Moving to the next stage of research with probiotic treatment of diarrhea

Yes, probiotics are “generally regarded as safe,” say researchers from Vrije Universiteit Brussel in Belgium.

But although most studies show “statistical shortening of the duration of diarrhea,” evidence that the results are really beneficial to patients is missing.

Here’s what we know.

• Until a few years ago, probiotics were viewed as CAM.
• They’re now entering the mainstream.
• In acute gastroenteritis (inflammation of the stomach and intestines), there’s evidence for efficacy of lactobacilli (eg, Lactobacillus caseii GG and Lactobacillus reuteri) and for Saccharomyces boulardii.
• Decreased severity and duration of infectious gastroenteritis in about 24 hours has been shown — with the most convincing evidence in patients with viral gastroenteritis.
• Therefore, probiotics are a potential add-on therapy in acute gastroenteritis.

But so what?

• A shorter duration of diarrhea and hospital stay should result in a social and economic benefit.
• But selection of the probiotic and timing of administration are important.
• And so far, evidence of significance to patients is elusive.

The bottom line?
This is all good news. The cornerstone of treatment remains replacement of water and electrolyte losses using rehydration solutions given by mouth.

However, when the discussion segues from “does it work” to “what must be done to show benefits to individual patients,” that’s progress.

There’s a lot more on probiotics and diarrhea here.

7/6/07 19:06 JR