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Michael Greger MD

Michael Greger MD

Posted December 26, 2013

Published in Health

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Probiotics and Diarrhea

Read More: alternative medicine, antibiotics, diarrhea, fecal enema, fecal transplant, gastroenteritis, gut flora, infection, Lactobacillus rhamnosis, mold, probiotics, Saccharomyces boulardii

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Preventing & Treating Diarrhea With Probiotics

Probiotics have slowly moved from the field of alternative medicine into the mainstream, particularly for the prevention of antibiotic-associated diarrhea and the treatment of gastroenteritis.

After taking antibiotics, up to 40 percent of people experience diarrhea. Administering probiotics along with the antibiotics, though, may cut this risk in half. Which kinds and how much? Lactobacillus rhamnosis and Saccharomyces boulardii appeared to be the most effective strains, and studies using more than 5 billion live organisms appeared to achieve better results than those using smaller doses. For example, taking 100 billion organisms seemed to work nearly twice as well as 50 billion in preventing antibiotic-associated diarrhea.

Of course the best way to avoid antibiotic-associated diarrhea is to avoid getting an infection in the first place. See, for example:

We can also try to avoid consuming antibiotics in our diet: Lowering Dietary Antibiotic Intake and More Antibiotics In White Meat or Dark Meat?

The second well-established indication for the use of probiotics is in the treatment of acute infectious diarrhea, shortening the duration of symptoms by about a day. We still don’t know the best probiotic doses and strains. Studies have used between 20 million organisms a day to 3 trillion, and there are thousands of different strains to choose from. Then, even if we wanted a particular strain, odds are the label is lying to us anyway. Less than a third of commercial probiotic products tested actually contained what the label claimed. About half had fewer viable organisms than stated, and half contained contaminant organisms–including potentially pathogenic ones–as well as mold.

The mislabeling of probiotic supplements will come as no surprise to those who’ve been following my work. For example:

Ideally, we’d repopulate our gut with the whole range of natural gut flora, not just one or two hand-picked strains. This has been attempted for serious infections, starting back in 1958. Patients were given a fecal enema. Gut bacteria was taken from a healthy colon and inserted into someone else's unhealthy colon. Or we can go the other route and administer the donor stool through the nose. Evidently, this route of administration saves time, is cheaper, and less inconvenient for the patient.

Preferred stool donors (in order of preference) were spouses or significant others, family members, and then anyone else they could find (including medical staff). Doctors pick a nice soft specimen, whip it up in a household blender until smooth, put it through a coffee filter and then just squirt it up the patient’s nose through a tube and into their stomach. Don’t try this at home!

How receptive were the patients to this rather unusual smoothie recipe? None of the patients in this series raised objections to the proposed stool transplantation procedure on the basis that it “lacked aesthetic appeal.”  However, since production of fresh material on demand is not always practical, researchers up in Minnesota recently introduced frozen donor material as another treatment option.  All described in great detail in the latest review on the subject out of Yale entitled, “The Power of Poop.”

Another mention of frozen “poopsicles” can be found in my video Relieving Yourself of Excess Estrogen.

Preventing and Treating Diarrhea with Probiotics is the first of a four-part series on the current state of probiotic science. See also:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Groume / Flickr


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