Probiotics

Probiotics can often be a good natural remedy for simple–if annoying– gastrointestinal complaints.  They are defined as ” live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” These products have been tried in a variety of situations.  The medical literature is actually quite extensive but, at the same time, conclusions are rather spotty.  Nevertheless I think they are useful in the right setting and, in particular, (“naturally”) I favor their use over most medicines in many instances.

Historically, probiotics have been among the top 3 non-vitamin, non-mineral supplements given to children ages 4-17.  They seem to be most helpful in 2 clinical situations: acute gastroenteritis (AGE) and in the prevention of post-antibiotic diarrhea.  For these conditions the data is quite strong.  For instance, in the latter, probiotic use in one study of over 3,000 children showed a 52% reduction in the risk of diarrhea.  The efficacy of the treatment seems most tied to 2 things.  Firstly is the organism used and the second parameter is the dose of treatment.  The most extensively studied organisms–and those with the best “track record” –are Lactobacillus rhamnosus GG and Saccharomyces boulardii.  For both, 5 billion CFU (“colony forming units”) once or twice daily for 2-4 days seems to be enough to be helpful.  Both of these treatments are available as commercial products in either chewable or packet form and can be purchased in pharmacies or health food stores (I do not list brand names of products in my blog posts).

People have also tried probiotics for a number of other medical conditions like community acquired infections, colic, eczema, and even more severe medical problems like Clostridium dificile (“C dif”) infections and inflammatory bowel diseases like Crohn’s or ulcerative colitis.  Here there is considerably less evidence to support their use so I do not recommend that you rely on probiotics for those problems.  Additionally, many brands of yogurt are touted as a useful source of probiotics.  However, recent studies have not shown significant benefit of yogurt as a probiotic in any of the above medical conditions.  Food experts postulate that there probably aren’t enough “CFU” organisms in yogurt to be effective.

Lastly, we should recall that this treatment utilizes living organisms.  Therefore, use in infants or immunocompromised children–those with HIV, cancer, or receiving other immunosuppressive treatments or with other immune compromised conditions–is not recommended and could even be quite dangerous.

Much of the above information is summarized from a very useful article I found in a professional journal “Infectious Diseases in Children” written by Edward Bell, PharmD at Drake University, Des Moines, Iowa.  So a “shout out” to Dr. Bell for his help here.

Please send along questions and comments, and thanks for following.