Probiotics and Diarrhea

Probiotics and Diarrhea
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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 picked a nice soft specimen, whipped it up in a household blender until smooth, put it through a coffee filter and then just squirted 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 videos for free by clicking here and watch my full 2012 – 2014 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, and From Table to Able.

Image credit: Groume / Flickr

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  • JEFF AND KAREN HAY

    Aloha Dr. Greger,

    How is it that fecal matter can be taken through the nose and travel into our stomachs without causing us to get sick?

    Mahalo.

  • EtienneJ

    Poopsicles. Lovely.

  • justme

    This is just gross! I shake my head at silly SADs, when they say, ‘I could never do that.’ However, I would rather die than eat…..fecal matter.

    • Em Crone

      Even if it could save your life? Gut bacteria can get so out of balance that this could actually save you. Just a thought, tho I agree that it would be “hard to swallow” hahaha.

    • VegAtHeart

      I share your view, though it is interesting to note that many animal species do not regard this subject the same way and, in fact, regularly practice coprophagia.

      Quoting Wikipedia, “Human perception of the odor is a subjective matter; an animal that eats feces may be attracted to their odor.”

    • justme

      Still…I say no way.

  • Leslie

    My fish-eating friends say that selenium binds to mercury and therefore if you eat seafood with selenium rich foods then mercury is not an issue. Is this true? I show them your videos and they are not convinced. What does the science suggest?

  • Ronald Chavin

    Dr. Greger spelled “Lactobacillus rhamnosus” incorrectly as “Lactobacillus rhamnosis.”

  • VegAtHeart

    The human microbiome is plays a crucial role in health and is tightly linked with diet and genetics as a health determinants.

    Building on this article by Dr. Greger is the National Academies Press book on The Human Microbiome, Diet and Health. In particular, starting from page 92 there is an extensive discussion on probiotics and prebiotics.

    This is a must read book for anyone interested in obtaining the latest understanding of how gut microbiota affect health. I learned so much from this book, including such topics as:

    - the connection between the microbiome and obesity as well as nutrient metabolism;
    - the difference between prebiotics and probiotics,
    - why breast milk is safer than infant formula;
    - risks associated with Caesarean sections;
    - how bacteria evolve resistance to antibiotics through horizontal gene transfer;
    - dangers associated with antibiotic use and unsanitary conditions in factory farming.

  • Kitsy WooWoo

    Interesting how some people claim to be horrified at the thought of eating animal “secretions” (eggs, milk products) , yet would not hesitate to scarf down human…um, sheeeyet.

    • Thea

      Kitsy: I know you are trying to be funny, so I don’t know if you were deliberately misunderstanding the post in order to make a joke (in which case you can stop reading here), or if you really missed the content of what the post is saying.

      For you or anyone who might have missed the point of the post: Those people who are getting fecal transplants are not vegans per say, but people with severe gut problems who desperately need help. And as the above post points out, you are far, far more likely to avoid being in such a situation in the first place if you avoid eating those animal secretions and flesh. Thus, you can hopefully avoid having to “scrarf down human…um, sheeeyet” by eating whole plant foods!

      Hope that helps.

      • Kitsy WooWoo

        Thanks for responding, Thea. I admit my little “joke” was pretty yucky. :-) But as far as recommending a whole plant foods diet, you’re pretty much preaching to the choir here. I don’t eat animal “secretions” either — I just find it hilarious for such foods to be referred to in that way.

        Yup, a healthy diet is very important — it’s too bad so many folks have to learn things hard way.

        • Thea

          :-) Ah. Now I see where you were coming from.

          I agree with your last sentiment too. But since I’m one who often takes the hard way on about any topic, I can hardly judge.