Dr. Jeremy F. Shapiro
Pediatrician
Dr Shapiro completed his undergraduate education at UC San Diego earning a B S in Biochemistry and Cell Biology and a B A in Political Science He furthered his education at UCLA where he earned a Masters Degree in Public…
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LOCATION: Los Angeles, CA, USA
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  • Attending Physician, Providence Tarzana Regional Medical Center
YEARS IN PRACTICE: 6
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Probiotics: Does the Research Justify Their Use?
17
Posted in Adoption by Dr. Jeremy F. Shapiro on Jan 15, 2009

Next to discussions of vaccines and developmental milestones, a frequently referred to topic with my patients involves the use of probiotics.  And as I find myself using them more and more with the patients I care for, I am also noticing many parents giving their children these live microorganisms on their own accord.   This, in fact, amazes me as just earlier this decade I recall a discussion with a distinguished pediatric gastroenterologist who was rather ambivalent regarding the use of probiotics.  And with due respect to my pediatric colleague, his reasoning stemmed from a lack of research supporting or refuting the potential health benefit of ingesting certain types of bacteria.  And while there is still much to be learned, I believe recent research will help cement the role of probiotics in pediatric care in the years to come.  So with thanks to Drs. Michael Land and Martin Martin, who together recently published a summary article in Contemporary Pediatrics, I will highlight some of their more interesting findings on the potential benefits of probiotics.


But what are probiotics?  Well, I think it's important to realize our body consists of billions of microorganisms, bacteria included.  Now many of these are good bacteria...which implies they help our digestive and immune systems to fully function.  And so probiotics are these good bacteria when given in some sort of supplementary form (powder, liquid) or food source (e.g. yogurt).


And why would we need probiotics if our body already naturally houses them?  Well, in certain disease states, there is a loss of the good bacteria and the thought is the sooner we replace them, an overall health benefit will occur.


So without further ado, I share with you some of the findings from Drs. Land and Martin's summary article as they relate to routine pediatric disease/health states.



  • Diarrhea when taking antibiotics: As I am sure just about everyone one of us has taken an antibiotic at some point during the course of our life, it should then follow that many of us are aware diarrhea or looser stools can be a common side effect of these antibiotics. The thought process behind this is the balance of the regular bacteria changes, thus leading to more frequent looser stools. But research has now shown that when giving probiotics while on antibiotics when compared to giving just a placebo, there is a reduction in the risk of diarrhea from nearly 30% to 12%...with Lactobacillus (L.) rhamnosus GG showing some of the best benefits.

  • Diarrhea from the acute "stomach bug" (viral gastroenteritis): These days, even with the benefit of the rotavirus vaccine, I'm still encountering many of these "bugs". In fact, in children less than 3 years of age, most experience about 2 episodes of these "bugs" each year. And so what does the data say about using probiotics to prevent the occurrence of diarrhea? Well, a recent meta-analysis of 34 trials has shown a 57% reduced risk of developing diarrhea when using probiotics...primarily the strains, L. Rhamnosus GG, L. acidophilus, L. bulgaricus and Saccharaomyces (S.) boulardii. And what if the diarrhea has already started? L. Rhamnosus appears to have the best clinical benefit in shortening the diarrheal time period.

  • Allergic diseases: This is now the area where I am seeing parents begin probiotics on their own initiative...when their child has asthma, allergies, and/or atopic dermatitis (AKA eczema). Unfortunately, although some evidence exists to support probiotic use when trying to prevent atopic dermatitis, the current research does not support the administration of probiotics after this condition appears. However, I remain hopeful that further research will support its use in the atopic world.


The one caveat, however, is to remember these are bacteria.  So before starting on your own, I recommend discussing with your child's physician as there may be some contraindication in probiotic use in children with chronic diseases (e.g. congenital heart disease, kidney disease) or those who are immunologically compromised.


 


Dr. Jeremy


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Displaying comments 17-1 of 17
17
My regular doctor is very forward-thinking when it comes to supplements, probiotics, etc. She believes that many auto-immune diseases are caused from the lack of proper "good bacteria" within our intestines. Lack of these bacteria can be a contributor when someone is diagnosed with rheumatoid arthritis, ms, lupus, etc. She says that "leaky gut" is a result of poor bacterial content in the intestines. Do you agree with this? I have RA. I also have had problems in the past with irritable bowel, but since eating at least one yogurt a day I have had improvement. Also, what is your opinion of ingesting pure Aloe Vera for intestinal problems?
By rusty1  Jan 19, 2009
16
We have suggested probiotics to our clientele for over twenty years with great success for a multitude of maladies. The protocol is simple:
1) Individualize the large number of probiotic strains in the marketplace to the client's needs.
2) Use strains with a proven track record of efficacy and research.
3) Make sure the probiotics are taken at the optimal time for the client to assure optimal absorption.
By nutrocon  Jan 19, 2009
15
Our pediarician recommends probiotics, as well as juicing, for excellent nutrient absorption. He also incorporates homeopathic medicine in his practice. How terrific it is that medicine, especially pediatric medicine, is now inclusive and positive towards the interconnections of whole foods and our body's natural wellness. In fact, he was just awarded "Doctor of the Year" for our large, metro area.

From my own experience, probiotics and whole food combining, as well as juicing, provided a turning point in my 20+ years of struggle with Crohn's disease and HS disease: I consider myself blessed to have found medical care that made (alkalizing) diet & nutrician first in managing serious diseases. I now have the tools to truly manage the disabling symptoms & effects of Crohn's and HS, without the (too common, but incurative)heart-breaking & challenging surgeries. What a healthful difference it has made in the quality of my life!

Thank you for stepping outside the box. As medicine shifts focus to supporting & sustaining wellness, not just eradicating & wrestling against illness, the result of improved health is so appreciated. Thank you for this inspiring article! :)
By Source  Jan 19, 2009
14
YES MY KIDS EAT YOUGURT.. THNKS FOR INFO..
By godsheavenlyangel06  Jan 18, 2009
13
For several years now I have suffered from chronic diarrhoea, frequently having to consume up to 8 Loperimide a day. Although I have diverticulites, this was something quite different and I have had every test possible including two colonoscopies and two endoscopies and many different blood tests until finally the consultants said it must be IBS. The only thing which helped was when, a year ago, I started taking Probiotic yoghourt and Manuka honey every morning, the attacks became fewer and less violent. Recently I have been prescribed a very small dose of anti-depressants to counter act the effects of serotonin in the brain and I'm delighted to report the diarrhoea has virtually gone, however I'll not stop taking the probiotic yoghourt. I should also add that I have never suffered from depression and the dose I take is about one tenth of what is prescribed for depression. My consultant also approves.
By AilP  Jan 18, 2009
12
I do know that some of these are in youghurt. I will start eating one small youghurt daily insted of resorting to another medication
By butterflyzrfree  Jan 18, 2009
11
A very interesting article . I have been looking for info on this topic. Very helpful!
By butterflyzrfree  Jan 18, 2009
10
I have to disagree about what type to take. GO REPUTABLE if you want the best results for your money. CVS and Wal-Mart type brands do NOT have the same effect on the body as the GOOD brands do. I must admit you are correct about the difficulty in remembering if kept in the refrigerator, but they are better and more easily digestible. Good Herbs sells 2 types avail online and Natures Sunshine also sells online and will be delivered to your door within 24 hrs of order in most cases. My daughter is immune defecient (severe) and she has been taking these for 7 years with great results. How much they take depends on the age of the child and severity of symptoms, as well as the strentgh of the product. My daughter at age 11 takes 2 pro vitality per day, but we just moved her to the strongest one avail (More $ but takes 1/2 as much so it's a btter deal). (She now takes Pro-Vitality Plus that has 1 million parts as opposed to 200,000.) Just make sure that they are NOT taken at the same time as an anti-biotic. Alternate at least an hour in between and avoid sugar intake when you have ANY infection. Sugar feeds bad bacteria and yogurt consumed that is flavored is also sugared, and therefore not a good choice. If you eat yougurt, eat plain and/or can be flavored with granola and /or oatmeal.
By Bixby  Jan 18, 2009
9
How much should a child receive?
By soh  Jan 18, 2009
8
i had serious gastrointensinal problems after taking a combination of Non-Corticosteroid Anti-Inflammatory drugs and antibiotics. One of the main symptoms was diarrhea, one of the doctors i visited suggested probiotics... I was taking them for about 2 months, the diarrhea never stopped, i just had a few good days. It seems I am the only person that my diarrhea stopped as soon as i stopped takign the probiotics!!!
By paparouna  Jan 17, 2009
7
Taking acidophilus, 2/day, is also a MUST if you can't or don't want to eat yogurt when you're taking an antibiotic, IF YOU'RE FEMALE. Antibiotics are known to cause yeast infections (candida) in the vagina, which you don't want. Be vigilant and start the acidophilus simultaneous to taking the antibiotics and even for a few days after. They restore the bacterial balance in your stomach. Trust me, I've been doing it for twenty years!
By fruitcup  Jan 17, 2009
6
To Appelbey, try the capsules of acidophilus. Any good brand will do, but if you get the probiotic kind (even those that you must refrigerate), you will have excellent results. The only reason not to get the kind that's refrigerated is that it's more difficult to remember to take it, even if you put a note on your door to the house so you see it before you leave. You don't need yogurt; acidophilus is IN it! Good luck and let me know what happens.
By fruitcup  Jan 17, 2009
5
I have been taking probiotic acidophilus for about 20 years for chronic cankersores in my mouth. I have never seen anything work so well. As long as I keep taking two per day, I never have a problem.

I also take L-lysine when I get a genital herpes outbreak or to prevent them. For maintenance therapy to keep it from returning, I take 500mg of L-lysine dailyi. When I have an outbreak, I take 2,000. It really shortens the duration of the outbreak.

My dog has atopic dermatitis, and I'm gong to ask her allergist if it would hurt to give her the contents of one acidoplilus capsule. Who knows? And my sister's dog has psoriasis. Maybe acidophilus will help him!
By fruitcup  Jan 17, 2009
4
I have avoided yoghurt because I dislike it but my nutritionist recommended the probiotic yoghurt for gastric problems and I have had far fewer since i started with it. I recommend it if you have stressed out stomachs or if you dont eat proper meals. But I find the type that includes *fiber* to be unpleasant.
By Appleby  Jan 17, 2009
3
My husband has had gastro problems ever since he was on a regiment of the drug Mobic. It litterly destroyed his intestines.He had severe diarrhea about 5-6 times a day and was tested for everything from C-Diff to exotic bugs that may be causing the problem. A friend suggested Colostrum and multidopholous 12. Amazingly the diarrhea stopped withing 3 days and he has been fines since. about 2 years ago he had his gallbladder taken out and now is on a low fat diet but still stays with his probiotics
By Ferr  Jan 16, 2009
2
My mother worked in the traditional medical field all my life and she was always my biggest critic when it came to natural healing and supplements. She had diarrhea a lot a couple of years ago. I told her to get a good probiotic. She did and she took it and it WORKED. She was amazed (I wasn't). In a later argument about some other supplement, she said 'None of those work for me.' I said 'The probiotics do.' she paused and admitted (reluctantly) 'Well that's true. They do.' Score 1 for the kid.
I take probiotics every day and I find them very helpful.
By ALC67  Jan 15, 2009
1
I have seriously wondered if it was just a gimmick....just another thing they are selling to us. Thank you for your medical input. I will suggest it to my hubby...had been sick with either flu or bad meat on a sub he had eaten. Was sick for over a week. Just now a little better. We are going to try the probiotics. For us and going to suggest my daughter find out from her doctor about for my grandsons whom have allergies and some asthma.

Thanks for the info.
Rhea
By tiredtiredtired  Jan 15, 2009
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