Probiotics?

[rachmoninov3]

I'm taking this infectious disease class in undergrad, and the prof. brought up the topic of probiotics, or using bacteria to treat a disease in a host. The idea comes from the idea that we are filled to the brim with our own normal collection of flora, and that disease (infectious disease especially) is caused by a change in the balanceo of our normal flora.

Example, c-dif, a common nosocomial infection, is hypothesized to occur when antibiotics taken for one infection also kill some of the bacteria in our gut. This allows c-dif, which is common in all healthy bowels at low levels, to grow to the point were clincal symptoms are observed.

So far, google results show only minimal results when using probiotics. However, with the rise in antibiotic resistance, and the idea of fighting fire with fire, this sounds real promising to me (which is purely an opinion at this point as most of the research seems to say otherwise). Has anyone else ever heard of this, or know of a case where probiotics are theraputic?

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[McDoctor]

There was some investigation into utilizing probiotics in management of IBD but I don't think it showed much promise.

Overall, there is probably scant research being done in probiotics primarily due to the fact that you cannot patent microorganisms and hence there is very little incentive to pour alot of money into large scale studies.

 

[USCguy]

Look up Jordan Rubin's story online. I"m pretty sure he used probiotics as part of his battle to overcome Crohn's disease. At the least, his story is inspiring. 👍

 

[albaniandoc]

The topic of probiotic is actually old. In my country we use like foods like yogurt that are loaded with probiotics like acidophilus to help offset the side effects of antibiotic therapy. In the mid 90s a bodybuilder by the name of Dorian Yates, 6 times Mr. Olympia developed the first protein meal replacement with high doses of acidophilus to help better digest the high doses of protein that bodybuilders take and help with the health of the gut. I used to personally use acidophilus and found it to be a great suplement when I used to work out hard.
Lately, I understand that some doctors will suggest to their patients to take acidophilus supplements when prescribing antibiotic therapy.
You can try doing a search under "acidophilus" on google and see what you come up with.
Good luck

 

[bananaface]

Acidophilus, lactobacillus, and Sacharomyces boulardii are encountered fairly commonly. I recommend that you do a PubMed search.

http://www.florastor.com/
http://www.culturelle.com/index.jsp

 

[SuperTrooper]

http://www.culturelle.com/index.jsp

I used culturelle a while back when i was having GI problems. This stuff is the best in my opinion - i noticed a difference. It's really expensive though; $18 for a package of 30 I believe. It's good because the bacteria lactobacillus GG is able to withstand the acidity of the stomach so it can get to the intestines. Other bacterial strains can't handle stomach acidity, and so are coated with something to get through the stomach. But who really knows if they're uncoated by the time they need to be.

 

[ljl1982]

I'm working with an attending in my Family Medicine clerkship who recommends probiotics for patients with Irritable Bowel Syndrome and/or symptoms of "abdominal bloating"

I did a quick PubMed search and have found some conflicting results. As previous posts have noted, not many randomized controlled studies have been done, and the outcomes measured (patients' perception of bloating symptoms, etc.) are difficult to measure objectively.
The IBS patients that I've seen with this attending seem to have symptomatic relief with probiotics (acidophilus i think), but he is the only attending in the group of 5 who uses this.

I searched PubMed using "probiotic AND IBS" and came up with a few interesting articles:
1. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating.
Neurogastroenterol Motil. 2005 Oct;17(5):687-96. CONCLUSION: VSL# 3 reduces flatulence scores and ******s colonic transit without altering bowel function in patients with IBS and bloating.

2. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial.
J Pediatr. 2005 Aug;147(2):197-201. Lactobacillus GG was not superior to placebo in the treatment of abdominal pain in children with IBS but may help relieve such symptoms as perceived abdominal distention.

3. The efficacy of Lactobacillus reuteri ATCC 55730 in the treatment of patients with irritable bowel syndrome--a double blind, placebo-controlled, randomized study. CONCLUSIONS: IBS symptoms did not improve with probiotic treatment with L. reuteri. A strong placebo effect and a lack of uniformity of the IBS population may have hindered a clearer demonstration of the effect.


<side note> sometimes this whole EBM/looking up articles thing can actually be helpful 🙂

I used culturelle a while back when i was having GI problems. This stuff is the best in my opinion - i noticed a difference. It's really expensive though; $18 for a package of 30 I believe. It's good because the bacteria lactobacillus GG is able to withstand the acidity of the stomach so it can get to the intestines. Other bacterial strains can't handle stomach acidity, and so are coated with something to get through the stomach. But who really knows if they're uncoated by the time they need to be.