functional medicine and nutritional genomics - American Association ...

AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS
11
Probiotics In
Gastrointestinal
Disease
Gerard E. Mullin,
MD
What are Probiotics?
Probiotics are ‚live microbial feed supplements
that beneficially affect the host animal by
improving its intestinal microbial balance.‛ 1
There are numerous organisms that meet the
criteria established by the WHO in order to be
classified as a probiotic.
Clinical Applications of Probiotics in Digestive
Disease
In IBS, the most commonly utilized and studied
probiotic species are Lactobacillus,
Bifidobacteria, and Saccharomyces boulardii. 2-4
The results of randomized, controlled clinical
trials using probiotics to treat IBS symptoms
are shown in Table 3. Bifidobacterium infantis
35624 (B. infantis) has been shown to be
associated with improvement in IBS symptoms
except stool frequency and consistency.
5, 6
Lactobacillus GG was shown in one study to
be more likely to have treatment success and
reduced frequency of pain compared to
placebo. 7
A probiotic mixture containing
103
Lactobacillus rhamnosus GG, L. rhamnosus
LC705,
Bifidobacterium breve Bb99, Propionibacterium
freudenreichii ssp, and shermanii JS was
shown to be associated with improvement in
IBS total symptom scores. 8, 9 VSL#3 was
shown to be superior to placebo for improving
bloating, flatulence in patients with IBS. 10
Fermented milk containing Bifidobacterium
animalis, S. thermophilus and L. bulgaricus
when compared to placebo was found superior
for improving symptoms in patients with
constipation-predominant IBS patients. 11
multispecies probiotic formulation used in a
smaller study again showed improvement in
composite IBS scores, specifically abdominal
distension and pain, compared to placebo. 12
VSL#3 was shown to be significantly superior
to placebo in the pediatric population. 13
Traveler’s Diarrhea
Traveler's diarrhea is a condition that disrupts
work and vacation and affects many individuals
traveling from developed countries to developing
countries. The most common causative bacterial
A
2012