Ethos Ho, BSc Pharm Candidate
What are Probiotics?
The word “probiotic” means “for life” as opposed to “antibiotic” which means “against life.” In medicine, probiotics refer to products containing live microorganisms that help improve the balance of intestinal microorganisms.1 In contrast to antibiotics, probiotics promote the growth of essential gut bacteria, instead of eradicating microorganisms. If you walk past the stomach aisle at a pharmacy, you’ll likely see various probiotics available on the shelves, some of which include:
- Culturelle® (Lactobacillus rhamnosus strain GG)
- Florastor® (Saccharomyces boulardii)
- Bio-Gaia® (Lactobacillus reuteri DSM 17938)
- Bio-K® (Lactobacillus casei)
How Safe are Probiotics?
Generally speaking, probiotics are relatively safe to use.1 However, there have been cases of serious side effects that have occurred in individuals who are immunocompromised or have a severely damaged gastrointestinal tract.1 Therefore, caution is advised when probiotics are used in these individuals.
What Does the Evidence Say?
Research on using probiotics for preventing diarrhoea and most of the information available focuses on children. There is strong evidence supporting the safety and effectiveness of using probiotics for treating acute, infectious diarrhoea in infants and children.2 Regarding its efficacy in adults, the use of Bio-K® (Lactobacillus casei) has been used to prevent antibiotic-associated diarrhoea in hospitalised patients successfully. On the other hand, taking Florastor® (Saccharomyces boulardii) may reduce the recurrence of antibiotic-associated diarrhoea.
The Bottom Line
Probiotics are relatively safe products that can be used to promote and maintain normal gut bacteria. Caution is advised in individuals who are immunocompromised or have significant damage to their gastrointestinal tract. Current evidence appears to support the use of probiotics in the treatment of diarrhea in infants and children. For adults, the use of probiotics remains controversial except in the case of antibiotic-associated diarrhoea. For adults, the use of probiotics remains controversial except in the case of antibiotic-associated diarrhoea, where probiotics seem to be a good preventative measure. Although more research is needed to support the use of probiotics, it’s worth giving a try for healthy individuals who are looking to prevent diarrhea, especially if antibiotic use is anticipated.
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- Allen, S., Martinez, E., Gregorio, G., & Dans, L. (2010). Probiotics for treating acute infectious diarrhoea. Cochrane Database Of Systematic Reviews. doi: 10.1002/14651858.cd003048.pub3
- Pillai, A., & Nelson, R. (2008). Probiotics for treatment of Clostridium difficile-associated colitis in adults. Cochrane Database Of Systematic Reviews. doi: 10.1002/14651858.cd004611.pub2
- Alberda, C., Marcushamer, S., Hewer, T., Journault, N., & Kutsogiannis, D. (2018). Feasibility of a Lactobacillus casei Drink in the Intensive Care Unit for Prevention of Antibiotic Associated Diarrhea and Clostridium difficile. Nutrients, 10(5), 539. doi: 10.3390/nu10050539