fermented milk products

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FYI.

POSTGRADUATE MEDICAL JOURNAL

Volume 80(947), September 2004, pp 516-526

Probiotics and human health: a clinical perspective

Abstract

There is unequivocal evidence that administration of probiotics could be effective in the treatment of acute infectious diarrhoea in children and the prevention of antibiotic associated diarrhoea and nosocomial/community acquired diarrhoea. Encouraging evidence is also emerging for the effectiveness of probiotics in the prevention and management of pouchitis and paediatric atopic diseases, and the prevention of postoperative infections. There is also strong evidence that certain probiotic strains are able to enhance immune function, especially in subjects with less than adequate immune function such as the elderly. Efficacy of probiotics in the prevention of traveller’s diarrhoea, sepsis associated with severe acute pancreatitis, and cancers, the management of ulcerative colitis, and lowering of blood cholesterol remains unproven. In addition to firm evidence of efficacy (for a range of conditions), major gaps exist in our knowledge regarding the mechanisms by which probiotics modulate various physiological functions and the optimum dose, frequency, and duration of treatment for different probiotic strains.

other than lactose intolerance, one thing of interest in the full text is:

IRRITABLE BOWEL SYNDROME

Symptoms of abdominal pain, bloating, flatulence, and diarrhoea are commonly seen in patients with irritable bowel syndrome, and abdominal pain and bloating are difficult to treat and have a significant impact on patients’ lives. Bacteria in the gut flora can produce intestinal gas but they also consume gas. Theoretically, probiotics might improve the balance and reduce gas accumulation within the bowel. In a double blind clinical trial, administration of a L plantarum strain decreased pain and flatulence in patients with irritable bowel syndrome. 122 Likewise, a recent placebo controlled trial concluded that the VSL#3 probiotic mixture is useful for the relief of abdominal bloating in patients with diarrhoea predominant irritable bowel syndrome, and the effect is unrelated to an alteration in gastrointestinal or colonic transit. 123 Probiotics need to be evaluated further but they appear to be useful for the control of symptoms due to the altered handling or perception of intestinal gas in this group of patients.

TREATMENT OF HELICOBACTER PYLORI INFECTION

Probiotics have been tested as a new strategy for eradication of Helicobacter pylori infection of the gastric mucosa in humans. Some strains of lactic acid bacteria are known to inhibit the growth of H pylori in vitro. However, administration of a probiotic-containing yogurt was found to be ineffective in the eradication of H pylori infection in 27 subjects.

PREVENTION OF SYSTEMIC INFECTIONS

Translocation of viable or dead bacteria in minute amounts constitutes a physiologically important boost to the immune system. However, dysfunction of the gut mucosal barrier may result in the passage of large quantities of viable micro-organisms, usually belonging to Gram negative aerobic genera, which can disseminate throughout the body producing sepsis. Bacterial translocation and its complications have been shown to occur in several pathological conditions such as postoperative sepsis, severe acute pancreatitis, advanced liver cirrhosis, multisystem organ failure, etc.

I've never tried yogurt for IBS, but I'm not sure it contains L plantarum strain anyway.

Regards.