When Can Probiotics Help?

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When Can Probiotics Help?

Evidence on the benefits of probiotics is building, and much of it is positive. Studies suggest that these natural remedies, which contain beneficial microbes, may help prevent or treat some digestive problems. They may also help regulate the immune system. They may even protect against common respiratory infections.

Probiotics come in many forms, including foods such as yogurt, capsules, powders, and liquids. The various foods and supplements contain one or more of dozens of different probiotic organisms. Each is thought to have its own benefits.

So which probiotics may be right for your needs? Specific probiotic organisms appear to be effective for particular illnesses, so choosing the right kind is crucial. Many questions remain about the best way to take these remedies. But researchers say there is enough evidence to offer some guidance. Here are their recommendations.

Benefits of Probiotics for Infectious Diarrhea

The most convincing evidence for probiotics comes from studies of infectious diarrhea. In 2008, an expert panel at Yale University reviewed available evidence and gave an “A” grade to probiotics for the treatment of childhood and adult infectious diarrhea.

“If you start children with infectious diarrhea on probiotics, you can shorten the length of the illness by 24 to 30 hours,” says Martin Floch, MD, a gastroenterologist at Yale University School of Medicine and consultant for the Dannon Company, who led the panel. “That may not seem like a lot. But if a child is suffering from severe diarrhea, it’s significant.”

Probiotics appear to be less effective at preventing infectious diarrhea, researchers say, although the evidence remains preliminary.

Organisms that may be helpful: Saccharomyces boulardii, Lactobacillus GG, and Lactobacillus reuteri

Probiotics to Prevent Antibiotic-Associated Diarrhea

As many as two in five children develop diarrhea after taking oral antibiotics. Many adults also develop diarrhea related to taking antibiotics. The reason: Because these powerful drugs target bacteria in general, they can disrupt populations of beneficial microbes.

Findings from several investigations show that probiotics taken before a course of antibiotics may help prevent antibiotic-associated diarrhea.

Organisms that may be helpful: Saccharomyces boulardii, Lactobacillus GG, combination of Lactobacillus casei, Lactobacillus bulgaricus, Streptococcus thermophilus

Fighting the Risk of Pouchitis

Pouchitis is an inflammation that can occur after bowel surgery for severe ulcerative colitis. During the surgery, most of the colon is removed and a small pouch is created. Studies show that probiotics can prevent pouchitis. They appear to be less effective at treating pouchitis once it occurs, however.

Organisms that may be helpful: A combination of eight bacterial strains referred to as VSL#3, which includes Streptococcus thermophilus, Bifidobacterium longum, Bifidobacterium breve,Bifidobacterium infantis, Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus casei, andLactobacillus bulgaricus

Preventing Eczema

Atopic eczema is an allergic reaction of the skin that affects many infants and children. The Yale University review panel gave an “A” grade to findings showing that probiotics can be effective for preventing or treating atopic eczema related to cow’s milk allergy.

Organisms that may be helpful: Lactobacillus GG, Bifidobacterium lactis

Probiotics to Ease Symptoms of Irritable Bowel Syndrome

Irritable bowel syndrome (IBS), which afflicts an estimated 58 million Americans, can cause bloating, cramps, and diarrhea. The underlying cause is not well understood. Some preliminary findings suggest the probiotics may help ease symptoms, although there are negative studies as well.

A 2010 study of children and teenagers found that the combination of eight probiotic organisms called VSL#3 significantly reduced symptoms of IBS.

Organisms that may be helpful: Bifidobacterium infantis, VSL#3

Probiotics for Ulcerative Colitis

In its 2008 recommendations, the Yale University panel found little convincing evidence that probiotics helped treat the inflammatory bowel disease ulcerative colitis.

Some recent findings are more promising. In 2010, researchers from China Medical University in Taiwan reviewed 13 trials. They concluded that probiotics were more effective than placebos in warding off flare-ups of ulcerative colitis.

Organisms that may be helpful: Bifidobacterium longum, VSL#3

Probiotics Help Fight Common Childhood Infections

By enhancing immune function, probiotics may help ward off childhood illnesses such as ear infections, colds, and infectious diarrhea. The Yale University panel gave a grade of “A” to evidence that probiotics improve immunity.

A Georgetown University study published in 2010 found that children who drank a yogurt drink containing the probiotic Lactobacillus casei were 19% less likely than those who didn’t to come down with a common infection.

Organisms that may be helpful: Lactobacillus casei, Lactobacillus LGG, Lactobacillus acidophilus, Lactobacillus plantarum, Bifidobacterium lactis, and Lactobacillus johnsonii

When Probiotics Don’t Seem to Help

Probiotics aren’t useful for all gastrointestinal complaints. There’s little strong evidence that they help treat the symptoms of Crohn’s disease, a sometimes-debilitating inflammatory bowel disease.

The Yale University review panel also found inadequate evidence that probiotics help treat vaginosis or vaginitis.

Still, only a small number of potentially beneficial organisms have been tested. Ongoing research may find additional uses for probiotics.

“We still have a lot more to learn about when and how to use probiotics,” says Stefano Guandalini, MD, professor of pediatrics and gastroenterology at the University of Chicago Medical Center. “But the use of these safe and effective therapies is likely to increase as we increase our knowledge.”