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Probiotics for Acute Infectious Diarrhea?

Probiotics for Acute Infectious Diarrhea?

It’s hard to imagine if you haven’t heard of the term, probiotic, by now.  Television commercials mostly about probiotic yogurt have already flooded cable television networks.  You’ve probably at least heard of the Activia 14 day challenge or similar marketing campaigns from their competitors.  If that’s the case, then I have good news and bad news for you.  First, the bad news…  Yes, those annoying Activia commercials are not going away any time soon.  Now the good news, ongoing research on probiotics continues to substantiate the several health benefits that they confer.

Prebiotic vs Probiotic

To summarize, the current adopted version of probiotics by the FAO/WHO defines them as follows:

“Live microorganisms which when administered in adequate amounts confer a health benefit on the host.”

In contrast, prebiotics are non-digestible (by the host) food ingredients that stimulated the activity of beneficial bacteria.  Typically, this includes carbohydrates such as oligosaccharides.  Soluble fiber itself is the most common nutritional class of prebiotics.

Probiotics for Infectious Diarrhea in Children

Researchers in Taiwan published the results of a recent study on a pharmaceutical preparation of probiotics on acute infectious diarrhea in children ranging from 3 months to 6 years of age (Chen et al, 2010).  304 children were randomized to receive either placebo or Biothree 2.5 x 107 CFU/kg/d in 3 divided doses by oral administration
for 7 days.

The study authors found that Biothree significantly reduced the duration of diarrhea in these children from 86.3 hours in placebo to 60.1 hours in Biothree group.  As well, hospital stay was also reduced in the intervention group.

Specifically, the study authors concluded:

This probiotics mixture reduced the severity of diarrhea and length of hospital stay in children with acute diarrhea. In addition to restoring beneficial intestinal flora, probiotics may enhance host protective immunity such as down-regulation of pro-inflammatory cytokines and up-regulation of anti-inflammatory cytokines.

Probiotics for Traveler’s Diarrhea

One of my older posts summarized a review analysis of probiotics for preventing traveler’s diarrhea.  Traveler’s diarrhea can be the quickest way to ruin a good vacation to destinations such as Mexico.  I’ve been to Cancun and Cabo San Lucas and even the nagging concern over the possibility of a case of Montezuma’s Revenge can alter your vacation plans.

Speaking of Cabo San Lucas, I remember the time I was there playing a round of golf.  Though the smell was unnoticeable, there were brownish red streams on the sides of the golf course.  Curious as to how they were able to maintain golf courses with the shortage of available water, I asked one of the other golfers.  He blithely informed me that the reddish brown streams were sewage water and that was what they used to maintain the golf course…

Back to traveler’s diarrhea, McFarland concluded:

“Several probiotics (Saccharomyces boulardii and a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum) had significant efficacy (at preventing traveler’s diarrhea)”

Key points:

  • Recent research suggests that probiotics may be effective at shortening the duration of acute infectious diarrhea in children
  • Previous research supports probiotic use to lower the risk of contracting traveler’s diarrhea.


  1. Chen CC, Kong MS, Lai MW, Chao HC, Chang KW, Chen SY, Huang YC, Chiu CH, Li WC, Lin PY, Chen CJ, Li TY. Probiotics have clinical, microbiologic, and immunologic efficacy in acute infectious diarrhea.  Pediatr Infect Dis J. 2010 Feb;29(2):135-8.
  2. McFarland LV.  Meta-analysis of probiotics for the prevention of traveler’s diarrhea.  Travel Med Infect Dis. 2007 Mar;5(2):97-105.


  • Karen Ross

    Probiotics are the best! We take our Vidazorb chewables everyday since their Belly Boost for kids helped our little boy so much with his food intolerance and Eczema. It was awful and we are so thankful that we found something safe to help him! They are great for IBS that's for sure.

  • Lynn Fadale

    I have been suffering now for four days from severe diarrhea. I started feeling like I had the flu on Sunday with severe body aches. Even my skin hurt to touch. That was followed by severe diarrhea, fever, and nausea. I have lost seven pounds in four days. The first day I ate nothing. The second day I had a few saltine crackers. The third day I had a little rice. Yesterday the only time I wasn't nauseous was when I was lying down and I also started getting stomach cramps yesterday. I went to my doctor on Tuesday. She ran blood and urine tests and stool samples, prescribed Phenegan for the nausea (which didn't work), but no antibiotics. I thought she was waiting to see what it was before she prescribed the antibiotics. I went back today for the test results. She said my blood count was low and all the stool sample results had not come back so she still didn't know what it was; however, she did prescribe an antibiotic. Someone told me probiotics might help. I have someone bringing me some tonight. My doctor said she definitely thought it was not the flu because the diarrhea was too severe. Yesterday and this morning I couldn't even drink the water, gatorade and club soda I had been drinking. As soon as I stood up, it would go right through me. That seems to be better now. Is there anything else you would suggest? If you would suggest probiotics, what kind and what dosage? I would appreciate any suggestions or ideas you might have.

    • Jarret Morrow, M.D.

      Lynn, I'm sorry to hear that you're not feeling well. I can't really comment on your specific situation, since I just provide general information on this blog. Generally speaking, probiotics have been studied for preventing traveler's diarrhea, acute infectious diarrhea in children, and antibiotic associated diarrhea. The data for their efficacy is less robust in adults than children for the treatment of diarrhea associated with acute gastroenteritis. Some research suggests probiotics may exert antidiarrheal effects as well as shorten the duration and severity of diarrheal illness. Though a wide variety of strains, doses, and schedules have been studied, the most widely test and effective strains for gastroenteritis/diarrhea include Lactobacillus rhamnosus GG and Saccharomyces boulardii. I don't recommend specific products with my blog, but a product containing one or both of the above strains of probiotics would have the best research behind it at the moment.

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