ABSTRACT
The efficacy of probiotics on persistent diarrhea remains uncertain. The purpose of this study was to evaluate the effect of Lactobacillus sp and Saccharomyces boulardii on persistent diarrhea in children. In a double-blind trial eighty-nine children, aged 6-24 months were randomly distributed to receive pasteurized cow milk containing 2 viable lyophilized strains Lactobacillus casei and Lactobacillus acidophillus strains CERELA, (10(10)-10(12) colony-forming units per g) (n = 30), or lyophilized S. boulardii, (10(10)-10(12) colony forming units per g) (n = 30) or pasteurized cow milk as placebo (n = 29); on each diet 175 g was given twice a day for a 5 day period. Number of depositions, duration of illness and frequency of vomiting were considered. Enteric pathogens were isolated from stools in 40 of the patients, 27 had rotavirus. Lactobacillus and S. boulardii significantly reduced the number of depositions (p < 0.001) and diarrheal duration (p < 0.005). Similarly both significantly (p < 0.002) reduced vomiting as compared with placebo. There was no difference between treatments depending on rotavirus status. In conclusion, L. casei and L. acidophillus strains CERELA and S. boulardii are useful in the management of persistent diarrhea in children
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Diarrhea, Infantile , Lactobacillus acidophilus , Lacticaseibacillus casei , Probiotics , Rotavirus Infections , Double-Blind MethodABSTRACT
Small bowel bacterial overgrowth and related diarrhea is a condition that frequently accompanies anatomic disorders, surgically created blind loops or strictures with partial small bowel obstruction and although it is often controlled with antimicrobial therapy, alternative treatment may be needed. The aim of this study was to evaluate the efficacy of an oral probiotic preparation of 2 viable lyophilized strains of lactobacilli (1.5 g each) compared with placebo. Twenty two patients with proven overgrowth and chronic diarrhea are described. In random order and double-blind fashion, 2 groups of patients received identical capsules with both Lactobacillus casei and L. acidophillus strains CERELA (12 patients) (LC) and placebo (10 patients) (P) during three consecutive periods of 7 days each followed by a similar three periods of control after withdrawal. At the end of each period the mean daily number of stools, glucose breath H2 test, and symptoms were considered. Lactobacillus were investigated in feces in both groups at day 0 (baseline), on day 21 of treatment with LC and P and on day 21 after withdrawal. Compared with P a significant reduction in mean daily number of stools was achieved with LC (p < 0.005) at 15 days, and (p < 0.0005) at 21 days and the effect was sustained at 7 days and 15 days (p < 0.005) after withdrawal. With respect to breath H2 level a significant decrease in H2 concentration was noted at 7 days (p < 0.005) at 15 days, and 21 days (p < 0.0001) with LC and only a significant decrease (p < 0.005) was observed at 7 days after withdrawal. No significant changes were observed with respect to symptoms. The Lactobacillus CERELA strains were isolated from the feces in all patients LC (n = 12) on day 21, and by contrast no Lactobacillus were observed except in two patients out of seven patients after withdrawal. In summary, this study provides evidence that LC are effective for treatment of bacterial overgrowth--related chronic diarrhea, and suggest that probiotics must be used with continuity.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Probiotics/therapeutic use , Diarrhea/microbiology , Lactobacillus acidophilus , Lacticaseibacillus casei , Chi-Square Distribution , Double-Blind Method , Chronic Disease , Statistics, Nonparametric , Diarrhea/therapyABSTRACT
El propósito fue determinar si una leche no comercial fermentada con Lactobacillus casei y Lalctobacillus acidophilus de origen humano (LFC) que fuera desarrollada por CERELA (Centro de Referencia para Lactobacilos) es mejor tolerada que la leche común (LC) por sujetos con deficiencia de lactasa (<1 unidad/g de tejido fresco) e intolerancia a la lactosa. Fueron estudiados 18 individuos sanos con deficiencia de lactasa intestinal e intolerancia a la lactosa, y 12 controles. Las preparaciones lácteas consistieron en 480 ml y 240 ml de LFC y LC. Se usó la prueba del H2 en el aire espirado para medir el grado de absorción de la lactosa y el tiempo de tránsito boca ciego (TTBC), y se evaluó la sintomatología clínica después de la administración de cada una de las preparaciones. La excreción de Ha luego de 480 ml de LFC fue de 19,5 ñ 12,1 ppm versus 52,6 ñ 31,9 ppm obtenido con igual dosis de LC (p < 0,0008). Los resultados también mostraron que 480 ml de la LFC prolonga significativamente el TTBC 111,0 ñ 6,78 minutos versus 54,0 ñ 5,09 minutos de LC (p < 0,001) y reduce la presencia de síntomas clínicos (p < 0,08) especialmente los borborismos (p < 0,025), el meteorismo (p < 0,05), la diarrea (p < 0,05) y los cólicos abdominales (p < 0,05). Se concluye que la LFC mejora la digestión de la lactosa, influye sobre el TTBC y disminuye la presencia de síntomas de intolerancia en sujetos con hipolactasia e intolerancia clínica a la lactosa