Nutrition Part III: Probiotics

Dear All, This is my amateur bad attempt to try to make my videos a little more fun. It's a conversation starter -- not medical advice.
If you'd like more information, please
check out my blog, where under the article "probiotics" I posted more detailed information:

www.bostonmedicalstudent.wordpress.com

here are some references:

The main point is that: 1) clostridium difficile is a serious, bad, bacterial problem in the U.S. that hits patients who have taken antibiotics and patients who are in the hospital. Just today, (4/30/07) our professor told us that four patients died of clostridium difficile at his hospital last year.

The bad news is that conventional antibiotics can fail to cure clostridium difficile. And when they fail it could lead to death.

The good news it that they could be potentially treated with probiotics (although a funkier version of probiotics) when conventional antibiotics fail.

It might seem ridiculous to try Dr. Aas' probiotics -- but I want to bring his work to your attention because conventional antibiotics do fail with regards to c. difficile. With Dr. Aas, he's reported success with this form of treatment when patients can't fight off C. difficile with metronidazole or vancomycin (these are the common antibiotic treatments).

Point #2: Von Niel argues that probiotics should be considered a mainstream therapy given the many positive results seen in randomized controlled trials (see the Von Niel reference). Unfortunately, it has been slow to catch on in the U.S., possibly because it usually takes 17 years for new scientific discoveries to get widely disseminated (Balas & Boren, 2000).
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For safety information on which strains are safe and who can take probiotics:

http://www.ajcn.org/cgi/content/abstract/83/6/1256

The authors noted: "We found that probiotics
are safe for use in otherwise healthy persons, but should be used with caution in some persons because of the risk of sepsis."
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Probiotics (from Von Neil, 2005)

We definitely know it works for:
Acute infectious diarrhea
Prevention of antibiotic-associated diarrhea

Conditions that are potentially treatable by probiotics:

Chronic diarrhea, Inflammatory bowel disease,
Irritable bowel syndrome, Food allergy

Conditions that are potentially preventable:

Traveler's diarrhea, Necrotizing enterocolitis,
Urogenital infections, Atopic disease, Dental caries

Future applications proposed for:
Cystic fibrosis, Rheumatoid arthritis, Cancers
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What is clostridium difficile? (from JG Bartlett, 2006) It's a nasty bacteria.

Who gets it? If you've taken antibiotics, are of advanced age, or in the hospital or recently came from the hospital.

What's the significance of this problem? A new epidemic strain of C. difficile has emerged that causes more frequent and more serious disease.

What are some symptoms? "Clinical disease and C. difficile toxin are present almost exclusively in patients with recent antibiotic exposure, with rare exceptions." So if you've taken antibiotics, that increases your risk.

Clinical expression of infection almost always includes diarrhea, but symptoms vary widely.

Common findings in patients with infection: 1) colitis (inflammation of the colon) with cramps, 2) fever, 3) abdominal pain 4) fecal leukocytes (white blood cells in the stool), 5) and inflammation on colonic biopsy (if you do a biopsy of the colon).

The disease is almost always restricted to the colon.

A recent report implicates gastric acid--suppressive agents as a risk for disease, but this has not been consistently observed.

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How come probiotics seems really weird?

"Frequently, years or even decades are required for laboratory discoveries to reach clinical practice. It takes an estimated average of 17 years for only 14% of new scientific discoveries to enter day-to-day clinical practice" (Balas & Boren).
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References

Aas et al., 2003. Recurrent Clostridium difficile Colitis...Clinical Infectious Diseases 2003; 36: 580-5

Balas EA, Boren SA. Yearbook of Medical Informatics: Managing Clinical Knowledge for Health Care Improvement. Stuttgart, Germany: Schattauer Verlagsgesellschaft mbH; 2000

Bartlett, JG. Narrative review: the new epidemic of Clostridium difficile-associated enteric disease. Ann Intern Med. 2006 Nov 21;145(10):758-64. Review.

Savino et al., (Randomized controlled trial talking about probiotics and cholic) Pediatrics 2007;119;e124-e130

Van Niel Pediatrics 2005; 115; 174-177

Weisman et al., (randomized controlled trial looking at probiotics and infections in day care centers) Pediatrics 2005;115;5-9

Category:

News & Politics

Tags:

• usmedstudent
• probiotics
• nutrition
• infection
• medical
• student
• health
• medicine
• disease
• urgelt
• diet

[gblueslover1]

well on a much lower level, I used to have acid reflux, commonly known as GERD. Since I've drinking Danactive evry day, i've totally skipped my Protonix treatments, and I'm CURED. Have no idea how that happened...but it works, and I've told others as well, and the news is spreading !

[usmedstudent]

wow interesting. i haven't heard about this before, but i will try to keep it on my radar screen. thanks!

[itsnotaspiderbite]

can you speak about how this bacteria is different than MRSA staph bacteria?

[usmedstudent]

thanks for your question and thanks for your interest in science and medicine! -- this bacteria is non-infectious (the probiotics I talk about in the video are non-infectious. MRSA staph

is a very nasty bacteria that if left untreated can basically kill a person -- it's a bug that is resistant to methycillin type antibiotic.

[mih9a]

USMedStudent, thanks for helping me appreciate science more.

[usmedstudent]

thank you mih9a!

[simplicityairjesus]

my father has this c diff with colitis he is really suffering, if a person has major surgery for a perferated ulcer, recieved a heavey does of antibiotics, he has had reocouring for three times now. why dont hospitals do this with out question they should do this for a person on heavey doeses of antibiotics, he is so sick

[ErmUhOkFine]

@ErmUhOkFine Jeff, don't comment on the affects of mercury amalgams as I'm sure you know that subject is STRICTLY taboo for anyone in good standing with the ADA. I don't wish you to open that can of worms. Specifically I'm wondering about the affect of fermented unpasteurized sauerkraut on digestion seeing as this video is on probiotics. BTW, I can't find unpasteurized sauerkraut available in stores, so I'll be making it at home the old fashioned way. The recipe looks pretty simple. Thanks.

[ErmUhOkFine]

I had 3 dental mercury amalgams removed 2 weeks ago. Didn't know I should see a specialist, so nothing done to prevent mercury exposure. I've ALWAYS had good gastrointestinal and overall health. This week my "end" is on FIRE so much that it wakes me. Maybe coincidence? I found a study on the herb cilantro shown to chelate toxic metal-comes out in urine. I found also about fermented sauerkraut (unpasteurized) and its affect on the gut and gastrointestinal well-being. Your thoughts? Many thanks.

[snowfert]

did you truly ask your micro teacher about clostridium and she didnt know?!? Or was that said just for the sake of this video? If your micro teacher didnt know, and youre on rotation...I would be quite concerned... =/

[bicepsca]

my father has c-dif and he is still in the hospital, he is fed a tube in the stomach do you suggest anything that can help him, he can't swallow because he had throat cancer

[alzghoulakef]

i got diarrhea over than 1 year now and i take so many things but nothing help :(

some 1 tell me what can i do even the doctor can't find wrong with me??

[Cellimmunitydotcom]

I used to have arthritis pain all throughout my body, had pain for years and years, not until a friend of mine told me about an all natural, little known protein, did my pain go away.

Cellimmunitydotcom

[xnerdfumasterx]

i think ur on meds

[hanksee]

One of the best probiotics supplments is Jarrow Formulas' Jarro-Dophilus. The enteric-coated (so that the bacteria will not be destroyed by the stomach acid enroute to the intestines) capsules are even individually blister-sealed. Get it from iherb and use YAN312 to receive a $5 discount off your oder. :)

[madscirat]

Great video. Truly our biology is an ecology, it doesnt pay to fuck with it.