Summary
In recent years, a large body of literature has been generated on the use of probiotics. Regarded initially as alternative medicine, probiotics – mostly lactic acid bacteria – has gained their position in mainstream medicine, after a robust research activity covering both in vitro and in vivo studies, as well as randomized clinical trials. In terms of diarrheal diseases, the most promising applications appear in the prevention and/or the treatment of acute gastroenteritis, antibiotic-associated diarrhea, neonatal-necrotizing enterocolitis, and ulcerative colitis. It should be kept in mind that different strains of probiotics have different specificities, so no generalizations on the efficacy (or lack thereof) of “probiotics” should be made. This chapter will analyze the evidence for the use of probiotics in such diarrheal diseases; in some cases this is quite consolidated, in others still emerging.
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References
Guandalini S. An update on the role of probiotics in the therapy of pediatric inflammatory bowel disease. Exp Rev Clin Immunol 2010;6:47–54.
Oberhelman RA, et al. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr 1999;134(1):15–20.
Pereg D, et al. The effect of fermented yogurt on the prevention of diarrhea in a healthy adult population. Am J Infect Control 2005;33(2):122–125.
Pedone CA, et al. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract 2000;54(9):568–571.
Hatakka K, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ 2001:322(7298):1327.
Thibault H, Aubert-Jacquin C, Goulet O. Effects of long-term consumption of a fermented infant formula (with Bifidobacterium breve c50 and Streptococcus thermophilus 065) on acute diarrhea in healthy infants. J Pediatr Gastroenterol Nutr 2004;39(2):147–152.
Chouraqui JP, Van Egroo LD, Fichot MC. Acidified milk formula supplemented with Bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pediatr Gastroenterol Nutr 2004:38(3):288–292.
Saavedra JM, et al. Long-term consumption of infant formulas containing live probiotic bacteria: tolerance and safety. Am J Clin Nutr 2004;79(2):261–267.
Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005;115(1):5–9.
Binns CW, et al. The CUPDAY Study: prebiotic–probiotic milk product in 1–3-year-old children attending childcare centres. Acta Paediatr 2007:96(11):1646–1650.
Mastretta E, et al. Effect of Lactobacillus GG and breast-feeding in the prevention of rotavirus nosocomial infection. J Pediatr Gastroenterol Nutr 2002;35(4):527–531.
Saavedra JM, et al. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet 1994;344(8929):1046–1049.
Szajewska H, et al. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr 2001;138(3):361–365.
McFarland LV. Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Med Infect Dis 2007;5(2):97–105.
Basu S, et al. Efficacy of high-dose Lactobacillus rhamnosus GG in controlling acute watery diarrhea in Indian children: a randomized controlled trial. J Clin Gastroenterol 2009:43(3):208–213.
Basu S, et al. Efficacy of Lactobacillus rhamnosus GG in acute watery diarrhoea of Indian children: a randomised controlled trial. J Paediatr Child Health 2007;43(12):837–842.
Canani RB, et al. Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations. BMJ 2007;335(7615):340.
Fang SB, et al. Dose-dependent effect of Lactobacillus rhamnosus on quantitative reduction of faecal rotavirus shedding in children. J Trop Pediatr 2009;55(5):297–301.
Guandalini S, et al. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J Pediatr Gastroenterol Nutr 2000;30(1):54–60.
Guarino A, et al. Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea. J Pediatr Gastroenterol Nutr 1997;25(5):516–519.
Isolauri E, et al. A human Lactobacillus strain (Lactobacillus casei sp strain GG) promotes recovery from acute diarrhea in children. Pediatrics 1991;88(1):90–97.
Isolauri E, et al. Oral bacteriotherapy for viral gastroenteritis. Dig Dis Sci 1994;39(12):2595–2600.
Kaila M, et al. Viable versus inactivated lactobacillus strain GG in acute rotavirus diarrhoea. Arch Dis Child 1995;72(1):51–53.
Kaila M, et al. Enhancement of the circulating antibody secreting cell response in human diarrhea by a human Lactobacillus strain. Pediatr Res 1992;32(2):141–144.
Majamaa H, et al. Lactic acid bacteria in the treatment of acute rotavirus gastroenteritis. J Pediatr Gastroenterol Nutr 1995;20(3):333–338.
Pant AR, et al. Lactobacillus GG and acute diarrhoea in young children in the tropics. J Trop Pediatr 1996;42(3):162–165.
Rautanen T, et al. Management of acute diarrhoea with low osmolarity oral rehydration solutions and Lactobacillus strain GG. Arch Dis Child 1998;79(2):157–160.
Raza S, et al. Lactobacillus GG in acute diarrhea. Indian Pediatr 1995;32(10):1140–1142.
Raza S, et al. Lactobacillus GG promotes recovery from acute nonbloody diarrhea in Pakistan. Pediatr Infect Dis J 1995;14(2):107–111.
Shornikova AV, et al. Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis. Pediatr Infect Dis J 1997;16(12):1103–1107.
Misra S, Sabui TK, Pal NK. A randomized controlled trial to evaluate the efficacy of lactobacillus GG in infantile diarrhea. J Pediatr 2009;155(1):129–132.
Billoo AG, et al. Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea. World J Gastroenterol 2006;12(28):4557–4560.
Htwe K, et al. Effect of Saccharomyces boulardii in the treatment of acute watery diarrhea in Myanmar children: a randomized controlled study. Am J Trop Med Hyg 2008;78(2):214–216.
Kurugol Z, Koturoglu G. Effects of Saccharomyces boulardii in children with acute diarrhoea. Acta Paediatr 2005;94(1):44–47.
Ozkan TB, et al. Effect of Saccharomyces boulardii in children with acute gastroenteritis and its relationship to the immune response. J Int Med Res 2007;35(2):201–212.
Villarruel G, et al. Saccharomyces boulardii in acute childhood diarrhoea: a randomized, placebo-controlled study. Acta Paediatr 2007;96(4):538–541.
Anukam KC, et al. Yogurt containing probiotic Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 helps resolve moderate diarrhea and increases CD4 count in HIV/AIDS patients. J Clin Gastroenterol 2008;42(3):239–243.
Rosenfeldt V, et al. Effect of probiotic Lactobacillus strains on acute diarrhea in a cohort of nonhospitalized children attending day-care centers. Pediatr Infect Dis J 2002;21(5):417–419.
Rosenfeldt V, et al. Effect of probiotic Lactobacillus strains in young children hospitalized with acute diarrhea. Pediatr Infect Dis J 2002;21(5):411–416.
Shornikova AV, et al. Lactobacillus reuteri as a therapeutic agent in acute diarrhea in young children. J Pediatr Gastroenterol Nutr 1997;24(4):399–404.
Henker J, et al. The probiotic Escherichia coli strain Nissle 1917 (EcN) stops acute diarrhoea in infants and toddlers. Eur J Pediatr 2007;166(4):311–318.
Henker J, et al. Probiotic Escherichia coli Nissle 1917 versus placebo for treating diarrhea of greater than 4 days duration in infants and toddlers. Pediatr Infect Dis J 2008;27(6):494–499.
Lievin-Le Moal V, Sarrazin-Davila LE, Servin AL. An experimental study and a randomized, double-blind, placebo-controlled clinical trial to evaluate the antisecretory activity of Lactobacillus acidophilus strain LB against nonrotavirus diarrhea. Pediatrics 2007;120(4):e795–e803.
Salazar-Lindo E, et al. Effectiveness and safety of Lactobacillus LB in the treatment of mild acute diarrhea in children. J Pediatr Gastroenterol Nutr 2007;44(5):571–576.
Dubey AP, et al. Use of VSL[sharp]3 in the treatment of rotavirus diarrhea in children: preliminary results. J Clin Gastroenterol 2008;42(Suppl 3 Pt 1):S126–S129.
Szajewska H, et al. Meta-analysis: Lactobacillus GG for treating acute diarrhoea in children. Aliment Pharmacol Ther 2007;25(8):871–881.
Vandenplas Y, Brunser O, Szajewska H. Saccharomyces boulardii in childhood. Eur J Pediatr 2009;168(3):253–265.
Szajewska H, Skorka A, Dylag M. Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther 2007;25(3):257–264.
Hauck FH, et al. Imerslund-Grasbeck syndrome in a 15-year-old German girl caused by compound heterozygous mutations in CUBN. Eur J Pediatr 2008;167(6):671–675.
Gaon D, et al. Effect of Lactobacillus strains and Saccharomyces boulardii on persistent diarrhea in children. Medicina (B Aires) 2003;63(4):293–298.
Alfaleh K, Anabrees J, Bassler D. Probiotics reduce the risk of necrotizing enterocolitis in preterm infants: a meta-analysis. Neonatology 2009;97:93–99.
Lin H, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics 2008;122:693–700.
Vanderpool C, Yan F, Polk DB. Mechanisms of probiotic action: implications for therapeutic applications in inflammatory bowel diseases. Inflamm Bowel Dis 2008;14(11):1585–1596.
Butterworth AD, Thomas AG, Akobeng AK. Probiotics for induction of remission in Crohn’s disease. Cochrane Database Syst Rev 2008(3):CD006634.
Pastorelli L, et al. Emerging drugs for the treatment of ulcerative colitis. Expert Opin Emerg Drugs 2009;14(3):505–521.
Miele E, et al. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009;104(2):437–443.
Sood A, et al. The probiotic preparation, VSL#3 induces remission in patients with mild-to-moderately active ulcerative colitis. Clin Gastroenterol Hepatol 2009;7(11):1202–1209.
Guandalini S, et al. VSL#3 improves symptoms in children with irritable bowel syndrome. A multicenter, randomized, placebo-controlled, double-blind, cross-over study. J Pediatr Gastroenterol Nutr 2010;51:24–30.
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Guandalini, S. (2010). Probiotics for Diarrheal Diseases. In: Guandalini, S., Vaziri, H. (eds) Diarrhea. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-183-7_27
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DOI: https://doi.org/10.1007/978-1-60761-183-7_27
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