Healthy Aging Archives

Probiotics Benefits for IBS, Cancer and Chemotherapy

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 YJ, Choi J, Pothoulakis C, Rhee SH, Im 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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Probiotics May Decrease Chemotherapy-Induced Diarrhea

Healthy Aging / By @drHoberman

Our March newsletter was just issued this week, and it addresses some interesting research findings with regard to the anti-cancer effect of probiotics and the ability of probiotics to assist with decreasing chemotherapy-induced diarrhea. Excerpts from the article are as follows:

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.

You may read the March newsletter in its entirety for more information about Probiotics’ Effects on Cancer and Chemotherapy.

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Probiotics and Irritable Bowel Syndrome

Drug interactions, Healthy Aging, Probiotics / By @drHoberman

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.

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Probiotics and Post-Gastric Bypass Surgery Weight Loss

Disease, Healthy Aging, Probiotics / By @drHoberman

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

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DNA Testing Provides Whole-Body Approach to Cancer Screening

Disease, Drug interactions, Healthy Aging / By @drHoberman

The 2009 Digestive Disease Week in Chicago presented numerous findings with regard to the GI tract and associated diseases. Among those findings is the usefulness of DNA testing of stool samples for the presence of cancer.

Previously, stool DNA testing was used for the early detection of colorectal cancer; recently scientists and physicians have discovered this screening is also a useful source of detection for other cancers such as pancreas, stomach, bile ducts and esophagus. This is a tremendous shift from the single organ approach to screening of such cancers. DNA sampling provides a “whole-body” approach to screening for multiple cancers at one time, potentially paving the way for early detection of cancers previously not screened.

According to ABC News, “The test developed by Mayo Clinic researchers, which checked a patient’s stool for the DNA of cells regularly shed from the surface of several types of tumors, detected 65 percent of esophageal cancers, 62 percent of pancreatic cancers, 75 percent of bile duct and gallbladder cancers and 100 percent of stomach and colorectal cancers. The test was equally successful at detecting early-stage and late-stage cancers.”

The report goes on to note, “One in four cancer deaths are the result of gastrointestinal cancers, the news release notes. These cancers are quite curable if detected at an early stage, but the only one widely tested for is colorectal cancer, generally through colonoscopy.”

Research and news with regard to GI disease continues to move in a positive direction.

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