Probiotics

Probiotics, according to a large number of  studies indicate that probiotics help restore and maintain healthy guts leading to overall better health.

What Causes Gas – Is it a Normal Occurence?

All humans have gas in their gastrointestinal tract. The type of food, and beverages consumed and whether the individual smokes or chews gum will have a significant impact on the amount of gas produced and passed. Carbonated beverages will increase intestinal gas. Eating a healthy diet of fruits, vegetables and high fiber grains increases intestinal gas formation.

Dependent upon how it is measured, the gas in the intestinal tract varies from 3 to 6 ounces. The average adult produces 16 to 48 ounces of intestinal gas resulting in about 14 to 23 gas passages/day.

  • Complex Carbohydrates: The human intestinal tract can’t digest some of the complex carbohydrates in vegetables, fruits and whole grain products. These carbohydrates pass through the small intestines into the colon where they are fermented by gas producing bacteria. Hydrogen, carbon dioxide and methane are the main gases produced. Depending on the diet and the intestinal microflora, the amount of gas produced and expelled will vary from individual to individual. The strong odor sometimes associated with intestinal gas is due to the very small production of sulfide gases which is dependent on diet and intestinal bacteria.
  • Lactose is a sugar in dairy products which must be broken down to a simpler form to be absorbed by the intestines. Thirty to 50 million Americans develop lactose intolerance beginning after the age of 2. It is a common problem in the Asian, African American, American Indian, Hispanic, and Eastern European Jewish populations. Undigested lactose prevents fluid absorption and the sugar is fermented by the bacteria in the colon which results in increased intestinal gas and at times, diarrhea. The main form of therapy is to avoid lactose containing foods.
  • Fructose: Another dietary sugar that can cause excessive gas, bloating and loose stools is fructose. Fruits that are high in fructose include apples, apricots, pears, cherries, plums, prunes and peaches (as well as their juices). It is also a used as sweetener in soft drinks and other products. The small intestine has a limited ability to absorb dietary fructose. If it is exceeded, fructose will be fermented in the colon leading to excess gas formation.
  • Sorbitol is found naturally in fruits, including apples, pears, peaches, and prunes. It is also used as an artificial sweetener in many dietetic foods and sugar free candies and gums. Sorbitol is not well absorbed by the small intestines. Excess intake will also lead to bloating, gas, and diarrhea.

Studies have found that some individuals with symptoms of bloating and distention may be more sensitive to the amount of gas and fluid in the intestines. Some may have slow intestinal motility leading more fluid and gas in the intestines.

Having the right balance of bacteria in the intestines can be important to lessen the symptoms of bloating, distention and gas.

Probiotics, containing bacterial strains similar to those in Endomune have been studied and utilized to help lessen these symptoms. There have been positive results in many of the studies. There are no effective prescription medications to alleviate excess gas formation. One of the nice aspects of probiotics is the fact that they are safe and without significant side effects. Given the positive studies, taking Endomune may improve the digestion and absorption of the complex and simple carbohydrates.

How Probiotics Can Aid IBS Sufferers

I have spent a lot of time talking with physicians, pharmacists, and patients about the benefits of probiotics. The one topic that comes up most frequently is how probiotics can aid individuals who suffer with Irritable Bowel Syndrome (IBS).

IBS affects up to one in five Americans. Second only to the common cold as a leading cause of workplace absenteeism in the U.S., IBS costs the U.S. healthcare system up to an estimated $30 billion annually in direct and indirect costs.

Medical Presciptions for IBS

When I first went into gastroenterology, the understanding of IBS was very limited. It was generally thought that the symptoms of bloating, gas, diarrhea, and constipation were most likely related to stress. If the intestinal symptoms were manifestation of the stress, then controlling the stress would alleviate the problem. Commonly prescribed therapies included tranquilizers like Librium and phenobarbitol, and antidepressants like Elavil and Aventyl, which were then combined with other drugs – antispasmotics – that affected the nerves that go to the GI tract.  The typical drug armament included such medications as Librax, Bentyl, Levsin and Donnatal. They were relatively safe, but did have side effects of dry mouth and sedation.

Other longtime therapies have included fiber type products that increase stool bulk, like Metamucil and Fibercon.

More recently, drugs that interact with serotonin receptors in the GI tract have been developed. Serotonin is a neurotransmitter that is primarily found in the gastrointestinal tract and in the brain. Serotonin increases intestinal motility, probably by stimulation of 5-HT4 and 5-HT3 receptors. Two prescription medications that interact with the serotonin receptors were developed and approved by the FDA.

Zelnorm, approved by the FDA in 2002, eases constipation by stimulating the 5HT4 serotonin receptor.  It was withdrawn from the market in 2007 due to serious adverse effects on the blood supply to the intestines.

Lotronex was approved by the FDA in 2000 for women with severe diarrhea-predominant irritable bowel syndrome. Lotronex blocks the 5HT3 serotonin receptor. It is called a 5HT3 antagonist. Clinical studies showed only a 15-20% improvement in diarrhea symptoms in patients taking Lotronex versus placebo.  There have been serious adverse effects associated with this medication. Overall, Lotronex has very limited use in treating IBS patients.

A major concern with prescribing prescription medications is adverse drug interactions. Most medications are metabolized and eliminated by the liver. In the liver there are enzymes that can modify and eliminate drugs. The blood level of a specific medication can be increased or decreased by a second drug’s effect on the liver enzymes. The second medication can induce or inhibit the enzyme system resulting in elevated or reduced blood levels of the first drug. Changing the blood level of a medication can cause significant adverse drug reactions.

What About Probiotics for IBS Sufferers?

Here is the good news with regard to probiotics:

  1. Probiotics are safe and not associated with any severe adverse effects in healthy individuals.
  2. There are no drug interactions with other medications.
  3. Studies have shown that probiotics can alleviate symptoms of IBS.

Two recent reports(1, 2) reviewed the available studies using probiotics to treat symptoms of IBS. Both reports concluded that probiotics appear to be efficacious in IBS but the magnitude of the benefit and the most effective species and strains are uncertain. This means that probiotics show statistical significance in reducing IBS symptoms compared to patients taking a placebo. The problem is determining what types of probiotic bacteria and what dosage of probiotics work best.

There are a number of studies that indicate that the dosage of a multispecies/strain probiotic should be at least 5-10 billon organisms per day.

The mechanisms by which probiotics lessen IBS symptoms are being actively investigated(3).  For example, studies have shown that the bacterial flora in patients with IBS is different than in individuals without IBS symptoms. The bacteria in IBS patients can produce increased gases like methane which causes constipation and bloating(4). By altering the bacteria population with probiotics, it is possible to lessen methane production and ease symptoms of constipation.

I can go on about how probiotics improve intestinal function, but I am afraid I will start to bore you.

The point I am trying to make is that probiotics can help people with IBS symptoms, and they are very safe. If you have symptoms, then consider a trial of a probiotic. Obviously, if you have new onset symptoms, it is best to consult your physician first.

The problem is trying to choose the right probiotic product. It’s important to consider:

  1. Dosage per serving size – how many billon organisms/serving?
  2. Number and type of different probiotic bacteria – how many Lactobacillus, Bifidobacteria strains in each serving?
  3. What is the shelf life at room temperature?
  4. Does the product also contain fructooligosaccharides (FOS) – prebiotics*?
  5. Is the packaging in dark, glass bottles, helping to lessen exposure to oxygen and sun light?

Take Home Message

If you have symptoms of IBS, consider taking an excellent probiotic like EndoMune Advanced. Each capsule contains 10 different bacteria strains.  A serving size of two capsules contains 16 billon organisms and 50mg of FOS.

For children, consider EndoMune Junior. Each serving size of ¼ Tsp contains four bacterial strains, a total of 10 billon organisms, and 50mg of FOS.

Eat healthy and live well!
Lawrence J Hoberman MD

*FOS are prebiotics. Prebiotics are starches in foods like those found in the fiber of fruits, beans and the bran in whole grain breads and cereals. They are called resistant starches because our intestines can’t break them down. These starches enter the colon and are used as nourishment by the good bacteria, Lactobacillus and Bifidobacteria. These bacteria ferment these starches and produce short chain fatty acids that nourish the colon cells and enhance its healthy function.

(1) The efficacy of probiotics in the therapy of irritable bowel syndrome: a systematic review.Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein A, Brandt L, Quigley E.Gut. 2008 Dec 17.

(2) Meta-analysis of probiotics for the treatment of irritable bowel syndrome. McFarland LV, Dublin S.World J Gastroenterol. 2008 May 7;14(17):2650-61.

(3) The role of probiotics in management of irritable bowel syndrome. Borowiec AM, Fedorak RN.Curr Gastroenterol Rep. 2007 Oct;9(5):393-400.

(4) Methane and the Gastrointestinal Tract.Sahakian AB, Jee SR, Pimentel M. Dig Dis Sci. 2009 Oct 15.

Probiotics Help with Stress Reduction

This is a wonderful time of the year. The holiday season is about relaxing and visiting with family and friends. It’s a special time when many of us redirect our attentions to sharing and giving to those less fortunate.

It goes without saying, though, that the holidays can be stressful. There are so many things to do and many people to visit – perhaps even people with whom we’d rather not spend time!

With this in mind, I wanted to share with you a new medical report about the benefits of probiotics in lessening stress and anxiety.  I know what you’re thinking; How could the bugs in our gut affect our mood?

Probiotics: The Anti-Stress Pill?

A recent article in the British Journal of Nutrition(1) reported the beneficial psychological effects of probiotics. Years of research studies have already established a link between stress and gastrointestinal diseases, such as irritable bowel syndrome and ulcerative colitis(2,3). Based on these studies, it’s reasonable to conclude that probiotics may have a positive influence on our moods. The article explored various studies.

One study was a randomized, placebo-controlled pilot study that found probiotics to improve the emotional symptoms of chronic fatigue syndrome patients(4). This finding was the result of two studies. The first study, conducted on rats, gave one group a daily dose of probiotic bacteria for two weeks, and the other group received a placebo. The animals were then given a mild shock from an electrode. The rats that received the probiotic had lower stress and anxiety scores as compared to the control group.

After conducting the test on rats, the researchers moved to human volunteers; participants received either a probiotic or a placebo for 30 days. Everyone was given a battery of psychological tests at the beginning and at the completion of the study.

These tests assessed levels of stress and anxiety. Psychological distress, including measures of depression, anger-hostility, anxiety and problem solving were significantly improved in individuals who received the probiotics, as compared to those in the placebo group.

The researchers concluded that “the results of these studies provide further evidence that gut microflora play a role in stress, anxiety and depression”.(1)

Researches have inferred two possible reasons for the results: (1) the intestinal bacteria send signals via nerves going from the intestinal tract to the brain, or (2) the bacteria release mood-enhancing substances that travel through the blood stream to the brain. Further studies will be needed to confirm the findings, but probiotics might be a novel additional therapy in treating psychiatric disorders.

Take Home Message

This brings us back to the holidays. If you are shopping and planning for special family and friend gatherings, you may be feeling just a little bit of stress. Consider taking a high quality probiotic like EndoMune. It might just ease some of the holiday stress and prevent any GI disturbances.

Best wishes for a very happy holiday season and a healthy New Year!!

Eat healthy and live well!
Lawrence J Hoberman MD

References:

(1) Assessment of psychotropic-like properties of a probiotic formulation ( Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Messaoudi M, Lalonde R, Violle N, Javelot H, Desor D, Nejdi A, Bisson JF, Rougeot C, Pichelin M, Cazaubiel M, Cazaubiel JM. Br J Nutr. 2010 Oct 26:1-9.

(2) The Brain-Gut Axis in Abdominal Pain Syndromes. Mayer EA, Tillisch K.Annu Rev Med. 2010 Jan 27.

(3) Curr Mol Med. 2008 Jun;8(4):282-98.The role of microbiota and probiotics in stress-induced gastro-intestinal damage.Lutgendorff FAkkermans LMSöderholm JD.

(4) A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome.Rao AV, Bested AC, Beaulne TM, Katzman MA, Iorio C, Berardi JM, Logan AC.Gut Pathog. 2009 Mar 19;1(1):6.

 

How Can Probiotics Keep Children Healthy?

During the holiday season, I thought I would dedicate this newsletter to discussing how probiotics can help keep children healthy. This discussion will review two articles that have been published in the last month about the benefits of probiotics for children.

Probiotics and Acute Infectious Diarrhea

The first study was to determine whether probiotics have clinical benefit for children with acute infectious diarrhea (1).

Study design:
The study involved 304 children, ages 3 months to 6 years who were hospitalized for acute diarrhea. All the children received rehydration therapy via intravenous fluids and oral rice or half strength formula as age appropriate. The children were randomized to receive a probiotic preparation or a placebo. The benefit of the treatment was assessed in terms of recovery time to the first normal stool. Other clinical symptoms evaluated included fever, vomiting, abdominal pain and appetite.

Results:
The average duration of diarrhea after start of therapy was reduced from 86.3 hours in the placebo group to 60.1 hours in the probiotic group. There was also lessening of abdominal pain, fever and overall length of hospital stay.

Discussion:
To understand how probiotics benefited these children, the immunologic effects of probiotics were evaluated. The study reveals the immune cells of the intestine reacted in two ways; 1) by increasing production of molecules that decrease inflammation and 2) by increasing the quantity of protective intestinal bacteria (bifidobacteria and lactobacillus).

While other studies have shown that probiotics can lessen infectious diarrhea in children, this is the first study that has simultaneously evaluated the clinical, immunologic, and microbiologic effects of probiotics.

Probiotics and Chronic Abdominal Pain (CAP)

The second article deals with the occurrence of chronic abdominal pain (CAP) in children. CAP accounts for approximately 25% of pediatric gastroenterology office visits.

This study’s purpose was to determine if excess build up of intestinal bacteria in the small intestine could be a common cause of the CAP symptoms (2). This condition is called small intestinal bacterial overgrowth and is referred to as “SIBO”. Sometimes, the bacteria in the small intestines can increase and disrupt the normal digestive process. When this occurs, diarrhea, excess gas, and abdominal pain can occur.

Study Design:
This study evaluated children ages 8 to 18. Of those involved in the study, 40 were healthy and 75 had chronic abdominal. Using a breath hydrogen test, it was possible to determine if there was abnormal buildup of small bowel bacteria.

Results:
The study found 91% of children with CAP had abnormal breath hydrogen indicating excess small intestinal bacteria, or SIBO. The control group had a 35% positive breath test.

Discussion:
This study found an objective measure to explain chronic abdominal pain in these children.  Often, psychological explanations are proposed to explain the ongoing symptoms, and the correct diagnosis is missed.

To the best of the authors’ knowledge, this is the first report on the frequency of abnormal breath hydrogen test in children with CAP.

If the breath test is abnormal, then the current recommended therapy is to use antibiotics to decrease the bacterial count in the small bowel (3).  Studies have shown up to a 75% improvement in symptoms after a course of antibiotics. Sometimes there is a relapse and further courses of antibiotics are required (4).

Another approach to treat SIBO is to give probiotics.  A recent study using a probiotic in patients with SIBO found a 47% decrease or normalization of the breath hydrogen test (5). The authors concluded that, “probiotics are a promising, easily handled and well-tolerated treatment option for SIBO”. In addition, since SIBO has a high recurrence rate, the availability of a treatment alternative to antibiotics could reduce both the risk of antibiotic resistance and the incidence of side effects.

Take Home Message

Current medical research continues to gain a better understanding of how the intestinal bacteria affect the function and health of our intestines. The results of these studies certainly further our knowledge about how probiotics can improve gastrointestinal disorders in children. Consider discussing with your child’s doctor taking a good probiotic, like EndoMune, if your child is having a problem with infectious diarrhea or chronic abdominal pain.

Best wishes for a very healthy happy holiday season and New Year!!

Eat healthy and live well!
Lawrence J Hoberman MD

(1) Probiotics Have Clinical, Microbiologic, and Immunologic Efficacy in Acute Infectious Diarrhea Chen, Chien-Chang; Kong, Man-Shan; Lai, Ming-Wei; Chao, Hsun-Chin; Chang, Kuei-Wen; Chen, Shih-Yen; Huang, Yhu-Chering; Chiu, Cheng-Hsun; Li, Wen-Chen; Lin, Pen-Yi; Chen, Chih-Jung; Lin, Tzou-YienThe Pediatric Infectious Disease Journal.2010 Feb;29(2)

(2) Chronic Abdominal Pain in Children Is Associated with High Prevalence of Abnormal Microbial Fermentation.Collins BS, Lin HC.Dig Dis Sci. 2009 Nov 4.

(3) Small intestinal bacterial overgrowth: diagnosis and treatment.Gasbarrini A, Lauritano EC, Gabrielli M, Scarpellini E, Lupascu A, Ojetti V, Gasbarrini G.Dig Dis. 2007;25(3):237-40.

(4) Small intestinal bacterial overgrowth recurrence after antibiotic therapy. Lauritano EC, Gabrielli M, Scarpellini E, Lupascu A, Novi M, Sottili S, Vitale G, Cesario V, Serricchio M, Cammarota G, Gasbarrini G, Gasbarrini Am J Gastroenterol. 2008 Aug;103(8):2031-5.

(5) Bacillus clausii as a treatment of small intestinal bacterial overgrowth. Gabrielli M, Lauritano EC, Scarpellini E, Lupascu A, Ojetti V, Gasbarrini G, Silveri NG, Gasbarrini A.Am J Gastroenterol. 2009 May;104(5):1327-8. Epub 2009 Apr 7.

 

Inflammatory Bowel Disease Increases Risk of Malnutrition

Inflammatory Bowel Disease (IBD) increases the risk of malnutrition in both adults and children, according to the American College of Gastroenterology. This incidence, likely due to malabsorption of essential nutrients, was the result of a recent study among a cross-section of adults a pediatric patients.

The study addressed patients with both Ulcerative Colitis and Chrohn’s Disease, with the latter showing higher incidence of malnutrition. Fortunately, the occurrence of malnutrition was low – but this study still indicates the need to monitor nutrients and maintain medical treatment to not only address the medical disease, but its impact on overall health and nutrition.

For more information:
http://www.medpagetoday.com/Gastroenterology/InflammatoryBowelDisease/16681

Should You Take a Probiotic During Flu Season?

Everyday in the news there are updates about this year’s flu season, especially about the H1N1 virus (Swine flu).  By all accounts, the infectivity rate is going to be very high.

We have all heard the recommendations:

  • Get the vaccine
  • Wash your hands
  • Avoid crowds
  • Don’t sneeze or cough into your hands
  • Drink lots of fluid, eat lots of fruits and vegetables, exercise and get 7 hours of sleep

Is there any other preventive therapy that is over the counter and without any adverse effects? You guessed it, PROBIOTICS!!

This month in the medical journal, Pediatrics, a study was published: “Probiotics Effects on Cold and Influenza-like Symptom Incidence and Duration in Children” (1).

Method: Healthy children ages 3-5 were randomly placed in one of three groups: 104 received a placebo; 110 received a probiotic containing Lactobacillus acidophilus; 112 received a probiotic containing L acidophilus in combination with Bifidobacterium lactis. The children were given the probiotics daily for 6 months and monitored for cold and influenza-like symptoms.

Results: Compared to the placebo group, single and combination probiotics reduced the following symptoms, antibiotic usage, and reduction in days missed from school:

Conclusion: Daily intake of a probiotic supplement for 6 months during the cold and flu season was a safe and effective way to reduce the frequency of symptoms of colds and flu, reduce antibiotic usage and lessen missed days from school. A two strain probiotic in a dosage of 10 billon colonies is very beneficial.

Discussion: So I imagine you are all saying, “that is very interesting, but I am not a 3 year old.”

Well, there have been a number of studies (2,3,4,5,6) done over the last 4-5 years to determine if probiotics can lessen or prevent viral upper respiratory infections in not only children but also healthy adults, young and old.

One study done on healthy adults investigated the effect of long-term consumption of probiotics on viral respiratory infections during two winter/spring periods (4). The combination of a probiotic containing lactobacilli and bifidobacteriaa successfully shortened the duration of cold infections by two days and reduced the severity of symptoms. The incidence of infections, however, was not affected.

Another published paper did a systematic review of probiotics efficacy in preventing respiratory tract infections (5). Twelve controlled trials were reviewed, half reviewed adults and the other half reviewed children and infants. While the trials varied in duration of probiotic taken, dosage and type of bacterial strain, most of the trials noted a significant reduction in the severity of symptoms, but not the incidence of infection. A few did report a decrease in the frequency of infections.

There is a considerable amount of research being directed toward the mechanisms by which orally ingested probiotics can affect the immune system to lessen viral respiratory infections. Studies have shown that use of probiotics can stimulate the immune system in the gastrointestinal tract, producing more immune cells. In turn, those immune cells can stop inflammation and can also attack the viruses as they invade the lining of the respiratory tract (4, 7, 8, 9). The stimulated immune cells can migrate from the GI tract to other areas of the body…including the respiratory tract.

Take Home Message

With these kinds of study results, it seems reasonable during the flu season to take a daily probiotic that contains a combination of lactobacilli and bifidobacteria in a serving size or dosage of 10 billon colonies or more — like EndoMune.

Thank you for your interest in EndoMune.
Eat healthy, exercise and live well!!

Larry Hoberman MD

(1)Probiotic effects on cold and influenza-like symptom incidence and duration in children.Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC; Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27

(2) Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Winkler P, de Vrese M, Laue Ch, Schrezenmeir J; Int J Clin Pharmacol Ther. 2005 Jul;43(7):318-26.

(3)A new chance of preventing winter diseases by the administration of synbiotic formulations.Pregliasco F, Anselmi G, Fonte L, Giussani F, Schieppati S, Soletti L; J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 2:S224-33.

(4) Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial.de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, Ott S, Hampe J, Schreiber S, Heller K, Schrezenmeir J; Vaccine. 2006 Nov 10;24(44-46):6670-4. Epub 2006 Jun 6.

(5) Probiotics for the prevention of respiratory tract infections: a systematic review.Vouloumanou EK, Makris GC, Karageorgopoulos DE, Falagas ME; Int J Antimicrob Agents. 2009 Sep;34(3):197.e1-10. Epub 2009 Jan 28.
Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence.
Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

(6) Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study.Turchet P, Laurenzano M, Auboiron S, Antoine JM; J Nutr Health Aging. 2003;7(2):75-7.

(7) Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence. Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

(8) Molecular and cellular basis of microflora-host interactions.Winkler P, Ghadimi D, Schrezenmeir J, Kraehenbuhl JP; J Nutr. 2007 Mar;137(3 Suppl 2):756S-72S. Review.

(9) Probiotic and prebiotic influence beyond the intestinal tract. Lenoir-Wijnkoop I, Sanders ME, Cabana MD, Caglar E, Corthier G, Rayes N, Sherman PM, Timmerman HM, Vaneechoutte M, Van Loo J, Wolvers DA; Nutr Rev. 2007 Nov;65(11):469-89. Review

Probiotics Prevent Colds in Children?

“When given preventively over the winter months, probiotics reduce fever, cough, and runny noses in children, researchers said.”

This is very exciting news for parents across the country. Many parents deal with the frustration of sick children during the winter months and the many associated problems including missed school, missed work and restless nights.

A recent study evaluated 326 children ages 3 to 5 years. Two groups of these children in a childcare center in China were given “twice-daily doses of L. acidophilus or L. acidophilus in combination with Bifidobacterium animalis for six months from November 2005 to May 2006.” The third group was given a placebo.

Both the single strain and the multi-strain probiotic doses were effective at reducing fever, cough, and rhinorrhea; the combination strain, however, had a more profound, positive impact. This seems to imply multi-strain, multi-species probiotics continue to prove more efficacy for prevention rather than their single-strain counterparts.

With profound research studies, such as this study in China, physicians may be able to begin moving away from antibiotics toward other forms of prevention like probiotics. While more studies are necessary, probiotic research continues to move forward in a very exciting direction.

For the article in its entirety, visit:
http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/15251

Source reference:
Leyer GJ, et al “Probiotic effects on cold and influenza-like symptom incidence and duration in children” Pediatrics 2009; DOI: 10.1542/peds.2008-2666.

Probiotics and Irritable Bowel Syndrome

Studies of how and which types of probiotics improve IBS symptoms have yielded contradictory results. Some studies have shown that probiotics improve IBS, while others have resulted in less promising findings. This variance reflects, in part, differences in the studies, such as trial design, the limited number of participants, and the type, dose and formulation of the probiotics used in a particular study.

The term “probiotics” refers to the beneficial bacteria that are ingested to improve intestinal health. Some probiotic supplements contain just one bacterial strain whereas others have up to 8 different strains. It is reasonable that different studies will reach different conclusions, directly dependant upon the type of strains used. Similarly, the quantity of bacteria in each probiotic supplement can vary from a low of about one million to more than 400 billon organisms per dosage – and this too will also influence results.

In order to determine whether there is a statistical benefit of probiotics in easing the symptoms of IBS, researchers will review hundreds of studies and select those that have been done following specific guidelines for creditability.

The selected studies are then evaluated using a statistical method called meta-analysis. This involves combining all the studies and measuring the outcome for a specific issue. For example, there may be 20 studies evaluating the effects of probiotics on IBS. Some studies may have positive results and others negative. Combining all the results can give an overall statistical evaluation of whether probiotics are beneficial.

Meta-Analysis Reports

Over the last 18 months there have been four major meta-analysis reports published in respected medical journals (1,2,3,4).

All four meta-analysis studies concluded that probiotics benefit individuals suffering with IBS. They all found that probiotics could ease the symptoms of:

  • Abdominal pain
  • Bloating
  • Flatulence
  • Improve the passage of stools

Only a few minor adverse side effects were reported, the most common being a temporary increase in abdominal bloating and flatulence.  No serious health or safety issues were identified.

The Conclusion: Probiotics are Promising

The general conclusion from these reports is that probiotics offer promise in the treatment of IBS.  Further studies of longer duration and use of specific strains and dosages of probiotics are needed to determine which probiotics are statistically better in treating IBS.

Because the drug therapies currently available to IBS sufferers have shown limited success, a trial of probiotics certainly seems worthwhile.

Take Home Message

Probiotics are helpful in treating the symptoms of IBS. Look for one that has at least 5 billon bacteria in a serving size and contains multiple strains of lactobacillus and bifidobacteria…like EndoMune.

Eat healthy, exercise and stay well!
Dr. Hoberman

 

(1) A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome.Hoveyda N, Heneghan C, Mahtani KR, Perera R, Roberts N, Glasziou P. BMC Gastroenterol. 2009 Feb 16;9:15.

(2) Meta-analysis of probiotics for the treatment of irritable bowel syndrome. McFarland LV, Dublin S. World J Gastroenterol. 2008 May 7;14(17):2650-61.

(3) The efficacy of probiotics in the therapy of irritable bowel syndrome: a systematic review.Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein A, Brandt L, Quigley E. Gut. 2008 Dec 17

(4) Effectiveness of probiotics in the treatment of irritable bowel syndrome. Wilhelm SM, Brubaker CM, Varcak EA, Kale-Pradhan PB. Pharmacotherapy. 2008 Apr;28(4):496-505.

Probiotics and Post-Gastric Bypass Surgery Weight Loss

The July issue of the Journal of Gastroenterology discusses the recent findings of a post-gastric bypass surgery weightloss study. The physicians and researchers administering the study were interested in whether gastrointestinal bacteria and gut health plays an impact in the weight loss of individuals.

Both a control and a probiotic group were on the same counseling and diet regimen, with the probiotic group receiving 2.4 billion colonies of Lactobacillus daily.

At both 6-weeks and 3-months, the probiotic group had a statistically significant increase in weight loss over their counterparts in the control group. However, at 6-months, the significance had decreased.

With more research studies in the future, researchers may be able to determine if probiotics do have an impact on post-gastric bypass weight loss.

View the article at: http://www.medscape.com/viewarticle/706023

Pediatric Studies and IBS Research

Interest in probiotics and their healthful links to gastrointestinal ailments has spurred the recent launch of the National Institute of Health’s Human Microbe Project. Baylor College of Medicine in Dallas, Texas is heavily involved in many of these studies; they received $3.7 million to map human bacteria genome.

Most recently, Dr. James Versalovic, a genetecist with the college, received a $750,000 grant to research the impact of bacteria on IBS in pediatrics. His studies are expected to explore methods of treating children without the use of invasive surgery. Dr. Robert Shulman, a pediatrics professor at Baylor College of Medicine and a practicing gastroenterologist, believes bacteria composition plays a major role in adult and child abdominal pain.

This is all very exciting and interesting news in the intestinal bacteria and probiotic front!

Read the entire article from the Houston Chronicle:
http://www.chron.com/disp/story.mpl/metropolitan/6526164.html

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