Among the most common questions parents and caregivers ask pediatricians when gastro issues arise may be about the use of probiotics.
In a world where advertising messaging to concerned parents is both well funded and ubiquitous, they turn to you for the best counsel in a field with few clinical practice guidelines, and a paucity of regulations, but an abundance of health claims. Worse, there seems a pervading sense that such supplements, because they are available over the counter, are innocuous and harmless.
Are you a probiotics pro?
How’s your grasp of fact and fiction in probiotics? Is there a role for them in the treatment or prevention of irritable bowel syndrome, constipation, diarrhea—even autism? Are there legitimate concerns about their use in a patient population with immature immune systems?
By definition, a probiotic is a microorganism that when consumed maintains or restores beneficial bacteria to the digestive tract. Probiotics can be supplied through foods, beverages, and dietary supplements.
Ilya Ilyich Mechnikov, a Ukrainian and Russian zoologist perhaps best known for his Nobel Prize-winning research in immunology, is regarded as the father of probiotics. In 1907, he hypothesized that replacing or diminishing the number of “putrefactive” bacteria in the gut with lactic acid bacteria could normalize bowel health and prolong life.
Today, although there are data pointing to the microbiome and the role it plays in systemic health and illness from eczema to autism, the wide variance of the efficacy of probiotic therapy appears to be both strain and disease specific—quite effective in some disease processes, not useful in others. So, then, thumbs up on Lactobacillus over Saccharomyces boulardii for infectious diarrhea?
Ready for a gut check on probiotics?
1. Probiotics have a well-established clinical benefit for treatment of gastroenteritis in children and is indicted as standard practice.