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While probiotic spores can confer health benefits, it is believed that germination of the spores is required for some probiotic activity (i.e. short chain fatty acids, antimicrobial peptides, enzymes, etc.).

A novel clinical trial in 11 ileostomy participants was conducted to directly investigate the presence and germination of the probiotic strain Bacillus subtilis DE111® in the small intestine.

Material from the ileostomy bags was collected every hour and analyzed for the presence of DE111 spores and vegetative cells. The figure below shows that DE111 spores and vegetative cells started showing up in ileal bags 3 hours post-ingestion and increased until about 6 hours