You mention that bifidobacteria can improve irritable bowel symptoms and may be superior to lactobacilli (“Latest review aims to simplify irritable bowel,” February 2010). A nutritionist once told me that probiotics in a dry form are useless, as bacteria cannot be a “live, active culture” in a dry medium. Also, many of my patients have gastroesophageal reflux disease and find taking tablets or capsules irritating to the esophagus. I have been unable to find a liquid bifidobacteria supplement.—JOAN SOBSEY, NP, Staten Island, N.Y.
Consider a pudding, yogurt, or milk product enriched with bifidobacteria. Also, there is no reason a person who has difficulty tolerating a capsule could not open it and mix the dry contents into another food. Finally, my May 2009 update on probiotics might be helpful.—Sherril Sego, FNP-C, DNP (138-9)