Transcript: Preventing and Treating Diarrhea with Probiotics
Probiotics have moved from the field of alternative medicine into the mainstream slowly but surely over the past decade. The best evidence we have is for the prevention of antibiotic-associated diarrhea, and the treatment of gastroenteritis.
Antibiotics administration is followed in up to 40% of cases by the appearance of diarrhea, but, for example, you may be able to cut the risk in half in kids by administering probiotics along with the antibiotics. 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. The importance of correct dosing cannot, evidently, be overemphasized. For example in adults, going 100 billion organisms seemed to work nearly twice as well as 50 billion, in preventing antibiotic-associated diarrhea.
The second well-established usage of probiotics is in the treatment of acute infectious diarrhea, shortening the duration of symptoms by about a day. But 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's thousands of different strains to choose from, and even if you wanted a particular strain odds are the label is lying to you 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.
Now ideally, we'd repopulate our gut with the whole range of natural gut flora, not just one or two hand-picked strains. And for serious infections, this has been attempted, starting back in 1958. Why not give people a fecal enema—take gut bacteria from a healthy colon and stuff it into an unhealthy colon. Or you can go the other route, and administar the donor stool through the nose. "Evidently, this route of administration saves times, it's 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, such as a medical staff member. What you do is first pick a nice soft specimen, whip it up in a household blender until smooth—a little vitamix action, put it through coffee filter and then just squirt it up their 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, researrchers up in Minnesota recently intro 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."
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.
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