Bifidobacteria

Last Editorial Review: 6/11/2021
Other Name(s):

B. Bifidum, B. Breve, B. Infantis, B. lactis, B. Longum, Bifido, Bifido Bacterium Longum, Bifidobacterias, Bifidobactérie, Bifidobactéries, Bifidobacterium, Bifidobacterium adolescentis; Bifidobacterium animalis, Bifidobacterium bifidum; Bifidobacterium breve; Bifidobacterium infantis; Bifidobacterium lactis; Bifidobacterium longum, Bifidum, Bifidus, Bifidus Brevis, Bifidus Infantis, Bifidus Longum, Bifidobacteria Bifidus, Lactobacillus Bifidus, L. Bifidus, Probiotic, Probiotique.

Overview

Bifidobacteria are a group of bacteria that normally live in the intestines. They can be grown outside the body and then taken by mouth as medicine.

Bifidobacteria are used for many conditions affecting the intestines, including preventing diarrhea in infants and children; as well as traveler's diarrhea in adults. Some people take bifidobacteria to restore “good bacteria” in the gut that have been killed or removed by diarrhea, radiation, chemotherapy, antibiotics, or other causes. Bifidobacteria are also used to treat a bowel disease called ulcerative colitis, as well as a condition called pouchitis, which sometimes develops after surgery for ulcerative colitis. Some people use Bifidobacteria to prevent a particular bowel infection called necrotizing enterocolitis in newborns.

Other uses for Bifidobacteria include treating a skin condition in infants called atopic eczema, yeast infections (candidiasis), cold, flu, reducing flu-like symptoms in children attending day-care centers, breast pain (mastitis), hepatitis, lactose intolerance, mumps, Lyme disease, and cancer. These bacteria are also used to boost the immune system and lower cholesterol.

How does it work?

Bifidobacteria belong to a group of bacteria called lactic acid bacteria. Lactic acid bacteria are found in fermented foods like yogurt and cheese. Bifidobacteria are used in treatment as so-called “probiotics,” the opposite of antibiotics. They are considered "friendly" bacteria and are taken to grow and multiply in areas of the body where they normally would occur. The human body counts on its normal bacteria to perform several jobs, including breaking down foods, helping the body take in nutrients, and preventing the take-over of “bad” bacteria. Probiotics such as bifidobacteria are typically used in cases when a disease occurs or might occur due to a kill-off of normal bacteria. For example, treatment with antibiotics can destroy disease-causing bacteria, but also normal bacteria in the GI (gastrointestinal) and urinary tracts. The theory is that taking Bifidobacterium probiotics during antibiotic treatment can prevent or minimize the death of good bacteria and the take-over by bad bacteria.

SLIDESHOW

Inflammatory Bowel Disease (IBD) Causes, Symptoms, Treatment See Slideshow

Uses & Effectiveness

Possibly Effective for...

  • Constipation. Some early research shows that taking a specific Bifidobacterium breve product (Yakult Co., Japan) can reduce constipation in children 3-16 years of age. Also, most research shows that mixing Bifidobacterium longum BB536 with milk or yogurt and taking the mixture daily for 2 weeks increases the number of bowel movements in adults prone to constipation. However, taking this same strain of Bifidobacterium for 16 weeks does not seem to reduce constipation in elderly adults receiving nutrition with a feeding tube.
  • Helicobacter pylori (H. pylori) infection. Taking bifidobacteria along with other probiotic bacteria strains seems to reduce side effects of treatment for the ulcer-causing bacterium Helicobacter pylori.
  • Irritable bowel syndrome (IBS). Taking Bifidobacterium infantis 35624 (Align or Bifantis, Proctor & Gamble) for 8 weeks seems to reduce symptoms of IBS. However, it does not seem to increase bowel movements. Taking a specific product containing species of Bifidobacterium, Lactobacillus, and Streptococcus (VSL#3) seems to decrease bloating in people with IBS.
  • A type of infection in the lining of the intestine caused by bacteria (necrotizing enterocolitis; NEC). Taking Bifidobacterium infantis along with another bacterium called Lactobacillus acidophilus seems to help prevent NEC in critically ill infants.
  • A complication after surgery for ulcerative colitis called pouchitis. Taking a specific product containing a combination of Bifidobacterium, Lactobacillus, and Streptococcus (VSL#3) by mouth seems to help prevent pouchitis after surgery for ulcerative colitis.
  • Lung infections. Some research suggests that taking a specific combination product containing Lactobacillus acidophilus and Bifidobacterium (HOWARU Protect) with milk helps reduce symptoms of fever, cough, runny nose, and decreases the amount of antibiotics needed in children. It may also shorten how long children have symptoms and decrease the number of days missed from daycare. Also, eating food containing Bifidobacterium longum BB536 for 3 weeks before getting a flu shot and for 14 weeks thereafter seems to help prevent the flu in elderly people.
  • Diarrhea in infants (rotaviral diarrhea). Taking Bifidobacterium bifidum seems to help prevent rotaviral diarrhea when used with other bacteria such as Streptococcus thermophiles or Bifidobacterium Bb12.
  • Traveler's diarrhea. Taking Bifidobacterium seems to help prevent traveler's diarrhea when used with other bacteria such as Lactobacillus acidophilus, Lactobacillus bulgaricus, or Streptococcus thermophilus.
  • Ulcerative colitis. Research suggests that taking specific products containing combinations of Bifidobacterium, Lactobacillus, and Streptococcus (VSL#3) or Bifidobacterium breve, Bifidobacterium bifidum, and Lactobacillus acidophilus (Yakult Co., Japan) helps control symptoms and prevent their recurrence in people with ulcerative colitis.

Insufficient Evidence to Rate Effectiveness for...

  • Diarrhea caused by antibiotics. So far, some studies have found Bifidobacterium effective for this use, but other study results have not agreed.
  • Scaly, itchy skin (eczema). Some research shows that giving Bifidobacterium lactis by mouth reduces eczema severity in infants. However, giving Bifidobacterium along with Lactobacillus does not seem to prevent eczema in infants with a family history of the condition.
  • Infections related to chemotherapy treatment. Early research suggests that taking specific products containing Bifidobacterium longum and Lactobacillus acidophilus (Morinaga Bifidus) or Bifidobacterium infantis, Lactobacillus acidophilus, and Enterococcus faecalis (Levenin) does not prevent Candida infection in people with leukemia who are undergoing chemotherapy.
  • High cholesterol. Early research suggests that taking milk containing Lactobacillus acidophilus 145 and Bifidobacterium longum BB536 reduces “bad” low-density lipoprotein (LDL) cholesterol in people with high cholesterol. However, it also seems to reduce “good” high-density lipoprotein (HDL) cholesterol.
  • Infant development. Giving formula containing Bifidobacterium longum BL999 plus prebiotics, or giving Bifidobacterium longum BB536 plus Lactobacillus rhamnosus or Lactobacillus paracasei, does not seem to improve growth in infants. However, drinking milk containing Bifidobacterium longum BB536, Lactobacillus rhamnosus, prebiotics, and fatty acids seems to increase weight gain in toddlers.
  • Japanese cedar pollen allergy. Some research suggests that taking Bifidobacterium longum BB536 during pollen season might reduce nose and eye symptoms of Japanese cedar pollen allergy. However, some conflicting evidence exists. Also, this strain of bifidobacteria does not seem to reduce sneezing or throat symptoms associated with Japanese cedar pollen allergy.
  • Preventing infections after exposure to radiation. Early research suggests that antibiotic-resistant Bifidobacterium longum can help improve short-term survival in the treatment of radiation sickness. In combination with antibiotics, bifidobacteria appear to help prevent dangerous bacteria from growing and causing a serious infection.
  • Common cold and flu (influenza).
  • Liver problems.
  • Lactose intolerance.
  • Breast pain, possibly due to infection (mastitis).
  • Mumps.
  • Cancer.
  • Stomach problems.
  • Replacing beneficial bacteria removed by diarrhea.
  • Lyme disease.
  • Aging.
  • Other conditions.
More evidence is needed to rate bifidobacteria for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

Bifidobacteria are LIKELY SAFE for adults and children when taken by mouth appropriately. In some people, treatment with bifidobacteria might upset the stomach and intestine, causing bloating and gas.

QUESTION

Ulcerative colitis affects the colon. The colon is also referred to as the... See Answer

Special Precautions & Warnings

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking bifidobacteria if you are pregnant or breast-feeding. Stay on the safe side and avoid use.

Weakened immune system: There is some concern that “probiotics” might grow too well in people with a weak immune system and cause infections. Although this has not occurred specifically with bifidobacteria, there have been rare cases involving other probiotic species such as lactobacillus. If you have a weakened immune system (e.g., you have HIV/AIDS or are undergoing cancer treatment), check with your healthcare provider before using bifidobacteria.

Interactions


Antibiotic drugsInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Antibiotics are used to reduce harmful bacteria in the body. Antibiotics can also reduce friendly bacteria in the body. Bifidobacteria are a type of friendly bacteria. Taking antibiotics along with bifidobacteria might reduce the effectiveness of bifidobacteria. To avoid this interaction, take bifidobacteria products at least two hours before or after antibiotics.

Dosing

The strength of bifidobacteria preparations is usually quantified by the number of living organisms per dose. The following doses have been studied in scientific research:

BY MOUTH:

  • For irritable bowel syndrome: 1 billion cells of Bifidobacterium infantis daily in a malted milk drink.
  • For lung infections in children: 120 mL of milk twice daily containing 5 billion colony forming units each of Lactobacillus acidophilus and Bifidobacterium contained in a specific product (HOWARU Protect, Danisco).
  • For chronic pouchitis: a dose of 600 billion bacteria consisting of species of Lactobacillus, Bifidobacterium, and Streptococcus (VSL#3) given once daily.
  • For Helicobacter pylori treatment: a dose of 5 billion bacteria consisting of Bifidobacterium lactis and Lactobacillus acidophilus once daily.
  • For constipation: 1-100 billion cells of a specific Bifidobacterium breve powder (Yakult Co., Japan) once daily.
  • For ulcerative colitis:
    • 100 mL per day of a specific fermented milk product (Yakult Co., Japan) containing at least 10 billion live Bifidobacterium breve, Bifidobacterium bifidum, and Lactobacillus acidophilus strains per dose has been used.
    • 3 grams of a specific combination probiotic containing living freeze-dried bacteria species including lactobacillus, bifidobacteria, and streptococcus (VSL#3) twice daily has also been used.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

References

Abe, F., Muto, M., Yaeshima, T., Iwatsuki, K., Aihara, H., Ohashi, Y., and Fujisawa, T. Safety evaluation of probiotic bifidobacteria by analysis of mucin degradation activity and translocation ability. Anaerobe. 2010;16(2):131-136. View abstract.

Akatsu, H., Iwabuchi, N., Xiao, J. Z., Matsuyama, Z., Kurihara, R., Okuda, K., Yamamoto, T., and Maruyama, M. Clinical Effects of Probiotic Bifidobacterium longum BB536 on Immune Function and Intestinal Microbiota in Elderly Patients Receiving Enteral Tube Feeding. JPEN J Parenter Enteral Nutr 11-27-2012; View abstract.

Andrade, S. and Borges, N. Effect of fermented milk containing Lactobacillus acidophilus and Bifidobacterium longum on plasma lipids of women with normal or moderately elevated cholesterol. J.Dairy Res. 2009;76(4):469-474. View abstract.

Araya-Kojima Tomoko, Yaeshima Tomoko Ishibashi Norio Shimamura Seiichi Hayasawa Hirotoshi. Inhibitory Effects of Bifidobacterium longum BB536 on Harmful Intestinal Bacteria. Bifidobacteria Microflora 1995;14(2):59-66.

Ballongue J, Grill J Baratte-Euloge P. Action sur la flore intestinale de laits fermentés au Bifidobacterium. Lait 1993;73:249-256.

Bennet, R., Nord, C. E., and Zetterstrom, R. Transient colonization of the gut of newborn infants by orally administered bifidobacteria and lactobacilli. Acta Paediatr. 1992;81(10):784-787. View abstract.

Bercik, P., Park, A. J., Sinclair, D., Khoshdel, A., Lu, J., Huang, X., Deng, Y., Blennerhassett, P. A., Fahnestock, M., Moine, D., Berger, B., Huizinga, J. D., Kunze, W., McLean, P. G., Bergonzelli, G. E., Collins, S. M., and Verdu, E. F. The anxiolytic effect of Bifidobacterium longum NCC3001 involves vagal pathways for gut-brain communication. Neurogastroenterol.Motil. 2011;23(12):1132-1139. View abstract.

Challa, A., Rao, D. R., Chawan, C. B., and Shackelford, L. Bifidobacterium longum and lactulose suppress azoxymethane-induced colonic aberrant crypt foci in rats. Carcinogenesis 1997;18(3):517-521. View abstract.

Chouraqui, J. P., Grathwohl, D., Labaune, J. M., Hascoet, J. M., de, Montgolfier, I, Leclaire, M., Giarre, M., and Steenhout, P. Assessment of the safety, tolerance, and protective effect against diarrhea of infant formulas containing mixtures of probiotics or probiotics and prebiotics in a randomized controlled trial. Am.J Clin.Nutr. 2008;87(5):1365-1373. View abstract.

Crociani, J., Grill, J. P., Huppert, M., and Ballongue, J. Adhesion of different bifidobacteria strains to human enterocyte-like Caco-2 cells and comparison with in vivo study. Lett.Appl.Microbiol. 1995;21(3):146-148. View abstract.

Das RR.Singh M, Shafiq N. Probiotics in Treatment of Allergic Rhinitis. World Allergy Organization Journal 2010;3(9):239-244.

del Giudice, M. M. and Brunese, F. P. Probiotics, prebiotics, and allergy in children: what's new in the last year? J Clin.Gastroenterol. 2008;42 Suppl 3 Pt 2:S205-S208. View abstract.

Firmansyah, A., Dwipoerwantoro, P. G., Kadim, M., Alatas, S., Conus, N., Lestarina, L., Bouisset, F., and Steenhout, P. Improved growth of toddlers fed a milk containing synbiotics. Asia Pac.J Clin.Nutr. 2011;20(1):69-76. View abstract.

Gianotti, L., Morelli, L., Galbiati, F., Rocchetti, S., Coppola, S., Beneduce, A., Gilardini, C., Zonenschain, D., Nespoli, A., and Braga, M. A randomized double-blind trial on perioperative administration of probiotics in colorectal cancer patients. World J Gastroenterol. 1-14-2010;16(2):167-175. View abstract.

Grill, J. P., Manginot-Durr, C., Schneider, F., and Ballongue, J. Bifidobacteria and probiotic effects: action of Bifidobacterium species on conjugated bile salts. Curr.Microbiol. 1995;31(1):23-27. View abstract.

Grzeskowiak, L., Gronlund, M. M., Beckmann, C., Salminen, S., von, Berg A., and Isolauri, E. The impact of perinatal probiotic intervention on gut microbiota: double-blind placebo-controlled trials in Finland and Germany. Anaerobe. 2012;18(1):7-13. View abstract.

Hascoet, J. M., Hubert, C., Rochat, F., Legagneur, H., Gaga, S., Emady-Azar, S., and Steenhout, P. G. Effect of formula composition on the development of infant gut microbiota. J Pediatr.Gastroenterol.Nutr. 2011;52(6):756-762. View abstract.

Igarashi M, Iiyama Y Kato R Tomita M Asami N Ezawa I. Effect of Bifidobacterium longum and lactulose on the strength of bone in ovariectomized osteoporosis model rates. Bifidus 1994;7:139-147.

Ishizeki, S. Sugita M. Takata M and Yaeshima T. Study of the effects of administering Bifidobacteria on the intestinal microflora in low birth weight infants: Effects of administering three species of Bifidobacteria. The Journal of the Japan Pediatric Society 2004;108:283.

Iwabuchi N, Hiruta N Kanetada S Yaeshima T Iwatsuki K Yasui H. Effects of Intranasal Administration of Bifidobacterium longum BB536 on Mucosal Immune System in Respiratory Tract and Influenza Virus Infection in Mice. Milk Science 2009;38(3):129-133.

Iwabuchi, N., Takahashi, N., Xiao, J. Z., Miyaji, K., and Iwatsuki, K. In vitro Th1 cytokine-independent Th2 suppressive effects of bifidobacteria. Microbiol.Immunol. 2007;51(7):649-660. View abstract.

Iwabuchi, N., Takahashi, N., Xiao, J. Z., Yonezawa, S., Yaeshima, T., Iwatsuki, K., and Hachimura, S. Suppressive effects of Bifidobacterium longum on the production of Th2-attracting chemokines induced with T cell-antigen-presenting cell interactions. FEMS Immunol.Med.Microbiol. 2009;55(3):324-334. View abstract.

Iwabuchi, N., Xiao, J. Z., Yaeshima, T., and Iwatsuki, K. Oral administration of Bifidobacterium longum ameliorates influenza virus infection in mice. Biol.Pharm.Bull. 2011;34(8):1352-1355. View abstract.

Kabeir, B. M., Yazid, A. M., Stephenie, W., Hakim, M. N., Anas, O. M., and Shuhaimi, M. Safety evaluation of Bifidobacterium pseudocatenulatum G4 as assessed in BALB/c mice. Lett.Appl.Microbiol. 2008;46(1):32-37. View abstract.

Kageyama T, Nakano Y Tomoda T. Comparative Study on Oral Administration of Some Bifidobacterium Preparations. Medicine and Biology(Japan) 1987;115(2):65-68.

Kageyama T, Tomoda T Nakano Y. The Effect of Bifidobacterium Administration in Patients with Leukemia. Bifidobacteria Microflora. 1984;3(1):29-33.

Kondo, J., Xiao, J. Z., Shirahata, A., Baba, M., Abe, A., Ogawa, K., and Shimoda, T. Modulatory effects of Bifidobacterium longum BB536 on defecation in elderly patients receiving enteral feeding. World J Gastroenterol 4-14-2013;19(14):2162-2170. View abstract.

Kulkarni, N. and Reddy, B. S. Inhibitory effect of Bifidobacterium longum cultures on the azoxymethane-induced aberrant crypt foci formation and fecal bacterial beta-glucuronidase. Proc.Soc Exp.Biol.Med 1994;207(3):278-283. View abstract.

Mah, K. W., Chin, V. I., Wong, W. S., Lay, C., Tannock, G. W., Shek, L. P., Aw, M. M., Chua, K. Y., Wong, H. B., Panchalingham, A., and Lee, B. W. Effect of a milk formula containing probiotics on the fecal microbiota of asian infants at risk of atopic diseases. Pediatr.Res. 2007;62(6):674-679. View abstract.

Makras, L. De Vuyst L. The in vitro inhibition of gram-negative pathogenic bacteria by bifidobacteria is caused by the production of organic acids. International Dairy Journal 2006;16:1049-1057.

Matsumoto, T., Ishikawa, H., Tateda, K., Yaeshima, T., Ishibashi, N., and Yamaguchi, K. Oral administration of Bifidobacterium longum prevents gut-derived Pseudomonas aeruginosa sepsis in mice. J Appl.Microbiol. 2008;104(3):672-680. View abstract.

Momose H, Igarashi M Era T Fukuda Y Yamada M and Ogasa K. Toxicological studies on Bifidobacterium longum BB536. Oyo yakuri 1979;17(5):881-887.

Namba K, Yaeshima T Ishibashi N Hayasawa H and Yamazaki Shoji. Inhibitory Effects of Bifidobacterium longum on Enterohemorrhagic Escherichia coli O157:H7. Bioscience Microflora 2003;22(3):85-91.

Namba, K., Hatano, M., Yaeshima, T., Takase, M., and Suzuki, K. Effects of Bifidobacterium longum BB536 administration on influenza infection, influenza vaccine antibody titer, and cell-mediated immunity in the elderly. Biosci.Biotechnol.Biochem. 2010;74(5):939-945. View abstract.

Odamaki, T., Sugahara, H., Yonezawa, S., Yaeshima, T., Iwatsuki, K., Tanabe, S., Tominaga, T., Togashi, H., Benno, Y., and Xiao, J. Z. Effect of the oral intake of yogurt containing Bifidobacterium longum BB536 on the cell numbers of enterotoxigenic Bacteroides fragilis in microbiota. Anaerobe. 2012;18(1):14-18. View abstract.

Odamaki, T., Xiao, J. Z., Iwabuchi, N., Sakamoto, M., Takahashi, N., Kondo, S., Iwatsuki, K., Kokubo, S., Togashi, H., Enomoto, T., and Benno, Y. Fluctuation of fecal microbiota in individuals with Japanese cedar pollinosis during the pollen season and influence of probiotic intake. J Investig.Allergol.Clin.Immunol. 2007;17(2):92-100. View abstract.

Odamaki, T., Xiao, J. Z., Iwabuchi, N., Sakamoto, M., Takahashi, N., Kondo, S., Miyaji, K., Iwatsuki, K., Togashi, H., Enomoto, T., and Benno, Y. Influence of Bifidobacterium longum BB536 intake on faecal microbiota in individuals with Japanese cedar pollinosis during the pollen season. J Med.Microbiol. 2007;56(Pt 10):1301-1308. View abstract.

Odamaki, T., Xiao, J. Z., Sakamoto, M., Kondo, S., Yaeshima, T., Iwatsuki, K., Togashi, H., Enomoto, T., and Benno, Y. Distribution of different species of the Bacteroides fragilis group in individuals with Japanese cedar pollinosis. Appl.Environ.Microbiol. 2008;74(21):6814-6817. View abstract.

Ogata T, Kingaku M Yaeshima T Teraguchi S Fukuwatari Y Ishibashi N Hayasawa H Fujisawa T Lino H. Effect of Bifidobacterium longum BB536 yogurt administration on the intestinal environment of healthy adults. Microb Ecol Health Dis 1999;11:41-46.

Ogata T, Nakamura T Anjitsu K Yaeshima T Takahashi S Fukuwatari Y Ishibashi N Hayasawa H Fujisawa T Iino H. Effect of Bifidobacterium longum BB536 administration on the intestinal environment, defecation frequency and fecal characteristics of human volunteers. Biosci Microflora 1997;16:53-58.

Orrhage, K., Sjostedt, S., and Nord, C. E. Effect of supplements with lactic acid bacteria and oligofructose on the intestinal microflora during administration of cefpodoxime proxetil. J Antimicrob.Chemother. 2000;46(4):603-612. View abstract.

Puccio, G., Cajozzo, C., Meli, F., Rochat, F., Grathwohl, D., and Steenhout, P. Clinical evaluation of a new starter formula for infants containing live Bifidobacterium longum BL999 and prebiotics. Nutrition 2007;23(1):1-8. View abstract.

Reddy, B. S. and Rivenson, A. Inhibitory effect of Bifidobacterium longum on colon, mammary, and liver carcinogenesis induced by 2-amino-3-methylimidazo[4,5-f]quinoline, a food mutagen. Cancer Res. 9-1-1993;53(17):3914-3918. View abstract.

Rouge, C., Piloquet, H., Butel, M. J., Berger, B., Rochat, F., Ferraris, L., Des, Robert C., Legrand, A., de la Cochetiere, M. F., N'Guyen, J. M., Vodovar, M., Voyer, M., Darmaun, D., and Roze, J. C. Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial. Am.J Clin.Nutr. 2009;89(6):1828-1835. View abstract.

Seki M, Igarashi T Fukuda Y Simamura S Kaswashima T Ogasa K. The effect of Bifidobacterium cultured milk on the "regularity" among an aged group. Nutr Foodstuff 1978;31:379-387.

Sekine I, Yoshiwara S Homma N Takanori H Tonosuka S. Effects of Bifidobacterium-containing milk on chemiluminescence reaction of peripheral leukocytes and mean corpuscular volume of red blood cells - a possible role of Bifidobacterium on activation of macrophages. Therapeutics (Japan) 1985;14:691-695.

Sekine K, Kawashima T and Hashimoto Y. Comparison of the TNF-a Levels Induced by Human-Derived Bifidobacterium longum and Rat-Derived Bifidobacterium animalis in Mouse Peritoneal Cells. Bifidobacteria Microflora 1994;13(2):79-89.

Simakachorn, N., Bibiloni, R., Yimyaem, P., Tongpenyai, Y., Varavithaya, W., Grathwohl, D., Reuteler, G., Maire, J. C., Blum, S., Steenhout, P., Benyacoub, J., and Schiffrin, E. J. Tolerance, safety, and effect on the faecal microbiota of an enteral formula supplemented with pre- and probiotics in critically ill children. J Pediatr.Gastroenterol.Nutr. 2011;53(2):174-181. View abstract.

Singh, J., Rivenson, A., Tomita, M., Shimamura, S., Ishibashi, N., and Reddy, B. S. Bifidobacterium longum, a lactic acid-producing intestinal bacterium inhibits colon cancer and modulates the intermediate biomarkers of colon carcinogenesis. Carcinogenesis 1997;18(4):833-841. View abstract.

Soh, S. E., Aw, M., Gerez, I., Chong, Y. S., Rauff, M., Ng, Y. P., Wong, H. B., Pai, N., Lee, B. W., and Shek, L. P. Probiotic supplementation in the first 6 months of life in at risk Asian infants--effects on eczema and atopic sensitization at the age of 1 year. Clin.Exp.Allergy 2009;39(4):571-578. View abstract.

Tahri, K., Crociani, J., Ballongue, J., and Schneider, F. Effects of three strains of bifidobacteria on cholesterol. Lett.Appl.Microbiol. 1995;21(3):149-151. View abstract.

Takahashi, N., Kitazawa, H., Iwabuchi, N., Xiao, J. Z., Miyaji, K., Iwatsuki, K., and Saito, T. Immunostimulatory oligodeoxynucleotide from Bifidobacterium longum suppresses Th2 immune responses in a murine model. Clin.Exp.Immunol. 2006;145(1):130-138. View abstract.

Takahashi, N., Kitazawa, H., Iwabuchi, N., Xiao, J. Z., Miyaji, K., Iwatsuki, K., and Saito, T. Oral administration of an immunostimulatory DNA sequence from Bifidobacterium longum improves Th1/Th2 balance in a murine model. Biosci.Biotechnol.Biochem. 2006;70(8):2013-2017. View abstract.

Takahashi, N., Kitazawa, H., Shimosato, T., Iwabuchi, N., Xiao, J. Z., Iwatsuki, K., Kokubo, S., and Saito, T. An immunostimulatory DNA sequence from a probiotic strain of Bifidobacterium longum inhibits IgE production in vitro. FEMS Immunol.Med.Microbiol. 2006;46(3):461-469. View abstract.

Takeda, Y., Nakase, H., Namba, K., Inoue, S., Ueno, S., Uza, N., and Chiba, T. Upregulation of T-bet and tight junction molecules by Bifidobactrium longum improves colonic inflammation of ulcerative colitis. Inflamm.Bowel.Dis. 2009;15(11):1617-1618. View abstract.

Tang, M. L., Lahtinen, S. J., and Boyle, R. J. Probiotics and prebiotics: clinical effects in allergic disease. Curr.Opin.Pediatr. 2010;22(5):626-634. View abstract.

Tomoda T, Nakano Y Kageyama T. Intestinal Candida Overgrowth and Candida Infection in Patients with Leukemia: Effect of Bifidobacterium Administration. Bifidobacteria Microflora 1988;7(2):71-74.

Tomoda T, Nakano Y Kageyama T. Variation in Small Groups of Constant Intestinal Flora during Administration of Anticancer or Immunosuppressive Drugs. Medicine and Biology(Japan) 1981;103(1):45-49.

Tomoda, T. Nakano Y. and Kageyama T. The Variation and Adherence of the Species of Bifidobacterium in the Intestine during Oral Administration of Bifidobacterium. Medicine and Biology (Japan) 1986;113(2):125-128.

Xiao J, Kondol S Odamaki T Miyaji K Yaeshima T Iwatsuki K Togashi H Benno Y. Effect of yogurt containing Bifidobacterium longum BB 536 on the defecation frequency and fecal characteristics of healthy adults: A double-blind cross over study. Japanese Journal of Lactic Acid Bacteria 2007;18(1):31-36.

Xiao, J. Z., Kondo, S., Takahashi, N., Odamaki, T., Iwabuchi, N., Miyaji, K., Iwatsuki, K., and Enomoto, T. Changes in plasma TARC levels during Japanese cedar pollen season and relationships with symptom development. Int.Arch.Allergy Immunol. 2007;144(2):123-127. View abstract.

Xiao, J. Z., Kondo, S., Yanagisawa, N., Miyaji, K., Enomoto, K., Sakoda, T., Iwatsuki, K., and Enomoto, T. Clinical efficacy of probiotic Bifidobacterium longum for the treatment of symptoms of Japanese cedar pollen allergy in subjects evaluated in an environmental exposure unit. Allergol.Int. 2007;56(1):67-75. View abstract.

Xiao, J. Z., Kondo, S., Yanagisawa, N., Takahashi, N., Odamaki, T., Iwabuchi, N., Iwatsuki, K., Kokubo, S., Togashi, H., Enomoto, K., and Enomoto, T. Effect of probiotic Bifidobacterium longum BB536 [corrected] in relieving clinical symptoms and modulating plasma cytokine levels of Japanese cedar pollinosis during the pollen season. A randomized double-blind, placebo-controlled trial. J Investig.Allergol.Clin.Immunol. 2006;16(2):86-93. View abstract.

Xiao, J. Z., Kondo, S., Yanagisawa, N., Takahashi, N., Odamaki, T., Iwabuchi, N., Miyaji, K., Iwatsuki, K., Togashi, H., Enomoto, K., and Enomoto, T. Probiotics in the treatment of Japanese cedar pollinosis: a double-blind placebo-controlled trial. Clin.Exp.Allergy 2006;36(11):1425-1435. View abstract.

Yaeshima T, Takahashi S Matsumoto N Ishibashi N Hayasawa H Lino H. Effect of yogurt containing Bifidobacterium longum BB536 on the intestinal environment, fecal characteristics and defecation frequency: A comparison with standard yogurt. Biosci Microflora 1997;16:73-77.

Yaeshima T, Takahashi S Ogura A Konno T Iwatsuki K Ishibashi N Hayasawa H. Effect of Non-fermented Milk Containing Bifidobacterium longum BB536 on the Defecation Frequency and Fecal Characteristics in Healthy Adults. Journal of Nutrition Food 2001;4(2):1-6.

Yaeshima T, Takahashi S Ota S Nakagawa K Ishibashi N Hiramatsu A Ohashi T Hayasawa H Iino H. Effect of sweet yogurt containing Bifidobacterium longum BB536 on defecation frequency and fecal characteristics of healthy adults: A comparison with sweet standard yogurt. Kenko Eiyo Shokuhin Kenkyu 1998;1(3/4):29-34.

Yamazaki, S., Machii, K., Tsuyuki, S., Momose, H., Kawashima, T., and Ueda, K. Immunological responses to monoassociated Bifidobacterium longum and their relation to prevention of bacterial invasion. Immunology 1985;56(1):43-50. View abstract.

Yap GC, Mah KW Lay C Shek LPC Aw M Chua KY Tannock GW Lee BW. Detection of fecal Bifidobacterium infantis in the first year of life in infants at risk of atopy supplemented with Lactobacillus rhamnosus GG and Bifidobacterium longum from birth till 6 months old. World Allergy Organization Journal. 2007;WAC 2007 Abstracts S130.

Zsivkovits, M., Fekadu, K., Sontag, G., Nabinger, U., Huber, W. W., Kundi, M., Chakraborty, A., Foissy, H., and Knasmuller, S. Prevention of heterocyclic amine-induced DNA damage in colon and liver of rats by different lactobacillus strains. Carcinogenesis 2003;24(12):1913-1918. View abstract.

AlFaleh K, Anabrees J, Bassler D, Al-Kharfi T. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database of Systematic Reviews 2011, Issue 3. Art. No.: CD005496. DOI: 10.1002/14651858.CD005496.pub3. View abstract.

Arunachalam K, Gill HS, Chandra RK. Enhancement of natural immune function by dietary consumption of Bifidobacterium lactis (HN019). Eur J Clin Nutr 2000;54:263-7. View abstract.

Bibiloni R, Fedorak RN, Tannock GW, et al. VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis. Am J Gastroenterol 2005;100:1539-46. View abstract.

Bouhnik Y, Pochart P, Marteau P, et al. Fecal recovery in humans of viable bifidobacterium ingested in fermented milk. Gastroenterology 1992;102:875-8. View abstract.

Chen RM, Wu JJ, Lee SC, et al. Increase of intestinal Bifidobacterium and suppression of coliform bacteria with short-term yogurt ingestion. J Dairy Sci 1999:82:2308-14. View abstract.

Chiang BL, Sheih YH, Wang LH, et al. Enhancing immunity by dietary consumption of a probiotic lactic acid bacterium (Bifidobacterium lactis HN019): optimization and definition of cellular immune responses. Eur J Clin Nutr 2000;54:849-55. View abstract.

Colombel JF, Cortot A, Neut C, Romond C. Yoghurt with Bifidobacterium longum reduces erythromycin-induced gastrointestinal effects. Lancet 1987;2:43.

Cremonini F, Di Caro S, Covino M, et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol 2002;97:2744-9. View abstract.

Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic Agents, A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-5. View abstract.

Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 2000;119:305-9. View abstract.

Goldin BR. Health Benefits of probiotics. Br J Nutr 1998;80:S203-7. View abstract.

Ha GY, Yang CH, Kim H, Chong Y. Case of sepsis caused by Bifidobacterium longum. J Clin Microbiol 1999;37:1227-8. View abstract.

Hirayama K, Rafter J. The role of probiotic bacteria in cancer prevention. Microbes Infect 2000;2:681-6. View abstract.

Hoyos AB. Reduced incidence of necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infantis to neonates in an intensive care unit. Int J Infect Dis 1999;3:197-202. View abstract.

Ishikawa H, Akedo I, Umesaki Y, et al. Randomized controlled trial of the effect of bifidobacteria-fermented milk on ulcerative colitis. J Am Coll Nutr 2003;22:56-63. View abstract.

Isolauri E, Arvola T, Sutas Y, et al. Probiotics in the management of atopic eczema. Clin Exp Allergy 2000;30:1604-10. View abstract.

Kalima P, Masterton RG, Roddie PH, et al. Lactobacillus rhamnosus infection in a child following bone marrow transplant. J Infect 1996;32:165-7. View abstract.

Kato K, Mizuno S, Umesaki Y, et al. Randomized placebo-controlled trial assessing the effect of bifidobacteria-fermented milk on active ulcerative colitis. Aliment Pharmacol Ther 2004;20:1133-41. View abstract.

Kim HJ, Camilleri M, McKinzie S, et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 2003;17:895-904. . View abstract.

Korschunov VM, Smeyanov VV, Efimov BA, et al. Therapeutic use of an antibiotic-resistant Bifidobacterium preparation in men exposed to high-dose gamma-irradiation. J Med Microbiol 1996;44:70-4. View abstract.

Kuhbacher T, Ott SJ, Helwig U, et al. Bacterial and fungal microbiota in relation to probiotic therapy (VSL#3) in pouchitis. Gut 2006;55:833-41. View abstract.

Lewis SJ, Freedman AR. Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. Aliment Pharmacol Ther 1998;12:807-22. View abstract.

Leyer GJ, Li S, Mubasher ME, et al. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009;124:e172-e179. View abstract.

Lievin V, Peiffer I, Hudault S, et al. Bifidobacterium strains from resident infant human gastrointestinal microflora exert antimicrobial activity. Gut 2000;47:646-52. View abstract.

Macfarlane GT, Cummings JH. Probiotics and prebiotics: can regulating the activities of intestinal bacteria benefit health? BMJ 1999;318:999-1003. View abstract.

McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol 2006;101:812-22. View abstract.

Meydani SN, Ha WK. Immunologic effects of yogurt. Am J Clin Nutr 2000;71:861-72. View abstract.

Miele E, Pascarella F, Giannetti E. et al. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009;104:437-43. View abstract.

Mimura T, Rizzello F, Helwig U, et al. Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut 2004;53:108-14. View abstract.

O'Mahony L, McCarthy J, Kelly P, et al. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology 2005;128:541-51. View abstract.

Phuapradit P, Varavithya W, Vathanophas K, et al. Reduction of rotavirus infection in children receiving bifidobacteria-supplemented formula. J Med Assoc Thai 1999;82:S43-S48. View abstract.

Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.

Rastall RA. Bacteria in the gut: friends and foes and how to alter the balance. J Nutr 2004;134:2022S-2026S. View abstract.

Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscess due to Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis 1999;28:1159-60. View abstract.

Roberfroid MB. Prebiotics and probiotics: are they functional foods? Am J Clin Nutr 2000;71:1682S-7S. View abstract.

Saavedra JM, et al. Feeding of bifidobacterium bifidum and streptococcus thermophilus to infants in hospital for prevention of diarrhea and shedding of rotavirus. Lancet 1994;344:1046-9. View abstract.

Sairanen, U., Piirainen, L., Grasten, S., Tompuri, T., Matto, J., Saarela, M., and Korpela, R. The effect of probiotic fermented milk and inulin on the functions and microecology of the intestine. J Dairy Res 2007;74(3):367-373. View abstract.

Saxelin M, Chuang NH, Chassy B, et al. Lactobacilli and bacteremia in southern Finland 1989-1992. Clin Infect Dis 1996;22:564-6. View abstract.

Scarpignato C, Rampal P. Prevention and treatment of traveler's diarrhea: A clinical pharmacological approach. Chemotherapy 1995;41:48-81. View abstract.

Sullivan A, Barkholt L, Nord CE. Lactobacillus acidophilus, Bifidobacterium lactis and Lactobacillus F19 prevent antibiotic-associated ecological disturbances of Bacteroides fragilis in the intestine. J Antimicrob Chemother 2003;52:308-11. View abstract.

Tabbers MM, Milliano I, Roseboom MG, Benninga MA. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study. Nutr J 2011;10:19. View abstract.

Tursi A, Brandimarte G, Giorgetti GM, et al. Low-dose balsalazide plus a high-potency probiotic preparation is more effective than balsalazide alone or mesalazine in the treatment of acute mild-to-moderate ulcerative colitis. Med Sci Monit 2004;10:PI126-31. View abstract.

Venturi A, Gionchetti P, Rizzello F, et al. Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis. Aliment Pharmacol Ther 1999;13:1103-8. View abstract.

Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. View abstract.