Review Finds Probiotics Help Shorten Episodes of Digestive Problems

by | Dec 9, 2010 | 2010, Diarrhea, Digestive Health, Infant and Children's Health

Written by Greg Arnold, DC, CSCS. Several studies showed that probiotics help reduce the duration of diarrhea by 19%, 24%, and 43%. 

The World Health Organization defines diarrhea as “3 or more loose or watery stools in a 24-hour period”, with “acute” episodes lasting less than 14 days and “persistent” episodes lasting longer than 14 days (1). Infectious diarrhea occurs due to a virus or bacteria and is much more severe in developing countries (6-12 episodes per year) compared to developed countries (2 per year) (2). Death rates from infectious diarrhea are most common in children younger than 5 years (up to 3.3 million deaths in industrialized country each year (3)) and can cause more than 200 million illnesses each year in the US (4).

The most common treatments for diarrhea include rehydration and antibiotics (if bacteria are the cause). Now a new review by the Cochrane Database (5) suggests that probiotics may also be an effective treatment. Reviewing more than 23 studies of 1,917 subjects, they looked at different classes of illness:

  • For diarrhea lasting more than 3 days, a 2000 study (6) found that 10 billion colony-forming units of Lactobacillus casei per day until cessation of symptoms in infants decreased illness time by 19% (58.3 vs 71.9 hours) while 2.7% of the probiotic group had diarrhea for longer than 7 days compared to 10.7% in the placebo group.
  • For diarrhea lasting more than 4 days, another 2000 study (7) in infants with diarrhea showed 10 billion CFUs of Lactobacillus acidophilus every 12 hours for 5 days decreased duration of illness by 24% (43.4 vs. 57.0 hours). For a separate subgroup of the infants who were not on antibiotic therapy, there was a 43% decrease (42.9 vs. 74.0 hours).
  • Finally, a 2002 study on children in day-care centers (8) showed 10 billion CFUs of Lactobacillus Rhamnosus twice daily for 5 days reduced illness duration by 40% (70 vs. 116 hours). For children with diarrhea for 5 days before starting treatment, there was a 43% decrease (79 vs. 139 hours).

For the researchers, “Probiotics appear to be a useful adjunct to rehydration therapy in treating acute, infectious diarrhoea in adults and children.”

Source: Allen, Stephen J., et al. “Probiotics for treating infectious diarrhoea.” The Cochrane Library (2003).

© 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Posted December 9, 2010.

References:

  1. Anonymous. Persistent diarrhoea in children in developing countries: memorandum from a WHO meeting. Bulletin of the World Health Organization 1988;66(6):709–17.
  2. Savarino SJ, Bourgeois AL. EpiDiarrhoeal disease: current concepts and future challenges. Epidemiology of diarrhoeal diseases in developed countries. Transactions of the Royal Society of Tropical Medicine and Hygiene 1993;87 Suppl 3:7–11.
  3. Bern C. The magnitude of the global problem of diarrhoeal disease: a ten-year update. Bulletin of the World Health Organization 1992;70(6):705–14.
  4. Guerrant RL.  Practice Guidelines for the Management of Infectious Diarrhea.  Clinical Infectious Diseases 2001; 32:331–50
  5. Allen SJ, Okoko B, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating infectious diarrhoea. Cochrane Database of Systematic Reviews 2004 (2). No.: CD003048. DOI: 10.1002/14651858.CD003048.pub2
  6. Guandalini S.  Lactobacillus GG administered in oral rehydration solution to children with acute diarrhoea: a multicenter European trial. Journal of Pediatric Gastroenterology and Nutrition 2000;30(1):54–60.
  7. Simakachorn N, Pichaipat V, Rithipornpaisarn P, Kongkaew C, Tongpradit P, Varavithya W. Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhoea in children. Journal of Pediatric Gastroenterology and Nutrition 2000;30(1): 68–72.
  8. Rosenfeldt V, Michaelsen KF, Jakobsen M, Larsen CN, Moller PL, Tvede M, et al.Effect of probiotic Lactobacillus strains on acute diarrhea in a cohort of nonhospitalized children attending day-care centers. The Pediatric Infectious Disease Journal 2002;21(5):417–9.

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