc.
4. Drugs that regulate the transit of intestinal contents. Used to improve digestion and evacuation of food. Preparations:, vitamins, etc.

Thus, the normal microflora with its specific functions - protective, metabolic and immunostimulating - determines the microbial ecology of the digestive tract and is involved in maintaining the constancy of the internal environment of the body (homeostasis).