Probiotics
Thursday, January 29, 2009
Probiotics are living microorganisms used to colonize the intestine to prevent or alleviate disease. The most common probiotics are bacteria of the Lactobacillus and Saccharomyces species. They may be used to prevent and treat antibiotic-associated diarrhea and acute infectious diarrhea. They may also be effective in relieving symptoms of irritable bowel syndrome, and in treating atopic dermatitis in children.
Typical dosages range from 5-10 billion CFU’s/day (colony forming units/day) for children and 10-20 billion CFU’s/day for adults. Adverse reactions are rare and there are no known interactions with medications. Probiotics should, however, be separated from any antibiotics by a couple of hours to prevent these medications from working against each other.
Antibiotic Associated Diarrhea
Antibiotic associated diarrhea is diarrhea caused by loss of normal intestinal flora secondary to taking antibiotics. When the antibiotics kill normal bacteria in the intestines then overgrowth of bacteria such as Clostridium Difficile can occur. This leads to colitis and diarrhea that requires treatment with additional antibiotics to cure. Preventing this unintended side effect of antibiotics would save patients anguish, time, and money.
Probiotics that contain species of Lactobacillus or Saccharomyces decrease the likelihood of diarrhea from antibiotics in children or adults (absolute risk reduction: 13 to 23 percent). Ten patients would need to be treated to prevent one episode of antibiotic associated diarrhea. Patients should look for these products in the “diarrhea section” of the pharmacy. A typical dosage is 5 to 10 billion viable organisms administered three to four times a day.
Most probiotics do not colonize the lower GI tract in a durable fashion. Even the most resilient strains generally can be cultured in stool for only one to two weeks after ingestion. To maintain colonization probiotics must be taken regularly, but they do not have to be taken regularly simply to prevent antibiotic associated diarrhea.
Infectious Diarrhea
Several studies have shown that probiotics can decrease the incidence and duration of infectious diarrhea of all causes. The mean reduction in duration was about thirty hours.
Atopic Dermatitis
Several studies have shown that prenatal probiotic administration to mothers followed by post-natal probiotic administration to high-risk infants can reduce the incidence of atopic dermatitis (also known as eczema). Additionally, children who already had atopic dermatitis improved their symptoms by taking probiotics.
Probiotics are not expensive and can be found in many yogurts with so called “active cultures.” Culturelle, Align, Primadophilus, and Florastor are all probiotics available over-the-counter in pill form. A site like Consumer lab can help you make informed decisions about probiotics.
Patients with severe immunocompromise should not take probiotics. Talk to your doctor if you have other questions, or send us a message using the form below.
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