Probiotics in management of Diarrhea

Probiotics in management of Diarrhea

The World Health Organization (WHO) estimates 8.1 million deaths occur yearly in children ( 5 years of age) with diarrhea accounting for 14% of those deaths . In addition to causing mortality, diarrhea elicits serious long-term effects with multiple episodes and persistent diarrhea affecting growth, nutrition, and cognition . Rotavirus is the most common cause of diarrhea in children . The beneficial effects of certain probiotics strains on preventing rotavirus-caused diarrhea have been studied. In one study, human infants aged 5 to 24 months who were admitted to a chronic medical care hospital were randomized to receive a standard infant formula or the same formula supplemented with Bifidobacterium bifidum (1.9×108 CFU/g) and Streptococcus thermophilus (1.4×107 CFU/g) for 14 days. The results demonstrated significantly lower numbers of children experiencing diarrhea who received the supplemented formula compared to un-supplemented control groups . Other beneficial effects recorded from clinical studies include shortening the duration of diarrhea by as much as 1.5 days and less shedding of rotavirus . The European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Pediatric Infectious Diseases recommend that only probiotic strains with proven clinical efficacy and in appropriate dosages be used as an adjunct to rehydration therapy for the management of children with acute diarrhea . Proven clinical efficacy was determined from formal systematic reviews of the literature; treatments were highly recommended if there was strong evidence from more than one systematic review of well-designed randomized control trials that a probiotic was more effective than a placebo. It was determined that probiotics L. reuteri (ATCC 55730), L. acidophilus LB, S. boulardii and a mixture of S. thermophilus, L. acidophilus and L. bulgaricus significantly reduced the duration of diarrhea when compared with placebo, particularly in rotaviral gastroenteritis . Effects of probiotics were also determined to be dose dependent dose-dependent, that is the effects were greater for doses higher than 1010 to 1011 colony-forming units . The World Gastroenterology Organization (WGO) included L. casei DN-114 001 in their evidence-based recommendation and pointed out that timing of administration (at the very first sign of illness) is considered highly important.

Antibiotic associated diarrhea: Many patients taking antibiotics that disturb the gastrointestinal flora experience diarrhea as a side effect. Symptoms range from mild and self-limiting to severe, and this antibiotic-associated diarrhea (AAD) is an important reason that patients refuse to take antibiotics or curtail their treatment regimen. Many studies indicate the ingestion of certain probiotic strains, primarily Lactobacilli either alone or in combination with other genera, before and during antibiotic treatment reduces the frequency, duration and severity of antibiotic induced diarrhea.