"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 kids in half
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 five 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 with 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 what the best probiotic doses and strains are.
Studies have used between 20 million organisms a day to three trillion,
and there are 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 the full complement of gut bacteria from a healthy colon,
stuff it into an unhealthy colon.
Or you can go the other route,
and administer the donor stool through the nose.
Evidently, this route of administration saves time,
it's cheaper, 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 a coffee filter
and then just squirt the stool 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,
—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."