A serious concern for little bodies

When diarrhea hits young children, it can be more than just an uncomfortable nuisance. This age group is especially sensitive to the loss of electrolytes that accompanies severe bouts of diarrhea, and they can become dehydrated very quickly.

Back in the 1970s, infectious diarrhea accounted for about five million childhood deaths each year. Since then, oral rehydration therapies have cut the number of infectious diarrhea deaths substantially, but they don’t do much to shorten the time that the diarrhea persists.

Good bugs for bad bugs

Probiotic are defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” Babies are given their first “dose” of probiotics as they pass through the birth canal. After that, the type and amount of bugs that take up residence in the intestines depends on different factors, including:

• Antibiotic use—Antibiotics kill off good bacteria, along with the bad.
• Probiotic intake—Kefir, yogurt, miso, pickles, and other fermented foods can all help build a healthy crop of beneficial bacteria in the gut.
• Diet type—Certain dietary patterns lend themselves to the growth of particular strains of gut flora. High-fat, low-fiber diets lead to the predominance of one type of bacteria, while low-fat, high-fiber diets lead to another. Breast-feeding babies also have different flora in their guts than bottle fed babies.

Sixty-nine children (average age 24 months) who were hospitalized with acute infectious diarrhea and dehydration were enrolled in the study. The children were given L. reuteri (400 million colony forming units per day) or placebo for seven days in addition to oral rehydration therapy.

• L. reuteri significantly reduced the duration of watery diarrhea compared with placebo (2.1 days in the L. reuteri group versus 3.3 days with placebo).
• The number of children with normal stool consistency was significantly higher on days two and three of treatment in the L. reuteri group than in the placebo group.

“Probiotics might be more effective when given early when patients might be less ill,” commented the researchers. “If this is the case, the efficacy of L. reuteri might have been even more pronounced if administered as early as possible.”

A strain for every occasion

Different probiotics have different effects in the human body. For instance, Lactobacillus plantarum is particularly good for relieving symptoms of gas and bloating associated with irritable bowel syndrome, Lactobacillus casei works well for post-antibiotic and traveler’s diarrhea, and Lactobacillus reuteri seems to be most helpful for infectious diarrhea.

(Aliment Pharmacol Ther 2012;doi:10.1111/j.1365-2036.2012.05180.x)