|
Lactobacillus acidophilus is a "friendly" strain of bacteria used to make yogurt and cheese. Although we are born without it, acidophilus soon establishes itself in our intestines and helps prevent intestinal infections. Acidophilus also flourishes in the vagina, where it protects women against yeast infections.
Acidophilus is one of several microbes known collectively as probiotics (literally, "pro life," indicating that they are bacteria and yeasts that help rather than harm). Others include the bacteria L. bulgaricus, L. reuteri, L. plantarum, L. casei, B. bifidus, S. salivarius, and S. thermophilus and the yeast Saccharomyces boulardii. Your digestive tract is like a rain forest ecosystem, with billions of bacteria and yeasts rather than trees, frogs, and leopards. Some of these internal inhabitants are more helpful to your body than others. Acidophilus and related probiotics not only help the digestive tract function, they also reduce the presence of less healthful organisms by competing with them for the limited space available. For this reason, use of probiotics can help prevent infectious diarrhea.
Antibiotics can disturb the balance of your "inner rain forest" by killing friendly bacteria. When this happens, harmful bacteria and yeasts can move in and flourish. This can lead to vaginal yeast infections. Conversely, it appears that the regular use of probiotics can help prevent vaginal infections and generally improve the health of the gastrointestinal system. Whenever you take antibiotics, you should probably take probiotics as well, and continue them for some time after you are done with the course of treatment.
-------------------------------------------------------------------------------- Sources Although we believe that they are helpful and perhaps even necessary for human health, we don't have a daily requirement for probiotic bacteria. They are living creatures, not chemicals, so they can sustain themselves in your body unless something comes along to damage them, such as antibiotics. Cultured dairy products such as yogurt and kefir are good sources of acidophilus and other probiotic bacteria. Supplements are widely available in powder, liquid, capsule, or tablet form. Grocery stores and natural food stores both carry milk that contains live acidophilus. -------------------------------------------------------------------------------- Therapeutic Dosages Dosages of acidophilus are expressed not in grams or milligrams, but in billions of organisms. A typical daily dose should supply about 3 to 5 billion live organisms. Other probiotic bacteria are used similarly. The typical dose of S. boulardii yeast is 500 mg twice daily (standardized to provide 3 x 1010 colony-forming units per gram), to be taken while traveling, or at the start of using antibiotics and continuing for a few days after antibiotics are stopped. Because probiotics are not drugs, but rather living organisms that you are trying to transplant to your digestive tract, it is necessary to take the treatment regularly. Each time you do, you reinforce the beneficial bacterial colonies in your body, which may gradually push out harmful bacteria and yeasts growing there. The downside of using a living organism is that probiotics may die on the shelf. In fact, a study reported in 1990 found that most acidophilus capsules on the market contained no living acidophilus.1 The container label should guarantee living acidophilus (or bulgaricus, and so on) at the time of purchase, not just at the time of manufacture. Another approach is to eat acidophilus-rich foods such as yogurt, where the bacteria are most likely still alive. To treat or prevent vaginal infections, mix 2 tablespoons of yogurt or the contents of a couple of capsules of acidophilus with warm water and use as a douche. Finally, in addition to increasing your intake of probiotics, you can take fructo-oligosaccharides, supplements that can promote thriving colonies of helpful bacteria in the digestive tract. (Fructo-oligosaccharides are carbohydrates found in fruit. Fructo means "fruit," and an oligosaccharide is a type of carbohydrate.) Taking this supplement is like putting manure in a garden; it is thought to foster a healthy environment for the bacteria you want to have inside you. The typical daily dose of fructo-oligosaccharides is between 2 and 8 g. -------------------------------------------------------------------------------- Therapeutic Uses Evidence from many but not all trials suggests that acidophilus and other probiotics may be helpful for preventing traveler's diarrhea and diarrhea caused by antibiotics, chemotherapy, or radiation therapy, as well as preventing and treating infectious viral diarrhea; it may also help irritable bowel syndrome.228,109-111, 121-122 Probiotics may also be helpful for preventing or treating eczema,29,30 preventing vaginal yeast infections,3136 treating ulcerative colitis,37-39 and improving immunity.4043 The bacteria Helicobacter pylori is the main cause of ulcers in the stomach and duodenum. Antibiotics can kill H. pylori, but more than one must be used at once, and even then the bacteria is not necessarily eradicated. Probiotics may be helpful. Evidence suggests that various probiotics in the Lactobacillus family can inhibit the growth of H. pylori.112-115 While this effect does not appear to be strong enough for probiotic treatment to eradicate H. pylori on its own, preliminary trials, including one double-blind trial,123 suggest that probiotics may help standard antibiotic therapy work better, improving the rate of eradication and reducing side effects.112-113,116-120,123 Preliminary double-blind trials suggest that probiotics might help prevent heart disease by reducing cholesterol levels.44,45,46 Probiotic treatment has also been proposed as a treatment for canker sores and as a preventative measure against colon cancer, but there is no solid evidence that it is effective. There is some evidence that probiotics can help reduce symptoms of milk allergies when added to milk.49 Finally, probiotics may be helpful in a controversial condition known as yeast hypersensitivity syndrome (also known as chronic candidiasis, chronic candida, systemic candidiasis, or just candida). As described by some alternative medicine practitioners, yeast hypersensitivity syndrome consists of a population explosion of the normally benign Candida yeast that live in the vagina and elsewhere in the body, coupled with a type of allergic sensitivity to it. Probiotic supplements are widely recommended for this condition because they establish large, healthy populations of friendly bacteria that compete with the Candida that is trying to take up residence. A year-long open trial of 150 women found Lactobacillus probiotics ineffective for preventing urinary tract infections as compared to cranberry juice or no treatment.50 -------------------------------------------------------------------------------- What Is the Scientific Evidence for Acidophilus and Other Probiotics? Traveler's Diarrhea According to several studies, it appears that regular use of acidophilus and other probiotics can help prevent "traveler's diarrhea" (an illness caused by eating contaminated food, usually in developing countries).51,52 One double-blind, placebo-controlled study followed 820 people traveling to southern Turkey, and found that use of a probiotic called Lactobacillus GG significantly protected against intestinal infection.53 Other studies using S. boulardii have found similar benefits,54,55,56 including a double-blind, placebo-controlled trial enrolling 3,000 Austrian travelers.57 The greatest benefits were seen in travelers who visited North Africa and Turkey. The researchers noted the benefit depended on consistent use of the product, and a dosage of 1,000 mg daily was more effective than 250 mg daily. Infectious Diarrhea Probiotics may also help prevent or treat acute infectious diarrhea in children and adults. A review of the literature published in 2001 found 13 double-blind, placebo-controlled trials on the use of probiotics for acute infectious diarrhea in infants and children; 10 of these trials involved treatment, and 3 involved prevention.109 Overall, the evidence suggests that probiotics can significantly reduce the duration of diarrhea and perhaps help prevent it. The evidence is strongest for the probiotic Lactobacillus GG, and for infection and with a particular virus called rotavirus. For example, one double-blind, placebo-controlled trial of 269 children (age 1 month to 3 years) with acute diarrhea found that those treated with Lactobacillus GG recovered more quickly than those given placebo.58 The best results were seen among children with rotavirus infection (rotavirus is a virus that can cause severe diarrhea in children). Similar results with Lactobacillus GG were seen in a double-blind study of 71 children.59 In addition, a double-blind study evaluated the possible benefits of the probiotic L. reuteri in 66 children with rotavirus diarrhea.60 The study found that treatment shortened the duration of symptoms, and the higher the dose, the better the effect. A double-blind, placebo-controlled study of 81 hospitalized children found that treatment with Lactobacillus GG reduced the risk of developing diarrhea, particularly rotavirus infection.61 A double-blind, placebo-controlled study found that Lactobacillus GG helped prevent diarrhea in 204 undernourished children.62 Other studies indicate that the probiotics B. bifidum, Streptococcus thermophilus,L. casei, Lactobacillus LB, and S. boulardii - both individually and combined with L. reuteri and L. chamnosus - may also help prevent or treat diarrhea in infants and children.6368, 121-122 One study found that bacteria in the B. bifidum family can kill numerous bacteria that cause diarrhea.69 Keep in mind that diarrhea in young children can be serious. If it persists for more than a day, you should take your child to a physician. A large (211 participant) double-blind, placebo controlled study found that adults can benefit from probiotic treatment as well.26 Antibiotic-Related Diarrhea The results of many but not all double-blind and open trials suggest that probiotics, including S. boulardii and Lactobacillus GG, may help prevent or reduce antibiotic-related diarrhea.7079 One study evaluated 180 people, who received either placebo or 1,000 mg of saccharomyces daily along with their antibiotic treatment, and found that the treated group developed diarrhea significantly less often.80 A similar study of 193 people also found benefit.81 However, a study of 302 people found no benefit with Lactobacillus GG.82 Other Forms of Diarrhea Preliminary evidence suggests that probiotics may be helpful for reducing diarrheas and other gastrointestinal side effects caused by cancer treatment (radiation or chemotherapy).83,84 Small double-blind studies suggest S. boulardii might be helpful for treating chronic diarrhea in people with HIV, hospitalized patients being tube-fed, and people with Crohn's disease.8588 Inflammatory Bowel Disease (Ulcerative Colitis and Crohns Disease) The conditions Crohns disease and ulcerative colitis fall into the family of conditions known as Inflammatory Bowel Disease. Chronic diarrhea is a common feature of these conditions. A double-blind trial of 116 people with ulcerative colitis compared probiotic treatment against a relatively low dose of the standard drug mesalazine.89 The results suggest that probiotic treatment might be equally effective as low-dose mesalazine for controlling symptoms and maintaining remission. Evidence of benefit was seen in other trials as well.90 Another study found S. boulardii helpful for the diarrhea of Crohns disease.87 Probiotics might be useful for people with ulcerative colitis who have had part or all of the colon removed. Such people frequently develop a complication called "pouchitis," inflammation of part of the remaining intestine. A 9-month double-blind trial of 40 people found that a combination of three probiotic bacteria could significantly reduce the risk of a pouchitis flare-up.91 Participants were given either placebo or a mixture of various probiotics, including four strains of Lactobacilli, three strains of Bifidobacteria, and one strain of Streptococcus salivarius. The results showed that treated people were far less likely to have relapses of pouchitis. Irritable Bowel Syndrome People with irritable bowel syndrome (IBS) experience crampy digestive pain as well as alternating diarrhea and constipation and other symptoms. Although the cause of irritable bowel syndrome is not known, one possibility is a disturbance in healthy intestinal bacteria. Based on this theory, probiotics have been tried as a treatment for IBS. In a 4-week, double-blind, placebo-controlled trial of 60 people with IBS, treatment with L. plantarum reduced intestinal gas significantly.92 The benefits persisted for an additional year after treatment was stopped. In another 4-week, double-blind trial, 40 people with IBS again received either L. plantarum or placebo.110 The results showed improved overall symptoms in the treated group as compared to the placebo group. A small 6 week trial using L. acidophilus also found indications of benefit.93 However, in a double-blind, placebo-controlled crossover study of 24 people with irritable bowel syndrome, use of Lactobacillus GG failed to produce any noticeable benefit.111 Eczema Use of probiotics during pregnancy and after childbirth may reduce risk of childhood eczema. In a double-blind, placebo-controlled trial that enrolled 159 women, participants received either placebo or Lactobacillus GG capsules beginning 2 to 4 weeks before expected delivery.94 After delivery, breast-feeding mothers continued to take placebo or the probiotic for 6 months; formula-fed infants were given placebo or probiotic directly for the same period of time. The results showed that use of Lactobacillus GG reduced children's risk of developing eczema by approximately 50%. According to two-double blind trials, infants who already have eczema may benefit from probiotics as well.95,96 Vaginal Yeast Infections A review of the many studies on the use of oral and topical acidophilus to prevent vaginal yeast infections concluded that it may be effective, but more study is needed.97,98 Immunity A number of studies suggest that various probiotics can enhance immune function; however, most of them were not double-blind.99 One 12-week, double-blind, placebo-controlled trial evaluated 25 healthy elderly people, half of whom were given milk containing a particular strain of Bifidobacterium lactis, the others milk alone.100 The results showed various changes in immune parameters which the researchers took as possibly indicating improved immune function. Another double-blind, placebo-controlled study of 50 people using B. lactis had similar results.101 In addition, a 7-month, double-blind, placebo-controlled study of 571 children in day-care centers in Finland found that use of milk fortified with Lactobacillus GG reduced the number and severity of respiratory infections.102 Cholesterol An 8-week, double-blind, placebo-controlled trial of 70 overweight people found that a probiotic treatment containing S. thermophilus and Enterococcus faecium could reduce LDL ("bad") cholesterol by about 8%.103 Similarly positive results were seen in other trials of the same or other probiotics.104107 However, a 6-month double-blind, placebo-controlled trial found no long-term benefit.108 Researchers speculate that participants stopped using the product regularly toward the later parts of the study. -------------------------------------------------------------------------------- Safety Issues There are no known safety problems with the use of acidophilus or other probiotics. Occasionally, some people notice a temporary increase in digestive gas. -------------------------------------------------------------------------------- Interactions You Should Know About If you are taking antibiotics, it may be beneficial to take probiotic supplements at the same time, and to continue them for a couple of weeks after you have finished the course of drug treatment. This will help restore the balance of natural bacteria in your digestive tract. References 1. Hughes VL. Microbiologic characteristics of Lactobacillus products used for colonization of the vagina. Obstet Gynecol. 1990;75:244248. 2. Nobaek S, Johansson M-L, Molin G, et al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol. 2000;95:12311238. 3. Halpern GM, Prindiville T, Blankenberg M, et al. Treatment of irritable bowel syndrome with Lacteol Fort: a randomized, double-blind, cross-over trial. Am J Gastroenterol. 1996;91:15791585. 4. Scarpignato C, Rampal P. Prevention and treatment of traveler's diarrhea: a clinical pharmacological approach. Chemotherapy. 1995;41(suppl 1):4881. 5. Shornikova AV, Casas IA, Mykkanen H, et al. Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis. Pediatr Infect DisJ. 1997;16:11031107. 6. Shornikova AV, Casas IA, Isolauri E, et al. Lactobacillus reuteri as a therapeutic agent in acute diarrhea in young children. J Pediatr Gastroenterol Nutr. 1997;24:399404. 7. Oksanen PJ, Salminen S, Saxelin M, et al. Prevention of traveller's diarrhoea by Lactobacillus GG.Ann Med. 1990;22:5356. 8. Saavedra JM, Bauman NA, Oung I, et al. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet. 1994;344:10461049. 9. Pedone CA, Bernabeu AO, Postaire ER, et al. The effect of supplementation with milk fermented by Lactobacillus casei (strain DN-114 001) on acute diarrhoea in children attending day care centres. Int J Clin Pract. 1999;53:179184. 10. Colombel JF, Cortot A, Neut C, et al. Yoghurt with Bifidobacterium longum reduces erythromycin-induced gastrointestinal effects. Lancet. 1987;2:43. 11. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870876. 12. Hilton E, Kolakowski P, Singer C, et al. Efficacy of Lactobacillus GG as a diarrheal preventive in travelers. J Travel Med. 1997;4:4143. 13. Kirchhelle VA, Fruhwein N, Toburen D. Treatment of persistent diarrhea with Saccharomyces boulardii. Results of a prospective study [in German; English abstract]. Fortschr Med. 1996;114:136140. 14. Kollaritsch VH, Holst H, Grobara P, et al. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo-controlled double-blind study [translated from German]. Fortschr Med. 1993;111:152156. 15. Chapoy P. Treatment of acute infantile diarrhea: controlled trial of Saccharomyces boulardii [in French; English abstract]. Ann Pediatr (Paris). 1985;32:561563. 16. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterology. 1989;96:981988. 17. Surawicz CM, McFarland LV, Elmer G, et al. Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii.Am J Gastroenterol. 1989;84:12851287. 18. McFarland LV, Surawicz CM, Greenberg RN, et al. Prevention of Beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995;90:439448. 19. Bleichner G, Blehaut H, Mentec H, et al. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. A multicenter, randomized, double-blind placebo-controlled trial. Intensive Care Med. 1997;23:517523. 20. Plein K, Hotz J. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrheaa pilot study. Z Gastroenterol. 1993;31:129134. 21. Elmer GW, Moyer KA, Vega R, et al. Evaluation of Saccharomyces boulardii for patients with HIV-related diarrhoea and in healthy volunteers receiving antifungals. Microecol Ther. 1995;25:2331. 22. Guandalini S, Pensabene L, Zikri MA, et al. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J Pediatr Gastroenterol Nutr. 2000;30:5460. 23. Simakachorn N, Pichaipat V, Rithipornpaisarn P, et al. Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhea in children. J Pediatr Gastroenterol Nutr. 2000;30:6872. 24. Armuzzi A, Cremonini F, Ojetti V, et al. Effect of Lactobacillus GG supplementation on antibiotic-associated gastrointestinal side effects during Helicobacter pylori eradication therapy: a pilot study. Digestion. 2001;63:17. 25. Thomas MR, Litin SC, Osmon DR, et al. Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial. Mayo Clin Proc. 2001;76:883889. 26. Buydens P, Debeuckelaere S. Efficacy of SF 68 in the treatment of acute diarrhea. A placebo-controlled trial. Scand J Gastroenterol. 1996;31:887891. 27. Vanderhoof JA, Whitney DB, Antonson DL, et al. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr. 1999;135:564568. 28. Tankanow RM, Ross MB, Ertel IJ, et al. A double-blind, placebo-controlled study of the efficacy of Lactinex in the prophylaxis of amoxicillin-induced diarrhea. DICP. 1990;24:382384. 29. Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357:10761079. 30. Isolauri E, Arvola T, Sutas Y, et al. Probiotics in the management of atopic eczema. Clin Exp Allergy. 2000;30:16041610. 31. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870876. 32. Reid G, Bruce AW, McGroarty JA, et al. Is there a role for Lactobacilli in prevention of urogenital and intestinal infections? Clin Microbiol Rev. 1990;3:335344. 33. McGroarty JA. Probiotic use of lactobacilli in the human female urogenital tract. FEMS Immunol Med Microbiol. 1993;6:251264. 34. Hilton E, Isenberg HD, Alperstein P, et al. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med. 1992;116:353357. 35. Friedlander A, Druker MM, Schachter A. Lactobacillus acidophillus and vitamin B complex in the treatment of vaginal infection. Panminerva Med. 1986;28:5153. 36. Hilton E, Rindos P, Isenberg HD. Lactobacillus GG vaginal supositories and vaginitis. JClin Microbiol. 1995;33:1433. 37. Rembacken BJ, Snelling AM, Hawkey PM, et al. Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet. 1999;354:635639. 38. Faubion WA, Sandborn WJ. Probiotic therapy with E. coli for ulcerative colitis: take the good with the bad. Gastroenterology. 2000;118:630631. 39. Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: A double-blind, placebo-controlled trial. Gastroenterology. 2000;119:305309. 40. Meydani SN, Ha WK. Immunological effects of yogurt. Am J Clin Nutr. 2000;71:861872. 41. Arunachalam K, Gill HS, Chandra RK. Enhancement of natural immune function by dietary consumption of Bifidobacterium lactis. Eur J Clin Nutr. 2000;54:263267. 42. Chiang BL, Sheih YH, Wang LH,et al. Enhancing immunity by dietary consumption of a probiotic lactic acid bacterium (Bifidobacterium lactis HN019): optimization and definition of cellular immune responses.Eur J Clin Nutr. 2000;54:849855. 43. Hatakka K, Savilahti E, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ. 2001;322:15. 44. Anderson JW, Gilliland SE. Effect of fermented milk (yogurt) containing Lactobacillus acidophilus L1 on serum cholesterol in hypercholesterolemic humans. J Am Coll Nutr. 1999;18:4350. 45. Agerholm-Larsen L, Raben A, Haulrik N, et al. Effect of 8 week intake of probiotic milk products on risk factors for cardiovascular diseases. Eur J Clin Nutr. 2000;54:288297. 46. Agerholm-Larsen L, Bell ML, Grunwald GK, et al. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. Eur J Clin Nutr. 2000;54:856860. 47. Sakamoto I, Igarashi M, Kimura K, et al. Suppressive effect of Lactobacillus gasseri OLL 2716 (LG21) on Helicobacter pylori infection in humans. J Antimicrob Chemother. 2001;47:709710. 48. Plein K, Hotz J. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrheaa pilot study. Z Gastroenterol. 1993;31:129134. 49. Pelto L, Isolauri E, Lilius EM, et al. Probiotic bacteria down-regulate the milk-induced inflammatory response in milk-hypersensitive subjects but have an immunostimulatory effect in healthy subjects. Clin Exp Allergy. 1998;28:14741479. 50. Kontiokari T, Sundqvist K, Nuutinen M, et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001;322:15. 51. Scarpignato C, Rampal P. Prevention and treatment of traveler's diarrhea: a clinical pharmacological approach. Chemotherapy. 1995;41(suppl 1):4881. 52. Hilton E, Kolakowski P, Singer C, et al. Efficacy of Lactobacillus GG as a diarrheal preventive in travelers. J Travel Med. 1997;4:4143. 53. Oksanen PJ, Salminen S, Saxelin M, et al. Prevention of traveller's diarrhoea by Lactobacillus GG.Ann Med. 1990;22:5356. 54. Kirchhelle VA, Fruhwein N, Toburen D. Treatment of persistent diarrhea with Saccharomyces boulardii. Results of a prospective study [in German; English abstract]. Fortschr Med. 1996;114:136140. 55. Kollaritsch VH, Holst H, Grobara P, et al. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo-controlled double-blind study [translated from German]. Fortschr Med. 1993;111:152156. 56. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870876. 57. Kollaritsch VH, Holst H, Grobara P, et al. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo-controlled double-blind study [translated from German]. Fortschr Med. 1993;111:152156. 58. Guandalini S, Pensabene L, Zikri MA, et al. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J Pediatr Gastroenterol Nutr. 2000;30:5460. 59. Isolauri E, Juntunen M, Rautanen T, et al. A human Lactobacillus strain (Lactobacillus casei sp strain GG) promotes recovery from acute diarrhea in children. Pediatrics. 1991;88:9097. 60. Shornikova AV, Casas IA, Mykkanen H, et al. Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis. Pediatr Infect DisJ. 1997;16:11031107. 61. Szajewska H, Kotowska M, Mrukowicz JZ, et al. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr. 2001;138:361365. 62. Oberhelman RA, Gilman RH, Sheen P, et al. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr. 1999;134:1520. 63. Saavedra JM, Bauman NA, Oung I, et al. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet. 1994;344:10461049. 64. Pedone CA, Bernabeu AO, Postaire ER, et al. The effect of supplementation with milk fermented by Lactobacillus casei (strain DN-114 001) on acute diarrhoea in children attending day care centres. Int J Clin Pract. 1999;53:179184. 65. Chapoy P. Treatment of acute infantile diarrhea: controlled trial of Saccharomyces boulardii [in French; English abstract]. Ann Pediatr (Paris). 1985;32:561563. 66. Simakachorn N, Pichaipat V, Rithipornpaisarn P, et al. Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhea in children. J Pediatr Gastroenterol Nutr. 2000;30:6872. 67. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870876. 68. Buydens P, Debeuckelaere S. Efficacy of SF 68 in the treatment of acute diarrhea. A placebo-controlled trial. Scand J Gastroenterol. 1996;31:887891. 69. Lievin V, Peiffer I, Hudault S, et al. Bifidobacterium strains from resident infant human gastrointestinal microflora exert antimicrobial activity. Gut. 2000;47:646652. 70. Colombel JF, Cortot A, Neut C, et al. Yoghurt with Bifidobacterium longum reduces erythromycin-induced gastrointestinal effects. Lancet. 1987;2:43. 71. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870876. 72. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterology. 1989;96:981988. 73. Surawicz CM, McFarland LV, Elmer G, et al. Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii.Am J Gastroenterol. 1989;84:12851287. 74. McFarland LV, Surawicz CM, Greenberg RN, et al. Prevention of Beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995;90:439448. 75. Arvola T, Laiho K, Torkkeli S, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics. 1999;104:e64. 76. Siitonen S, Vapaatalo H, Salminen S, et al. Effect of Lactobacillus GG yoghurt in prevention of antibiotic associated diarrhoea. Ann Med. 1990;22:5759. 77. Vanderhoof JA, Whitney DB, Antonson DL, et al. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr. 1999;135:564568. 78. Thomas MR, Litin SC, Osmon DR, et al. Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial. Mayo Clin Proc. 2001;76:883889. 79. Tankanow RM, Ross MB, Ertel IJ, et al. A double-blind, placebo-controlled study of the efficacy of Lactinex in the prophylaxis of amoxicillin-induced diarrhea. DICP. 1990;24:382384. 80. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterology. 1989;96:981988. 81. McFarland LV, Surawicz CM, Greenberg RN, et al. Prevention of Beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995;90:439448. 82. Thomas MR, Litin SC, Osmon DR, et al. Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial. Mayo Clin Proc. 2001;76:883889. 83. Urbancsek H, Kazar T, Mezes I, et al. Results of a double-blind, randomized study to evaluate the efficacy and safety of Antibiophilus in patients with radiation-induced diarrhoea. Eur J Gastroenterol Hepatol. 2001;13:391396. 84. Unger C, Haring B, Kruse A, et al. Double-blind randomised placebo-controlled phase III study of an E. coli extract plus 5-fluorouracil versus 5-fluorouracil in patients with advanced colorectal cancer. Arzneimittelforschung. 2001;51:332338. 85. Elmer GW, Moyer KA, Vega R, et al. Evaluation of Saccharomyces boulardii for patients with HIV-related diarrhoea and in healthy volunteers receiving antifungals. Microecol Ther. 1995;25:2331. 86. Bleichner G, Blehaut H, Mentec H, et al. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. A multicenter, randomized, double-blind placebo-controlled trial. Intensive Care Med. 1997;23:517523. 87. Plein K, Hotz J. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrheaa pilot study. Z Gastroenterol. 1993;31:129134. 88. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870876. 89. Rembacken BJ, Snelling AM, Hawkey PM, et al. Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet. 1999;354:635639. 90. Faubion WA, Sandborn WJ. Probiotic therapy with E. coli for ulcerative colitis: take the good with the bad. Gastroenterology. 2000;118:630631. 91. Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: A double-blind, placebo-controlled trial. Gastroenterology. 2000;119:305309. 92. Nobaek S, Johansson M-L, Molin G, et al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol. 2000;95:12311238. 93. Halpern GM, Prindiville T, Blankenberg M, et al. Treatment of irritable bowel syndrome with Lacteol Fort: a randomized, double-blind, cross-over trial. Am J Gastroenterol. 1996;91:15791585. 94. Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357:10761079. 95. Isolauri E, Arvola T, Sutas Y, et al. Probiotics in the management of atopic eczema. Clin Exp Allergy. 2000;30:16041610. 96. Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol. 1997;99:179185. 97. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA. 1996;275:870876. 98. Reid G, Bruce AW, McGroarty JA, et al. Is there a role for Lactobacilli in prevention of urogenital and intestinal infections? Clin Microbiol Rev. 1990;3:335344. 99. Meydani SN, Ha WK. Immunological effects of yogurt. Am J Clin Nutr. 2000;71:861872. 100. Chiang BL, Sheih YH, Wang LH, et al. Enhancing immunity by dietary consumption of a probiotic lactic acid bacterium (Bifidobacterium lactis HN019): optimization and definition of cellular immune responses.Eur J Clin Nutr. 2000;54:849855. 101. Arunachalam K, Gill HS, Chandra RK. Enhancement of natural immune function by dietary consumption of Bifidobacterium lactis. Eur J Clin Nutr. 2000;54:263267. 102. Hatakka K, Savilahti E, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ. 2001;322:15. 103. Agerholm-Larsen L, Raben A, Haulrik N, et al. Effect of 8 week intake of probiotic milk products on risk factors for cardiovascular diseases. Eur J Clin Nutr. 2000;54:288297. 104. Anderson JW, Gilliland SE. Effect of fermented milk (yogurt) containing Lactobacillus acidophilus L1 on serum cholesterol in hypercholesterolemic humans. J Am Coll Nutr. 1999;18:4350. 105. Agerbaek M, Gerdes LU, Richelsen B. Hypocholesterolaemic effect of a new fermented milk product in healthy middle-aged men. Eur J Clin Nutr. 1995;49:346352. 106. Bertolami MC, Faludi AA, Batlouni M. Evaluation of the effects of a new fermented milk product (Gaio) on primary hypercholesterolemia. Eur J Clin Nutr. 1999;53:97101. 107. Agerholm-Larsen L, Bell ML, Grunwald GK, et al. The effect of a probiotic milk product on plasma cholesterol: a meta-analysis of short-term intervention studies. Eur J Clin Nutr. 2000;54:856860. 108. Richelsen B, Kristensen K, Pedersen SB. Long-term (6 months) effect of a new fermented milk product on the level of plasma lipoproteinsa placebo-controlled and double blind study. Eur J Clin Nutr. 1996;50:811815. 109. Szajewska H, Mrukowicz JZ. Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials. J Pediatr Gastroenterol Nutr. 2001;33(4 Suppl):S17-S25. 110. Niedzielin K, Kordecki H, Birkenfeld B. A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2001;13:1143-1147. 111. OSullivan MA, et al. Bacterial supplementaion in the irritable bowel syndrome. A randomized double-blind placebo-controlled crossover study. Digest Liver Dis 2000;32:294-301. 112. Aiba Y, Suzuki N, Kabir AM, et al. Lactic acid-mediated suppression of Helicobacter pylori by the oral administration of Lactobacillus salivarius as a probiotic in a gnotobiotic murine model. Am J Gastroenterol. 1998 Nov;93(11):2097-2101. 113. Sakamoto I, Igarashi M, Kimura K, et al. Suppressive effect of Lactobacillus gasseri OLL 2716 (LG21) on Helicobacter pylori infection in humans. J Antimicrob Chemother. 2001;47:709-710. 114. Felley CP, Corthesy-Theulaz I, Rivero JL, et al. Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. Eur J Gastroenterol Hepatol. 2001;13:25-29. 115. Michetti P, Dorta G, Wiesel PH, et al. Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans Digestion. 1999;60:203-209. 116. Armuzzi A, Cremonini F, Bartolozzi F, et al. The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther. 2001;15:163-169. 117. Armuzzi A, Cremonini F, Ojetti V, et al. Effect of Lactobacillus GG supplementation on antibiotic-associated gastrointestinal side effects during Helicobacter pylori eradication therapy: a pilot study. Digestion. 2001;63:1-7. 118. Canducci F, Armuzzi A, Cremonini F, et al. A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Aliment Pharmacol Ther. 2000;14:1625-1629. 119. De Francesco V, Stoppino V, Sgarro C, et al. Lactobacillus acidophilus administration added to omeprazole/amoxycillin-based double therapy in Helicobacter pylori eradication. Dig Liver Dis. 2000;32:746-747. 120. Wendakoon CN, Thomson AB, Ozimek L. Lack of therapeutic effect of a specially designed yogurt for the eradication of Helicobacter pylori infection. Digestion. 2002;65:16-20. 121. Van Niel CW, Feudtner C, Garrison MM, et al. Lactobacillus Therapy for Acute Infectious Diarrhea in Children: A Meta-analysis. Pediatrics. 2002;109:678-684. 122. Rosenfeldt V, Michaelsen KF, Jakobsen M, et al. Effect of probiotic Lactobacillus strains in young children hospitalized with acute diarrhea. Pediatr Infect Dis J. 2002;21:411-416. 123. Cremonini F, Di Caro S, Covino M, et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002;97:2744-2749. |
 |
 |
