Probiotic supplements are included in a new and revolutionary way to modulate the gut microbiota, the immune system, certain aspects of neuronal function, and much more.
However, they were initially used in medicine to treat diarrhea, and it is still an effective way to stop the incidence of watery stools.
In each capsule or probiotic solution, you will find millions of microorganisms meant to be delivered to your gastrointestinal tract. Once in your intestines, these microorganisms change the pH and modulate the colonization of the intestinal lumen.
There is strong evidence that this modulation improves gastrointestinal symptoms, and that’s why probiotics are essential for the management of various forms of diarrhea.
Why is your microbiome important?
The intestines are one of the largest organs in the human body. Even though they are classically known to absorb nutrients from food, there are many other functions associated with the human gut. It is linked to different body systems, including the central nervous system and the immune system. Thus, the interconnections between the gastrointestinal system and the rest of the body modulate many different functions. That is why keeping your gut microbiome healthy is so important.
There are different types of microorganisms in the human gut, and for educational purposes, we can narrow down the classification into two different types: commensal and pathogenic organisms. Commensal microbiota is also known as healthy or friendly bacteria because they take up the space and resources of the human gut and do not allow pathogenic bacteria to colonize and cause disease.
There are many different reasons why the gut microbiota might become altered:
- Diarrhea: Diarrhea can be both a cause and a consequence of an imbalance in the gut microbiota. Watery stools sweep away healthy bacteria from the intestines, and this leaves the way for pathogenic bacteria to colonize and cause more diarrhea.
- Antibiotics: Using antibiotics for any cause, either intravenously or orally, affects the microbiome of the intestines as well. Antibiotics modulate our gut microbiota and may lead to antibiotic-associated diarrhea, which is more prolonged than infectious diarrhea if not treated with probiotics. (LINK TO INTERNAL ANTIBIOTIC ARTICLE)
- Chemotherapy: Both radiotherapy and chemotherapy are meant to kill cancer cells, but these cytotoxic agents kill healthy cells and your gut microbiota in the process. At the same time, chemotherapy destroys intestinal cells and causes alterations in the usual exchange of nutrients and liquid, which ultimately progresses to watery stools. Diarrhea caused by chemotherapy agents is often very difficult to treat and prolonged. Similar to antibiotic-associated diarrhea, it requires probiotics supplements to improve the symptoms.(INTERNAL LINK TO CHEMO ARTICLE)
The best probiotics to stop acute diarrhea or Traveler’s diarrhea
Probiotics are among the most important treatments for acute diarrhea, and there are many studies in adults with traveler’s diarrhea and children with rotavirus infections. In cases of acute diarrhea in children, the most common probiotic strains are Lactobacillus rhamnosus and Lactobacillus reuteri.
Diarrhea can be very dangerous and kills millions of people around the world every year!
- Lactobacillus rhamnosus: It is also known as LGG, and it is the most frequently used lactobacillus strain in acute diarrhea. There are several multi-centered studies and meta-analysis of young children with rotavirus infections who improved their symptoms significantly after receiving Lactobacillus rhamnosis alone or in combination with other probiotics. For example, a large clinical trial involving pediatric patients from 10 different countries reported that children who received Lactobacillus rhamnosus probiotics had a shorter hospital stay and fewer days with diarrhea.
- Lactobacillus reuteri: This bacterial strain has been proven to be effective in reducing the duration of diarrhea alone or in combination with other probiotics. The most frequently used strain is L. rhamnosus. However, many cases of acute diarrhea are managed with a combination of L. rhamnosus and L. reuteri. In combination with LGG, Lactobacillus reuteri improves the diarrheic symptoms and reduces the duration of rotavirus infection.
There are still other bacterial strains useful to improve acute diarrhea. For example, Lactobacillus acidophilus, Lactobacillus delbrueckii var bulgaricus, and Streptococcus thermophilus are associated with a shorter duration of diarrhea, but not as significant as in L. rhamnosus and L. reuteri.
On the other hand, traveler’s diarrhea has a slightly different approach. This disease is common in tourists traveling to developing countries and soldiers on the battlefield. According to studies, the most effective probiotics in these cases are Lactobacillus strains and Saccharomyces boulardii.
- Saccaromyces booulardii: This probiotic strain is slightly different from other bacterial strains because it is a yeast that regulates the homeostasis of bacteria in the intestines. It modulates the enzymatic activity and the immune response, and that’s why it is very effective in cases of traveler’s diarrhea. Using this bacterial strain and Lactobacillus strains before traveling reduces the risk of suffering diarrhea to 3.9% in patients receiving probiotics against 7.4% in patients receiving placebo.
The best probiotics to stop antibiotic-associated diarrhea
According to the latest review published in Cochrane about antibiotic-associated diarrhea and probiotics, the most commonly used strains in clinical trials are:
- Lactobacilli spp.
- Bifidobacterium spp.
- Streptococcus spp.
- Saccharomyces boulardii.
All of these probiotic strains have been shown to be effective in preventing and reducing the incidence of antibiotic-associated diarrhea. According to data reported by the review, these probiotics will prevent one case of diarrhea for every 9 children treated with antibiotics.
The probiotic dose suggested for these cases is more than 5 billion CFUs per day, and the incidence of side effects in children is minimal and very infrequent. Find out more in our article about the best Probiotics for constipation; including cases of flatulence and abdominal bloating, nausea and constipation.
At the end of the review, it was concluded that the most appropriate strains to improve antibiotic-associated diarrhea are Lactobacillus rhamnosus and Saccharomyces boulardi at a dose of 5 to 40 billion CFUs per day.
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