Digestive Problems and Bloating: Where Prebiotics and Probiotics Fit

Most everyday digestive problems, such as bloating, wind, irregular bowel habits and mild constipation, come from things you can change: too little fibre or fluid, rushed or irregular meals, fizzy drinks, stress, travel or a recent course of antibiotics. Food and daily habits come first. If you would also like to try a food supplement, Pectiflor Tablets combine a prebiotic fibre (inulin) with a probiotic (Bacillus coagulans), and our pharmacist can help you decide whether it suits you.

This guide covers the lower gut: what prebiotics and probiotics are, what helps, and the warning signs that need a doctor. If your main problem is burning in your chest after meals, read our guide to heartburn relief and choosing an antacid instead.

Common digestive problems and their everyday causes

Bloating is a feeling of fullness or tightness in your tummy, often caused by gas in the gut, and it usually comes and goes. Irregular bowel habits can mean going less often, harder stools, straining, or swinging between loose and firm. Most of the time, the cause is everyday life:

• Too little fibre: meals low in vegetables, fruit, whole grains and pulses can lead to constipation.
• Too little fluid: in UAE heat you lose fluid through sweat, even when you move between air conditioning and the heat outside. Less fluid can mean harder stools.
• Rushed or irregular meals: eating quickly or chewing gum means swallowing air, and a large late meal can leave you bloated.
• Fizzy drinks: the bubbles add gas to your gut.
• Ramadan meal timing: a large iftar, a quick suhoor and less water overall can upset your usual rhythm.
• Travel: new foods, different water, long flights and time-zone changes often upset bowel habits for a few days.
• Stress and long hours sitting: the gut and brain are closely linked, and little movement slows things down.
• Antibiotics: they can disturb the balance of gut bacteria, and loose stools during or after a course are common.
• Lactose intolerance: some people do not fully digest lactose, the sugar in milk, so dairy can cause wind, bloating, cramps or diarrhoea.

Beans, lentils and cabbage naturally produce more gas. That is normal and not a reason to cut them out, but portion size can make a difference.

Prebiotics and probiotics: what they are and how they differ

Your gut is home to trillions of bacteria and other microbes, called the gut microbiota. Prebiotics and probiotics both relate to these microbes, in different ways.

Probiotics: live bacteria you take in

Probiotics are live microorganisms, mostly bacteria and some yeasts, intended to have a health benefit when you take them. They are found in some yoghurts, fermented foods and food supplements. Each probiotic is a specific strain, and a benefit seen with one strain does not mean another will do the same.

Prebiotics: food for your gut bacteria

Prebiotics are types of fibre that your body cannot digest, but that the helpful bacteria in your gut can use. Inulin is a common prebiotic, found naturally in foods such as onions, garlic, leeks, asparagus, bananas and chicory root.

In short, probiotics add bacteria, and prebiotics feed the ones already there. Products containing both are called synbiotics.

Food and habits come first

• Add fibre slowly. Vegetables, fruit, oats, whole grains, beans, lentils and chickpeas all add fibre. Increase it over a few weeks, as a sudden jump can cause wind and bloating.
• Drink regularly. Water is best. Fibre works better with enough fluid, and you need more in hot weather or after exercise. Cut down on fizzy drinks.
• Keep moving. A daily walk helps your bowel work regularly. In summer, walk early in the morning, in the evening or in an air-conditioned mall.
• Eat regular meals, slowly. Chew well with your mouth closed, and try smaller, more frequent meals rather than one large late meal.
• Do not ignore the urge to go, and give yourself enough time. Resting your feet on a low stool can help.
• Include yoghurt and fermented foods. Yoghurt with live cultures, laban and kefir are easy to add to your meals. If dairy upsets you, ask our pharmacist about other options.

During Ramadan

Break your fast gently with water and dates, then a moderate meal. Spread your fluids between iftar and suhoor, and include vegetables, fruit, oats or whole grains at suhoor.

When you travel

Drink bottled or safe water, wash your hands before eating, keep up your fluids on flights and walk when you can.

Where a prebiotic or probiotic supplement fits

A food supplement can sit alongside a good diet, but it cannot replace one. The evidence is mixed, and it depends on the strain and the problem:

• Some probiotics may help ease some symptoms of irritable bowel syndrome (IBS), but it is not yet clear which strains work best.
• Research suggests some probiotics may lower the chance of diarrhoea linked to antibiotics, though the quality of the studies varies.
• For constipation and traveller's diarrhoea, the evidence is limited and results differ between studies.

Probiotic food supplements are not tested in the same way as medicines, and a study's result only applies to the strain it used. If you try one, follow the directions on the pack and stop if it does not help.

Digestive health products at Bait Al Dawaa Pharmacy

Here are some products we stock for digestive health. They do not replace a balanced diet or your doctor's advice. You can browse more in our supplements collection.

• Pectiflor Tablets: made by Mar Farma, these combine inulin, a prebiotic plant fibre that favours the balance of the gut microbiota and helps intestinal transit, with Bacillus coagulans, a spore-forming probiotic bacterium. The spores resist stomach acid, bile and heat, so they pass through the stomach and germinate in the intestine.
• Pectiflor sparkling 20 tablets (2+1): an offer pack of Pectiflor sparkling tablets, an effervescent form that you dissolve in water, containing the prebiotic inulin together with a probiotic.
• HealthAid Psyllium Husk 1000mg: a fibre supplement in vegetarian capsules (60 per pack), a source of soluble fibre for adults who want to add more fibre to their diet. Drink plenty of fluid when taking it.
• Proflora Daily Probiotics: a probiotic food supplement in capsules (30 per pack), made to be taken every day.
• Delictase Lactase Drops: lactase enzyme drops (15ml) that break down the lactose in milk and dairy foods, for people with lactose intolerance who want to enjoy dairy more comfortably.

Taking a prebiotic or probiotic supplement safely

• Follow the directions on the pack, and do not take more than the stated amount.
• Start gently. Gut bacteria ferment inulin and other fibres, so at first you may notice more wind or bloating. This often settles; if it does not, stop and ask our pharmacist.
• Check with your doctor first if you have a weakened immune system (for example from chemotherapy, an organ transplant or medicines that suppress immunity), a serious illness, or a central line or other long-term catheter. In these situations probiotics carry a higher risk of infection.
• Pregnancy, breastfeeding and children: ask our pharmacist or your doctor before using any probiotic or fibre supplement.
• Taking medicines? Fibre supplements can affect how some medicines are absorbed, so ask our pharmacist how to space them.
• Store them well: somewhere cool and dry, never in a parked car, and out of reach of children.

When to see a doctor or ask our pharmacist

Ask our pharmacist if you are not sure which product suits you, if you take other medicines, or if mild bloating or constipation has not improved after a couple of weeks of changes to your diet and routine. Our pharmacist can also explain other pharmacy options.

See your doctor if you have:

• blood in your stools, or black, tarry stools
• weight loss you cannot explain
• a change in your bowel habit that lasts more than a few weeks, especially if you are over 50
• tummy pain that is severe, keeps coming back or does not go away
• vomiting, or difficulty swallowing
• a fever with diarrhoea or tummy pain
• signs of dehydration, such as dark urine, dizziness or passing little urine
• symptoms that wake you at night
• bloating that happens most days or does not go away
• a family history of bowel cancer or coeliac disease

Call an ambulance on 998 or go to the emergency department straight away if you have severe tummy pain with a hard, swollen tummy, heavy bleeding from your bottom, or if you vomit blood.

Frequently asked questions

What is the difference between prebiotics and probiotics?

Probiotics are live bacteria or yeasts taken in food or a supplement. Prebiotics are fibres, such as inulin, that feed the helpful bacteria already in your gut. Pectiflor contains both.

Can I take a probiotic while I am on antibiotics?

Many people do. Ask our pharmacist how to time it around your antibiotic doses, and keep taking your antibiotic exactly as prescribed. If you get severe or bloody diarrhoea during or after the course, contact your doctor.

How long should I try a probiotic before deciding if it helps?

There is no fixed rule, but many people try one for about a month. If you notice no difference, it may not suit you. If your symptoms are severe or getting worse, see your doctor rather than waiting.

This article is general information, not medical advice. For advice about your own health, speak to your doctor or ask our pharmacist at Bait Al Dawaa Pharmacy.