13 november 2010: Bron: Cochrane Institute

Een nadere analyse van gerandomiseerde studies toont aan dat probiotica - melkzuurbacterien diarree kan voorkomen en sneller kan doen genezen. Het Cochrane Instituuut analyseerde alle beschikbare gerandomiserde studies van de afgelopen 10 jaar en komt tot de conclusie dat probiotica - melkzuurbacterien helend werkt bij diarree. Hier het abstract van recent studie, daaronder onze berichtgeving over zelfde onderwerp met zelfde positieve conclusies uit 2003 waarbij probiotica ook helend werkte bij de bestrijden van de Heliocopter Pylori, die vaak de oorzaak is van darmkanker en maagkanker.

November 12, 2010 — Probiotics shorten diarrheal episodes, according to the results of a systematic review reported online in the November 10 issue of the Cochrane Database of Systematic Reviews.

"A striking finding of this review is that most trials reported that probiotics reduced diarrhoea," said lead author Stephen J. Allen, from the School of Medicine at Swansea University, Swansea, United Kingdom, in a news release. "The beneficial effect was consistent and significant across many different types of trials."

To evaluate the impact of probiotics in proven or presumed acute infectious diarrhea, the investigators searched the Cochrane Infectious Diseases Group's trials register through July 2010, the Cochrane Controlled Trials Register (The Cochrane Library Issue 2, 2010), MEDLINE (1966 - July 2010), EMBASE (1988 - July 2010), and bibliographies of retrieved studies and reviews. They also contacted relevant organizations and experts, as well as pharmaceutical companies manufacturing probiotic agents.

Inclusion criteria were randomized and quasirandomized controlled trials in which a specified probiotic was compared vs a placebo or no probiotic in persons with acute diarrhea proven or presumed to be caused by an infectious agent. Two reviewers independently evaluated the methodologic quality of and extracted data from included trials. The main study endpoints, which were analyzed with use of a random-effects model, were mean duration of diarrhea, stool frequency on day 2 after treatment, and ongoing diarrhea on day 4.

Of 63 studies meeting inclusion criteria and enrolling a total of 8014 participants, 56 trials enrolled infants and young children. There was some heterogeneity among trials in the risk for bias in definitions used for acute diarrhea and for the end of the diarrheal illness, settings, organisms tested, dosage, and participants' characteristics.

Although the magnitude of the effect varied considerably among studies, probiotics significantly reduced the mean duration of diarrhea (mean difference, 24.76 hours; 95% confidence interval , 15.9 - 33.6 hours; n = 4555; trials = 35). Probiotics also reduced diarrhea lasting at least 4 days (risk ratio, 0.41; 95% CI, 0.32 - 0.53; n = 2853; trials = 29) and stool frequency on day 2 (mean difference, 0.80; 95% CI, 0.45 - 1.14; n = 2751; trials = 20). In the trials reviewed, probiotics were not associated with any significant adverse effects.

Limitations of this review include great variability in the methodologic quality of the trials, persistence of statistical heterogeneity in subgroup analyses, marked clinical variability among studies, and lack of cost-effect analyses.

"The differences in effect size between studies was not explained by study quality, probiotic strain, the number of different strains, the viability of the organisms, dosage of organisms, the causes of diarrhoea, or the severity of the diarrhoea, or whether the studies were done in developed or developing countries," the study authors write. "Used alongside rehydration therapy, probiotics appear to be safe and have clear beneficial effects in shortening the duration and reducing stool frequency in acute infectious diarrhoea. However, more research is needed to guide the use of particular probiotic regimens in specific patient groups." The study authors also suggest that future research include evaluation of different probiotic strains to treat diarrhea and prevent the progression from acute to persistent diarrhea.

Swansea School of Medicine, United Kingdom, and Cochrane Infectious Disease Group, Liverpool School of Tropical Medicine, United Kingdom, supported this study. Some of the study authors have disclosed various financial relationships with Cultech Ltd, United Kingdo; Scientific Hospital Supplies, United Kingdom; Valio Ltd, Finland; and United Laboratories Inc, Philippines.

Cochrane Database Syst Rev. Published online November 10, 2010.

d.d. 14 november 2003: Bron: Nutra Ingredients

Op een conferentie over gebruik en effecten van probiotica , levende melkzuurbacteriën, afgelopen september in Canada is naar voren gekomen dat verschillende studies met zowel dieren als mensen hebben bewezen dat probiotica, al of niet in combinatie met antibiotica een positief effect heeft op verschillende darmproblemen waaronder naast diarree, de bestrijding van de bacterie Helicobacter pylori, die vaak verantwoordelijk lijkt voor o.a. de ziekte van Crohn, (zie o.a. verhaal van Ed ) en darmkankers en maagkanker.

Producenten van probiotica vertelden ons dat probiotica vooral ook de darmflora na bv. een chemokuur en/of bestraling weer snel op orde krijgt. Er lopen een aantal trials in ziekenhuizen in binnen- en buitenland naar het effect van probiotica bij o.a. darmproblemen enz. , maar dit zijn langjarige studies en resultaten mogen nog niet gepubliceerd worden. Toch aandacht voor deze probiotica omdat wij verschillende mensen kennen die hier baat bij hebben gehad of nog hebben. Ook kankerpatiënten.

Mounting scientific evidence for the therapeutic use of probiotics suggests that these products should be incorporated into conventional medical practices, concluded a recent meeting of experts in probiotics. 

Continuing research reveals the significant potential for the live bacteria to improve and protect health, especially when used in co-therapy with antibiotics, the participants heard. 
The conference, organised by the probiotic supplier Institut Rosell-Lallemand, gathered doctors, veterinarians, nutritionists and researchers from various regions of Europe and North America. Presentations focused on the use and safety of probiotics (yeast and bacteria) and mineral enriched yeast in the prevention and treatment of dysfunctions in animals and humans. Novel approaches aiming to better understand the mechanisms involved were also discussed. 

The session highlighted a need for a harmonisation of biomarkers used in studies whether to investigate the effect of probiotics in livestock, lab animals, in vitro assay systems or in human clinical trials. This was the first of the four annual meetings to combine human health and animal health topics. 

Several recent studies have assessed the interest of lactic acid bacteria on infection by Helicobacter pylori (the bacteria associated to ulcers), which is a major issue for public health in several countries. A clinical trial conducted by Dr. Bielanski (Jagiellonian University Medical College, Krakow, Poland) demonstrated that Lacidofil probiotic may improve the Hp eradication rate and the tolerance of the anti-Hp conventional treatment. 

Another study conducted in mice by Dr Johnson-Henry, Hospital of Sick Children in Toronto, showed that Lacidofil may reduce the severity of Hp gastric colonisation. Institut Rosell is also currently dedicating a part of its R&D to this area. 

In the studies comparing different strains, it repeatedly observed that not all probiotics are equal. Furthermore, there is growing evidence that heat-inactivated bacteria are much less active than live cells as probiotics. 

Dr David Mack, head of Gastroenterology at the Children’s Hospital of Eastern Ontario, said: “I am concerned with recent reports suggesting either no effect or negative effects on gastrointestinal function with the administration of heat-killed probiotics to humans. It appears that dead bacteria may have effects in the body and not what is expected from the ingestion of live, viable bacteria."

The question of dose-effect relationship was also debated. A review of recent clinical probiotic studies suggests that a minimum of 10 billion CFU per day are necessary for clinically demonstrable effectiveness in the treatment of diarrhoea. However, several of the positive results presented at the meeting (Dr Bielanski, Jagiellonian University Medical College, Krakow, Poland, Dr Savoini, Veterinary University of Milan, Italy) were obtained with doses in the range of 1 billion CFU per day in non-diarrheal situations. The consensus was that future clinical studies on probiotics should focus on the importance of establishing effective doses. 

Institut Rosell-Lallemand’s fourth Annual Scientific Exchange took place in Quebec, Canada from 12-14 September. 

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