Probiotics diarrhoea

Kim, H.J., Camilleri, M., McKinzie, S., Lempke, M.B., Burton, D.D., Thomforde, G.M., and Zinsmeister, A.R. A randomized controlled trial of a probiotic VSL 3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol. Ther., 17, 895, 2003. 

Plummer, S., Weaver, M. A., Harris, J.C., Dee, P, and Hunter, J. Clostridium difficile pilot study effects of probiotic supplementation on the incidence of C. difficile diarrhoea, Int. Microbiol, 7, 59, 2004. 

Sissons, J.W. (1989) Potential of probiotic organisms to prevent diarrhoea and promote digestion in farm animals. A review. Journal of the Science of Food and Agriculture A9 1-13. 

Given that probiotics are consumed, it is not surprising that the prime target for probiotic use has traditionally been various diarrhoeas, with intestinal health as the main benefit. 

D Souza, A.L., Rajkumar, C., Cooke, J., and Bulpitt, C.J. 2002. Probiotics in prevention of antibiotic associated diarrhoea meta-analysis. Brit Med Jl 324(7350), 1361-1364. 

Probiotic strains have been evaluated for their anti-diarrhoeal capabilities, with some proving more successful than others (Table 6.1). L. rhamnosnus GG has repeatedly been shown to reduce the duration of diarrhoea by about 50% in patients with acute infantile diarrhoea caused by rotavirus (Isolauri et al. 1999). The mechanisms of action have not been fidly elucidated but may involve fortification of the mucosal integrity and/or stimulation of specific anti-rotavirus IgA. Other probiotic strains have been shown to reduce the incidence of rotaviral diarrhoea, that is, B. hifidum given in conjunction with S. thermophilus in standard milk formula (Saavedra etal. 1994). 

Table 6.1 Examples of human feeding studies showing a positive effect of probiotic consumption on the symptoms of gastrointestinal infections, for example diarrhoea ...

The mode of action of these probiotic strains is hkely to be a fortification of the compromised gut microflora, thus restoring colonization resistance and/or direct inhibitory effects against the diarrhoea-causing pathogen. Probiotic strains have been shown to inhibit pathogenic bacteria both in vitro and in vivo in animal models through a number of different mechanisms (Paubert-Braquet etal. 1995 Asahara etal. 2001 Likotrafiti etal. 

Beneficial effects of probiotic consumption in the prevention and treatment of several gastrointestinal diseases, such as inflammatory bowel diseases, antibiotic associated-diarrhoea, neonatal necrotizing enterocolitis, irritahle bowel syndrome, Helicobacter pylori infection, as well as food allergies and intolerances, have been clearly assessed (Sanders et al. 2013). Furthermore, probiotics are effective in reducing cholesterol levels and lowering blood pressure (Kumar et al. 2012). However, molecular mechanisms underlying strain-specific probiotic action and the identity of effector molecules (peptidoglycan, teichoic acid, cell surface polysaccharides, extracellular proteins) still remain to be fully elucidated. 

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