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.

References:

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.