Probiotics could ease intestinal woes
DEAR DOCTOR: Can you explain probiotics? Who should take them, and are they harmful in any way?
DEAR READER: For many generations, society feared bacteria, seeing only the devastation that bacterial disease created. Today, with the advent of antibiotics, we have been able to cure infections that once led to illness and death. However, our primary tool — drugs known as antibiotics — also indiscriminately kill bacteria that don’t cause disease. Only recently have we come to realize how important these non-dangerous microorganisms are to our health.
Many probiotic preparations promise to help replenish beneficial bacteria in the colon, with the theory being that they increase the health of the intestinal lining, suppress inflammation caused by damaging bacteria and reduce inflammation caused by an overactive immune system.
In a 2008 study of 224 children with a diarrheal illness related to rotavirus, participants took either a probiotic preparation (containing various strains of Lactobacillis, Bifidobacterium
and Streptococcus) or a placebo. On the second and third days of the illness, the group that took the probiotic had a decrease in stool frequency, improved stool consistency and less need for either oral or intravenous rehydration.
A 2010 review of 63 studies assessed the impact of different probiotics on acute diarrheal illness; 56 of these studies looked only at children and infants. On average, probiotics decreased the duration of diarrhea by 24 hours and decreased stool frequency by the second day. Although the authors could definitely say there was benefit in children, they could not conclude if these benefits occurred in adults.
One potential issue with probiotics is that, unlike medications, they’re not regulated, so there is no true way to know exactly what you’re getting. Some patients do develop bloating with probiotics, but for the most part the preparations are well-tolerated. If they’re helping you, it seems prudent to continue using your current brand.
Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.