Generally, the monthly newsletter is on a specific topic related to probiotics. This month I thought I would present a potpourri of recent scientific articles on probiotic benefits.

1) Post Infectious Irritable Bowel Syndrome

There have been a number of studies published on the relationship between acute infectious gastroenteritis (diarrhea) and the subsequent development of ongoing symptoms of Irritable Bowel Syndrome (IBS). IBS is characterized by intermittent abdominal pain, altered bowel habits and other gastrointestinal symptoms such as bloating and flatulence in the absence of structural abnormalities in the intestine.

When healthy individuals develop gastroenteritis due to food and water contamination, studies have found up to 30% of the infected population will have chronic ongoing gastrointestinal symptoms of IBS.  The general opinion is that the infecting bacteria or parasite stimulated the immune system, leading to chronic inflammation(1,2,3).

Probiotics can suppress the inflammatory process and may alleviate symptoms. No study has been specifically done in post infectious IBS, but the safety and potential anti-inflammatory properties of probiotics make them an intriguing option for management of these patients (4,5,6).

Commentary
This can be a real concern for our military troops. A recent study reported that “infectious diarrhea is one of the most common medical problems associated with military deployments”  (7). Overall, diarrhea was reported in 76.8% of the troops in Iraq and 54.4% in Afghanistan (8). There have been no published reports on the use of probiotics in our troops, but it seems a reasonable to consider the use of probiotics to lessen the risk of gastroenteritis and post infectious IBS.

2) Anticancer Effect of Probiotics

Evidence that probiotics have anticancer activity has been emerging from laboratory studies. A recent study investigated the effect of a probiotic on the growth of colon cancer cells in a test tube and the development of colon cancer in mice (9). The probiotic suppressed the activity of a cell receptor called ErbB2 which has to do with cell division and growth. There is an anticancer drug called Herceptin that acts as an antibody to inhibit this receptor in breast cancer cells.

Commentary
There have been a number of studies on probiotics protective effect against colon cancer (10).  There are no direct experimental investigations for cancer suppression in human subjects using probiotics. However, there are a wealth of studies indicating indirect evidence for cancer suppression in human subjects. This study helps to identify one of the mechanisms how probiotics can prevent cancer development. Bottom line, it doesn’t hurt to take a probiotic.

3) Chemotherapy-Induced Diarrhea

Diarrhea is a common side effect induced by anticancer treatments such as chemotherapy and radiation. A recent case study reported on a patient receiving chemotherapy for breast cancer who developed severe diarrhea requiring discontinuation of the medication and hospitalization for 2 weeks(11). The patient was prescribed a probiotic to be taken twice daily. The probiotic controlled the intestinal symptoms and diarrhea, and no adverse effects were noticed. The patient reported that if she stopped taking the probiotics, the diarrhea returned immediately. The patient was discharged from the hospital and was able to continue the scheduled chemotherapy medications while taking the probiotic.

Commentary
Chemotherapy agents cause diarrhea by damaging the intestinal mucosa. In addition, the normal intestinal bacterial flora can be disrupted. A study published in 2007 on the frequency of severe diarrhea in patients receiving chemotherapy for colon cancer was reduced with the supplementation of a probiotic (12).  In addition, there was less abdominal discomfort, need for hospital care and fewer chemotherapy dose reductions due to bowel toxicity. No probiotic related toxicity was detected. Hopefully these reports will stimulate further clinical studies to determine whether probioitcs are an effective treatment for controlling diarrhea in patients receiving chemotherapy agents.

Take Home Message

Probiotics are entering a new era in clinical medicine. No longer are they just considered complimentary and alternative therapies.  Each month, there are new published reports on the therapeutic benefits of probiotics.

When you consider taking a probiotic, think EndoMune Advanced for adults and EndoMune Juniorfor children. These are high quality, potent probiotics!

Thank you for your interest in EndoMune.

Eat healthy, exercise and live well!
Dr. Lawrence Hoberman

(1) Travel and travelers’ diarrhea in patients with irritable bowel syndrome. DuPont HL, Galler G, Garcia-Torres F, Dupont AW, Greisinger A, Jiang ZD. Am J Trop Med Hyg. 2010 Feb;82(2):301-5.

(2) Bugs and irritable bowel syndrome: The good, the bad and the ugly. Ghoshal UC, Park H, Gwee KA.J Gastroenterol Hepatol. 2010 Feb;25(2):244-51. Epub 2010 Jan 14.

(3) Post-infectious irritable bowel syndrome.Thabane M, Marshall JK. World JGastroenterol. 2009 Aug 7;15(29):3591-6.Review

(4) Immunosuppressive effects via human intestinal dendritic cells of probiotic bacteria and steroids in the treatment of acute ulcerative colitis. Ng SC, Plamondon S, Kamm MA, Hart AL, Al-Hassi HO, Guenther T, Stagg AJ, Knight SC.Inflamm Bowel Dis. 2010 Feb 12.

(5) Probiotics have clinical, microbiologic, and immunologic efficacy in acute infectious diarrhea.Chen CC, Kong MS, Lai MW, Chao HC, Chang KW, Chen SY, Huang YC, Chiu CH, Li WC, Lin PY, Chen CJ, Li TY.Pediatr Infect Dis J. 2010 Feb;29(2):135-8.

(6) Probiotics: their role in the treatment and prevention of disease. Doron S, Gorbach SL.Expert Rev Anti Infect Ther. 2006 Apr;4(2):261-75. Review.

(7) Military importance of diarrhea: lessons from the Middle East.Sanders JW, Putnam SD, Riddle MS, Tribble DR.Curr Opin Gastroenterol. 2005 Jan;21(1):9-14. Review.

(8) Outcomes of diarrhea management in operations Iraqi Freedom and Enduring Freedom.Brown JA, Riddle MS, Putnam SD, Schlett CD, Armstrong AW, Jones JJ, Tribble DR, Sanders JW.Travel Med Infect Dis. 2009 Nov;7(6):337-43. Epub 2009 Sep 30.

(9) Int J Cancer. 2009 Oct 28. [Epub ahead of print]The anticancer effect of probiotic Bacillus polyfermenticus on human colon cancer cells is mediated through ErbB2 and ErbB3 inhibition.Ma EL,Choi YJChoi JPothoulakis CRhee SHIm E.

(10) The effects of probiotics on colon cancer development. Rafter J.Nutr Res Rev. 2004 Dec;17(2):277-84.

(11) Use of probiotics in the management of chemotherapy-induced diarrhea: a case study.Abd El-Atti S, Wasicek K, Mark S, Hegazi R. JPEN J Parenter Enteral Nutr. 2009 Sep-Oct;33(5):569-70. Epub 2009 May 7.

(12) Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study.Osterlund P, Ruotsalainen T, Korpela R, Saxelin M, Ollus A, Valta P, Kouri M, Elomaa I, Joensuu H.Br J Cancer. 2007 Oct 22;97(8):1028-34. Epub 2007 Sep 25.

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