Science
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Established benefits of probiotics
- Probiotics and immunity
- Probiotics and stress
- Probiotics and diarrhoea in young children
- Probiotics and winter infections
- Probiotics and Clostridium Difficile
- Probiotics and Heliobacter pylori (H.pylori)
Link to abstracts
1 Psychoneuroimmunology: stress effects on pathogenesis and immunity during infection.
Sheridan J F, Dobbs C, Brown D, and Zwilling B
Clin Microbiol Rev. 1994; 7:200-212
The mammalian response to stress involves the release of soluble products from the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. Cells of the immune system respond to many of the hormones, neurotransmitters, and neuropeptides through specific receptors. The function of the immune system is critical in the mammalian response to infectious disease. A growing body of evidence identifies stress as a cofactor in infectious disease susceptibility and outcomes. It has been suggested that effects of stress on the immune system may mediate the relationship between stress and infectious disease. This article reviews recent psychoneuroimmunology literature exploring the effects of stress on the pathogenesis of, and immune response to, infectious disease in mammals.
2 Functional gastrointestinal disorders: psychological, social, and somatic features
Bouvier M, Meance S, Bouley C, Berta J-L, Grimaud J-C
Gut. 1998 March; 42(3): 414-420
Background Psychological, social, and extraintestinal (somatic) disturbances are prominent features of functional gastrointestinal disorders (FGID); little attention, however, has been given to differences in the nature of these disturbances in the various FGID subgroups.
Aims (1) To determine whether psychological, social, and extraintestinal factors are associated with specific FGID, and/or with the overall severity and extent of FGID disturbance (the number of coexistent FGID subgroups present in any individual); and (2) to determine whether chronic social stressors link gastrointestinal, extraintestinal, and emotional symptomatologies in FGID.
Patients One hundred and eighty eight outpatients, fulfilling standard criteria for one or more functional gastroduodenal or functional bowel disorders.
Methods Utilising detailed and objective interview and questionnaire methods, detailed gastrointestinal, extraintestinal, psychological, and social data were collected.
Results Chronic stressors and extraintestinal and emotional symptomatologies were prominent features of functional dyspepsia (FD) and irritable bowel syndrome (IBS) alone. These particular features were, however, highly specific for particular FD and/or IBS subgroups. The chronic threat component of social stressors predicted the nature and extent of multisystem (gastrointestinal, extraintestinal, and emotional) symptomatology.
Conclusions Notable differences between the various FGID subgroups support the symptom based classification of FGID. Chronic stressor provoked psychological and extraintestinal disturbance is most specific for the FD-IBS group of syndromes.
3 Exercise, immunity and aging
Venjatraman JT, Fernandes G
Aging (Milano). 1997 Feb-Apr;9(1-2):42-56
In general population, many protective immune responses are impaired in old age, leading to an increased risk of infection. However, recent studies in SENIEUR subjects (healthy centenarians who are examples of successful aging) suggest that complex remodeling and reshaping of the immune system occurs with aging. An appropriate regular regimen of endurance exercise might help elderly to lead a quality of life by preserving immune function. However, very little is known regarding the interaction between exercise, aging and the immune system. Given that a number of age-related changes occur in many physiological systems which are known to alter the immune function both at rest and during exercise, it would be of value to learn the extent to which both acute and chronic exercise influence immune function in the elderly. The immune system response to exercise is multifaceted, depending on the nature of exercise. Significant interaction between the neuroendocrine and immune systems, and the role of lifestyle factors in immune function are known to occur. In theory, moderate exercise should help to reverse the adverse effects of aging upon the immune system by increasing the production of endocrine hormones which may contribute to less accumulation of autoreactive immune cells by enhancing the programmed cell death. Active elderly subjects demonstrated a significantly greater proliferative response to phytohemagglutinins (PHA) and to pokeweed mitogen (PWM), and higher rates of interleukin-2 (IL-2), interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) production. A moderate training program can enhance the resting natural killer (NK) cell function of healthy elderly people, potentially increasing resistance to both viral infections and preventing the formation of malignant cells. Recent studies have suggested that endurance training in later life is associated with a lesser age-related decline in certain aspects of circulating T cell function and related cytokine production. It is important that the dose of physical activity needed to optimize immune function be defined more clearly at various points during the aging process both in females and males in order to optimize the immune function and to prevent any rise in adverse effects of exercise on the elderly population.
4 Stressful life events promote the manifestation of asthma and atopic diseases
KILPELÄINEN M, KOSKENVUO M, HELENIUS H, TERHO E. O
Clinical & Experimental Allergy, 2002; 32, 2: 256-263(8).
Background Psychosocial stress is known to aggravate asthma. Less is known about the impact of stressful life events on the expression of asthma and atopic disorders.
ObjectiveTo determine whether the onset of asthma, allergic rhinitis or conjunctivitis, and atopic dermatitis, are associated with stressful life events.
Methods A postal survey on risk factors for asthma and atopic diseases was carried out among 10 667 Finnish first-year university students aged 18-25 years. Stressful life events, (i) severe disease or death of a family member, and (ii) parental or personal conflicts, were retrospectively recorded during the preceding year, 1-5 years, 6-10 years, and more than 10 years prior to the survey response. In a case-control setting, conditional multiple logistic regression analysis was used to assess the temporal association between major stressful life events occurring during a period either preceding, concomitant or subsequent with subject's diagnoses.
Results Concomitant parental and personal conflicts increased the risk of asthma (OR 1.72, 95% CI 1.10-2.69) when adjusted by parental asthma, education and passive smoking at early age. Concomitant severe disease or death of mother, father or spouse (OR 1.52, 95% CI 1.09-2.16) and precedent parental and personal conflicts (OR 1.75, 95% CI 1.15-2.77) increased the risk of manifestation of allergic rhinoconjunctivitis when adjusted for parental atopic disease, education and passive smoking. Subjects' asthma and atopic dermatitis, but not allergic rhinoconjunctivitis, were related to excess of subsequent stressful life events.
Conclusion An association between stressful life events and subjects' asthma, allergic rhinoconjunctivitis and atopic dermatitis is suggested.
5 Probiotics and athletic performance: A systematic review
Nichols AW
Current Sports Medicine Reports 6 (4): 269 - 273.
Probiotic bacteria are defined as live food ingredients that are beneficial to the health of the host. Probiotics occur naturally in fermented food products such as yogurt, kefir, sauerkraut, cabbage kimchee, and soybean-based miso and natto. Numerous health benefits have been attributed to probiotics, including effects on gastrointestinal tract function and diseases, immune function, hyperlipidemia, hypertension, and allergic conditions. A systematic review of the medical literature failed to identify any studies that directly investigated the potential ergogenic effects of probiotics on athletic performance. Two published articles suggest that probiotics may enhance the immune responses of fatigued athletes. In summary, although scientific evidence for an ergogenic effect of probiotics is lacking, probiotics may provide athletes with secondary health benefits that could positively affect athletic performance through enhanced recovery from fatigue, improved immune function, and maintenance of healthy gastrointestinal tract function.
6 Probiotics as functional food: microbiological and medical aspects
Toma M, Pokrotnieks J
Acta Universitatis Latviensis, 2006, Vol. 710, Biology, pp. 117-129
Probiotic bacteria are sold mainly in fermented foods, and dairy products play a predominant role as carriers of probiotics. Functional dairy foods are well suited to promoting the positive health image of probiotics for several reasons: (i) fermented foods and dairy products in particular, already have a positive health image by their traditional use for centuries; (ii) people are familiar with the fact that fermented food contain living microorganisms; (iii) probiotics are used as starter to join together the positive images of fermentation and probiotic cultures. Probiotics are defi ned as live bacterial preparations (food or medicine) with clinically documented health eff ects in humans. Most probiotics exert benefi cial eff ects by modulating the mucosal barrier function and immune activity. Probiotics have specifi c properties and targets in the human intestinal tract and intestinal microbiota. Understanding the mechanisms by which probiotics infl uence the normal intestinal microfl ora and counteract aberrancies in microfl ora can facilitate the use of probiotics for dietary management and reduction in risk of specifi c diseases. In reference of the immune system, many studies have pointed out that not only pro- and prebiotics, but also single micronutrients incorporated into functional foods contribute to an enhancement of immunocompetence. In this article, the eff ect of some functional foods and ingredients such as probiotics and selenium on health and especially immune function are reviewed.
7 Considerations for use of probiotic bacteria to modulate human health
Sanders ME
J Nutr. 2000;130:384S-390S.
Oral consumption of probiotic bacteria has the potential to support the health of American consumers. This paper will discuss the rationale of the probiotic theory, several health targets for probiotic bacteria, probiotic products in the U.S. and, finally, issues pertaining to communication about probiotic products to the consumer.
Guerin-Danan C, Chabanet C, Pedone C, Popot F, Vaissade P, Bouley C, Szylit O and Andrieux C
American Journal of Clinical Nutrition, Vol 67, 111-117
Ingestion of fermented dairy products induces changes in the equilibrium and metabolism of the intestinal microflora and may thus exert a healthful influence on the host. We compared the effects of consumption of a traditional yogurt, a milk fermented with yogurt cultures and Lactobacillus casei (YC), and a nonfermented gelled milk on the fecal microflora of healthy infants. Thirty-nine infants aged 10- 18 mo were randomly assigned to one of three groups in which they received 125 g/d of one of the three products for 1 mo. The following indexes were not modified during the supplementation period or for 1 wk after the end of supplementation: total number of anaerobes, bifidobacteria, bacteroides, and enterobacteria; pH; water content; concentrations of acetate, butyrate, propionate, and lactate; and bacterial enzyme activity of beta-galactosidase and alpha-glucosidase. In contrast, in the yogurt group the number of enterococci in fecal samples increased (P < 0.05), whereas the percentage of branched-chain and long-chain fatty acids, which are markers of proteolytic fermentation, decreased (P < 0.05). In the YC group, the percentage of children with > 6 log10 colony-forming units lactobacilli/g feces increased (P < 0.05), whereas the potentially harmful enzyme activity of beta-glucuronidase and beta-glucosidase decreased (P < 0.05). These decreases were particularly marked in those infants in the YC group in whom activity of the enzymes was initially unusually high.
9 The effect of fermented milk containing Lactobacillus casei on the immune response to exercise
Pujol P, Huguet J, Drobnic F, Banquells M, Ruiz O, Galilea P, Segarra N, Aguilera S, Burnat A, Mateos JA, Postaire E
Sports Medicine, Training and Rehabilitation [Sports Med., Train. Rehabil.]. Vol. 9, no. 3, pp. 209-223. 2000.
There is evidence that exhaustive exercise produces depression of the immune system, especially on the number and activity of Natural killer (NK) cells. On the other hand, fermented milk has been shown to moderate the immune response by inducing NK activity. The present work was carried out to determine if a Lactobacillus casei (LC) fermented milk supplemented diet would provide protection of the immune system against an exercise induced immune system depression of NK cells. Twenty-five athletes were selected out of 94 for their significant decrease in NK cell concentration compared with a normal basal concentration in plasma 2 h after an exercise stress test. Subjects ingested a daily fermented milk diet with LC for one month and a standard milk diet also for one month. After each phase of dieting, a subject was investigated before, 5 min and 2 h after an exercise stress test, testing for NK cells and IL-1 beta , IL-6, IL-2, IFN gamma , IgA, IgM, IgG, NK cells, CD8, CD4, CD3 and sIL-2 receptor. A significant smaller decrease of NK cell concentration after 2 h was found in the fermented milk feeding phase vs. the standard milk period.
Borruel N, Carol M, Casellas F, Antolín1M, de Lara F, Espin E, Naval J, Guarner F, Malagelada J R
Gut 2002;51:659-664
Background and aims: Tumour necrosis factor (TNF- ) plays a key role in the pathogenesis of intestinal inflammation in Crohn's disease. The effect of bacteria on TNF- release by intestinal mucosa was investigated.
Methods: Ileal specimens were obtained at surgery from 10 patients with Crohn's disease (ileal stricture) and five disease controls undergoing right hemicolectomy (caecal cancer). Mucosal explants from each specimen were cultured for 24 hours with either non-pathogenic Escherichia coli, Lactobacillus casei DN-114001, L bulgaricus LB10, or L crispatus (each study contained blank wells with no bacteria). Tissue and bacterial viability was confirmed by lactate dehydrogenase (LDH) release and culture. Concentrations of TNF- were measured in supernatants and the phenotype of the intestinal lymphocytes was analysed by flow cytometry.
Results: Coculture of mucosa with bacteria did not modify LDH release. Release of TNF- by inflamed Crohn's disease mucosa was significantly reduced by coculture with L casei or L bulgaricus; changes induced by L crispatus or E coli were not significant. The effect of L casei and L bulgaricus was not prevented by protease inhibitors. Coculture with L casei and L bulgaricus reduced the number of CD4 cells as well as TNF- expression among intraepithelial lymphocytes from Crohn's disease mucosa. None of the bacteria induced changes in non-inflamed mucosa.
Conclusions: Probiotics interact with immunocompetent cells using the mucosal interface and modulate locally the production of proinflammatory cytokines.
Marcos A, Wärnberg J, Nova E , Gómez S, Alvarez A, Alvarez R, Mateos JA and Cobo JM
European Journal of Nutrition. 2004; Vol 43 (No. 6): 381-389
Background A suppressed immune response has been documented in students under examination stress.
Aims The current study aimed to evaluate the effect of milk fermented with yogurt cultures plus Lactobacillus casei DN-114001 (Actimel®) on the immune system of subjects under academic examination stress.
Methods University students were allocated to one of two groups, receiving during 6 weeks (3 weeks prior to, as well as the 3-week duration of the examination period) either: a) a glass of semi-skimmed milk each day (control group, n=63) or b) two 100mL portions per day of fermented milk (treatment group, n=73). Anxiety and immunological measurements were monitored at baseline (Phase 0) and study end (Phase 1).
Results The results were expressed as the differences between the data obtained from Phase 0 and Phase 1. This was calculated by subtracting Phase 1 results from the Phase 0 and it is denominated Treatment effect . Mean (± SE) anxiety increased significantly (P < 0.05) over the 6-week study in all students, from 40.74±2.50 to 61.19±2.64 (in percentiles). There was no significant treatment effect since this increase was similar in the control and the treatment groups (21.65±5.09 vs 19.14±3.67, respectively). However, there was a significant treatment effect (P < 0.05) on the mean change in absolute number of lymphocytes during the 6-week study, which decreased in the control group (-0.04±0.12 cells x 103/mm3) and increased in the treatment group (0.37±0.11 cells x 103/mm3). There was also a significant treatment effect (P < 0.05) on the change in absolute numbers of CD56 cells during the 6-week study. Mean absolute CD56 cells significantly decreased (P < 0.05) in the control group (-51.97±21.33 cells/mm3),while remaining similar in the treatment group (17.29±17.27 cells/mm3). During the study, mean serum cortisol increased 4.30±0.98 µg/dL in the control group, and 1.75±1.05 µg/dL in the treatment group and no significant differences were found between both values (P=0.062).
Conclusions Milk fermented with yogurt cultures plus Lactobacillus casei DN-114001 was able to modulate the number of lymphocytes and CD56 cells in subjects under academic examination stress.
Pedone CA, Bernabeu AO, Postaire ER, Bouley CF, Reinert P
Int J Clin Pract. 1999 Apr-May;53(3):179-84
The objective of this study was to determine if supplementation with milk fermented by yogurt cultures and Lactobacillus casei (strain DN-114 001) could lessen acute diarrhoea in healthy children. The study was conducted over six months, with 287 children aged 18.9 (SD 6.0) months, comprising three periods of one month supplementation, each month being followed by one month without supplementation. Subjects were supplemented daily with either 125 g or 250 g (according to age) of one of three tested dairy products: standard yogurt, milk fermented by yogurt cultures and Lactobacillus casei (10(8) cfu/ml), or a jellied milk (control product). A daily record was kept of the number and type of stools. Although the incidence of diarrhoea was not shown to be different between the groups, the severity of diarrhoea over the six-month study was significantly decreased (4.3 days) with the supplementation of L. casei fermented milk compared with the jellied milk (8.0 days) (p = 0.009).
Pedone CA, Arnaud CC, Postaire ER, Bouley CF, Reinert P
Int J Clin Pract. 2000 Nov;54(9):568-71
The aim of this study was to determine if supplementation of healthy children with milk fermented by yogurt cultures and Lactobacillus casei strain DN-114 001 could affect the incidence of acute diarrhoea when compared with traditional yogurt. The study was a multicentre, randomised, double-blind trial, conducted over four months, on 928 children aged, at inclusion, 6-24 months. The study consisted of two periods: supplementation and observation. Subjects were supplemented daily with 100 g of one of the two dairy products being tested: standard yogurt and milk fermented by yogurt cultures and Lactobacillus casei (10(8) cfu/ml). Frequency or duration of any diarrhoea episode was evaluated. As far as frequency was concerned there was a statistically significant difference between the groups, the incidence of diarrhoea being significantly reduced by supplementation with L. casei fermented milk (15.9%) compared with yogurt (22%) (p = 0.03). These results suggest an additional benefit of L. casei in acute diarrhoea in children compared with standard yogurt.
Turchet P, Laurenzano M, Auboiron S, Antoine JMv
Journal of nutrition, Health and Ageing. 2003; 7:75-77.
Probiotics are being increasingly studied for their ability to enhance host resistance to, and recovery from, infection. The probiotic strain Lactobacillus casei DN-114 001 has previously been shown to reduce the incidence and duration of episodes of diarrhoea in children. Our controlled pilot study aimed to evaluate the effect of supplementation for 3 weeks with milk fermented with yoghurt cultures and L. casei DN-114 001 on the incidence and severity of winter infections (gastrointestinal and respiratory) in elderly people. We found no difference in the incidence of winter infections between groups. However, duration of all pathologies was significantly lower in the treatment group (7.0±3.2 days, n=180) than in the control group (8.7±3.7 days; n=180) (p=0.024), as was maximal temperature (38.3±0.5°C treatment group vs. 38.5±0.6°C control; p=0.01). The potential for a 20% reduction in the duration of winter infections that we have found warrants further investigation on a larger scale.
Sýkora J, Valecková K, Amlerová J, Siala K, Dedek P, Watkins S, Varvarovská J, Stozický F, Pazdiora P, Schwarz J.
J Clin Gastroenterol. 2005 Sep;39(8):692-8.
GOALS: To determine the efficacy of triple therapy supplemented with a specially designed fermented milk product containing specific probiotic Lactobacillus casei (L. casei) DN-114 001 strain on Helicobacter pylori eradication in children. BACKGROUND: Lactobacillus species possess in vitro activity against H. pylori. There are no consistent data on the impact of eradication therapy supplemented with probiotics on H. pylori cure rates in childhood in vivo. STUDY: Multicenter, prospective, randomized, double-blind controlled study. Eighty-six symptomatic H. pylori-positive children were randomized either to receive the control treatment of omeprazole, amoxicillin, and clarithromycin (OAC) for 7 days or the test treatment of omeprazole, amoxicillin, and clarithromycin for 7 days supplemented with fermented milk (Actimel) containing L. casei DN-114 001 (OAC-LC), for 14 days. H. pylori status was assessed at 4 weeks following therapy using two noninvasive tests. RESULTS: Intention-to-treat (ITT) based eradication rates for the OAC-LC group were 84.6% (95% CI, 71.2%-95.5%), and 91.6% (95% CI, 76.9%-98.2%) by per-protocol (PP) analysis. Eradication in the OAC group was 57.5% (95% CI, 42.2%-72.3%) in the ITT set and 61.3% (95% CI, 44.4%-75.0%) in the PP group. Eradication success was higher in the OAC-LC group compared with the OAC group in both ITT (P=0.0045) and PP analysis (P=0.0019). Primary resistance for clarithromycin could be determined in 21.2%. Side effects were infrequent. Drug compliance was good throughout the study. CONCLUSION: Supplementation with fermented milk, containing live special probiotic L. casei DN-114 001, confers an enhanced therapeutic benefit on H. pylori eradication in children with gastritis on triple therapy.
16 Probiotics and inflammatory bowel diseases
BAI AP, OUYANG Q.
Postgrad Med J. 2006 Jun; 82(968):376-82.
Enteric microflora profiles vary considerably between active inflammatory bowel diseases (IBD) and healthy conditions. Intestinal microflora may partake in the pathogenesis of IBD by one or some ways: specific pathogenic infection induces abnormal intestinal mucosal inflammation; aberrant microflora components trigger the onset of IBD; abnormal host immune response loses normal immune tolerance to luminal components; luminal antigens permeate through the defective mucosal barrier into mucosal lamina propria and induce abnormal inflammatory response. Preliminary studies suggest that administration of probiotics may be benefit for experimental colitis and clinical trials for IBD. Researches have been studying the function of probiotics. Introduction of probiotics can balance the aberrant enteric microflora in IBD patients, and reinforce the various lines of intestinal defence by inhibiting microbial pathogens growth, increasing intestinal epithelial tight junction and permeability, modulating immune response of intestinal epithelia and mucosal immune cells, secreting antimicrobial products, decomposing luminal pathogenic antigens.
17 Probiotic effects on inflammatory bowel disease.
Sheil B, Shanahan F, O'Mahony L
J Nutr. 2007 Mar;137(3 Suppl 2):819S-24S
Components of the commensal flora, including Bifidobacteria and Lactobacilli, have been associated with beneficial effects on the host. These beneficial effects include maintenance of intestinal homeostasis, competitive exclusion of pathogens, production of antimicrobial compounds, promotion of gut barrier function, and immune modulation. Probiotics currently can be administered in dairy yogurts and drinks and also in the form of sachets or capsules. Although preliminary studies are clearly promising, placebo-controlled, randomized, double-blind clinical trials are required to clarify the role of probiotic bacteria in the treatment of inflammatory bowel disease. The choice of probiotic bacteria, the optimal dose, mode of administration, and duration of therapy still need to be established. Detailed strain characterization is also required for all potential probiotic strains. As evidence accumulates to suggest a breakdown in tolerance toward ubiquitous intestinal bacteria, it appears logical to intervene by modulating the enteric flora. Increasingly, research suggests that probiotics may offer an alternative or adjuvant approach to conventional therapy by altering the intestinal microflora and modulating the host immune system.
18 Irritable bowel syndrome and probiotics: from rationale to clinical use.
Verdu EF, Collins SM
Curr Opin Gastroenterol. 2005 Nov;21(6):697-701
PURPOSE OF REVIEW: Few therapies are of proven efficacy in irritable bowel syndrome. Thus, there is great interest in the development of a natural therapy that can be both safe and effective. An understanding that probiotics are heterogeneous, with multiple targets and mechanisms of action, is fundamental to the development of clinical trials. RECENT FINDINGS: A bidirectional model for the pathogenesis of irritable bowel syndrome is proposed in which gut-driven and brain-driven mechanisms contribute to the genesis of gut dysfunction and symptoms. In-vitro and animal studies have generated most of the mechanistic rationale for the use of probiotics in functional bowel disorders. A MEDLINE search of publications from 1989 to date revealed only eight placebo-controlled clinical trials on the subject of probiotics and irritable bowel syndrome. All these studies suffer from methodologic problems. By contrast, numerous reviews have been published in the past 2 years on this subject. SUMMARY: Animal research will continue to identify novel targets and elucidate the mechanisms of action of probiotics, thus providing a rational basis for their use in irritable bowel syndrome. The notion of treating irritable bowel syndrome with probiotics is particularly attractive to patients and generates great interest, although clinical evidence is not yet sufficient to enable clear guidelines to be designed. Large, well-designed, controlled clinical trials using specific probiotics are warranted.
Guyonnet D, Chassany O, Ducrotte P, Picard C, Mouret M, Mercier CH, Matuchansky C
Aliment Pharmacol Ther. 2007 Aug 1;26(3):475-86
BACKGROUND: Health-related quality of life (HRQoL) has been rarely evaluated as a primary endpoint in the assessment of the effect of probiotics on the irritable bowel syndrome (IBS). AIM: To study the effects of fermented milk containing Bifidobacterium animalis DN-173 010 and yoghurt strains on the IBS in a multicentre, double-blind, controlled trial. METHODS: A total of 274 primary care adults with constipation-predominant IBS (Rome II) were randomized to consume for 6 weeks either the test fermented milk or a heat-treated yoghurt (control). HRQoL and digestive symptoms were assessed after 3 and 6 weeks on an intention-to-treat population of 267 subjects. RESULTS: The HRQoL discomfort score, the primary endpoint, improved (P < 0.001) in both groups at weeks 3 and 6. The responder rate for the HRQoL discomfort score was higher (65.2 vs. 47.7%, P < 0.005), as was the decrease in bloating score [0.56 +/- (s.d.)1.01 vs. 0.31 +/- 0.87, P = 0.03], at week 3 in the test vs. the control group. In those subjects with < 3 stools/week, stool frequency increased (P < 0.001) over 6 weeks in the test vs. control group. CONCLUSIONS: This study suggests a beneficial effect of a probiotic food on discomfort HRQoL score and bloating in constipation-predominant IBS, and on stool frequency in subjects with < 3 stools/week.
Bouvier M, Meance S, Bouley C, Berta J-L, Grimaud J-C
Bioscience and Microbiota 2001;20(2):43-8
Objectives: The aim of our study was to ascertain whether the specific Bifidobacterium animalis DN-173010 fermented milk could modulate colonic transit time in humans. Bifidobacteria are a major component of the gut microflora and may interact with gut transit. Methods: The trial compared in a parallel double blind study in seventy two healthy volunteers the effect of a Bifidobacterium animalis fermented milk containing 2.6*108CFU/g living bifidobacteria versus heat-treated Bifidobacterium fermented milk on colonic transit times. The main marker was the total colonic transit time(CTT) measured with radio-opaque pellets. Segmental colonic transit times were also calculated. Results: A 11-day-consumption of this Bifidobacterium animalis DN-173 010 fermented milk significantly reduced the total CTT (-20.6%) comparatively to the initial CTT and to the control group where no significant change were recorded. The effect was more pronounced in women than in men. Conclusion: Our study demonstrated that the consumption of the fermented milk containing living Bifidobacterium animalis DN-173 010 was able to improve CTT in humans. (author abst.)
Moyad MA.
Urol Clin North Am. 2002 Feb;29(1):31-48, viii
Apart from smoking, certain occupational exposures, and schistosomiasis, little is known about other potential lifestyle risk factors for bladder cancer. Other investigations thus far have also been important because of the large number of individuals who are diagnosed with this cancer that apparently have no known risk factors. Preventing the recurrence of bladder cancer has generated some interest because several preliminary trials have found that a combination dietary supplement of vitamins and minerals or a probiotic agent (Lactobacillus casei) may impact this outcome favorably. Advising patients on some of these lifestyle modifications is currently recommended because the majority of them are also currently recommended for cardiovascular disease reduction.
Hickson M, D'Souza AL, Muthu N, Rogers TR, Want S, Rajkumar C, Bulpitt CJ
BMJ. 2007 Jul 14;335(7610):80. Epub 2007 Jun 29
OBJECTIVE: To determine the efficacy of a probiotic drink containing Lactobacillus for the prevention of any diarrhoea associated with antibiotic use and that caused by Clostridium difficile. DESIGN: Randomised double blind placebo controlled study. PARTICIPANTS: 135 hospital patients (mean age 74) taking antibiotics. Exclusions included diarrhoea on admission, bowel pathology that could result in diarrhoea, antibiotic use in the previous four weeks, severe illness, immunosuppression, bowel surgery, artificial heart valves, and history of rheumatic heart disease or infective endocarditis. INTERVENTION: Consumption of a 100 g (97 ml) drink containing Lactobacillus casei, L bulgaricus, and Streptococcus thermophilus twice a day during a course of antibiotics and for one week after the course finished. The placebo group received a longlife sterile milkshake. MAIN OUTCOME MEASURES: Primary outcome: occurrence of antibiotic associated diarrhoea. Secondary outcome: presence of C difficile toxin and diarrhoea. RESULTS: 7/57 (12%) of the probiotic group developed diarrhoea associated with antibiotic use compared with 19/56 (34%) in the placebo group (P=0.007). Logistic regression to control for other factors gave an odds ratio 0.25 (95% confidence interval 0.07 to 0.85) for use of the probiotic, with low albumin and sodium also increasing the risk of diarrhoea. The absolute risk reduction was 21.6% (6.6% to 36.6%), and the number needed to treat was 5 (3 to 15). No one in the probiotic group and 9/53 (17%) in the placebo group had diarrhoea caused by C difficile (P=0.001). The absolute risk reduction was 17% (7% to 27%), and the number needed to treat was 6 (4 to 14). CONCLUSION: Consumption of a probiotic drink containing L casei, L bulgaricus, and S thermophilus can reduce the incidence of antibiotic associated diarrhoea and C difficile associated diarrhoea. This has the potential to decrease morbidity, healthcare costs, and mortality if used routinely in patients aged over 50. TRIAL REGISTRATION: National Research Register N0016106821.