Q&A: Should I give probiotics for diarrhea?

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Question: My son is taking an antibiotic to clear up his sinus infection and has developed diarrhea. My friend told me that I can give him a probiotic to help the diarrhea. Aren’t probiotics bacteria?

Christine Climer responds: Probiotics are indeed bacteria, and the thought of intentionally ingesting bacteria is one that seriously concerns many parents. It is important to understand though that not all bacteria are bad for you, and not all bacteria cause illness.

Many different kinds of bacteria live in and on our bodies all the time and never cause illness. In fact, the bacteria that make up our normal flora are responsible for helping to keep our bodies healthy! Some types of bacteria make vitamins for our bodies to use, some release substances that kill disease-causing germs and others help teach our immune systems to work properly.

Why do antibiotics cause diarrhea?
Your son is taking his antibiotic to kill the bacteria that are infecting his sinuses, but the antibiotic doesn’t just work in the sinuses; it works all over the body. Antibiotics also can’t tell the difference between those good bacteria making up our normal flora and bacteria causing an infection, so some of the good bacteria get killed along with some of the bad.

When the delicate flora balance is disturbed so that a significant enough percentage of beneficial flora is lost, potentially harmful bacteria and fungi are able to predominate. This causes irritation of the bowel — and diarrhea. If you replace those good bacteria while he is taking the antibiotic, the balance is less likely to be disturbed.

Are probiotics safe?
The consumption of probiotic bacteria is nothing new or revolutionary. Though many of us think of a probiotic as something that comes in a pill from our local health food store, many cultures have consumed probiotics for centuries as a part of their daily lives.

Most of us are familiar with yogurt, but many cultures consume other foods that have been fermented by probiotic bacteria such as kefir, cheeses, sauerkraut and miso, and they have long enjoyed the health benefits of these foods.

Scientific research has proven that whether taken as a pill, powder or fermented milk, probiotic bacteria may be safely consumed to treat and prevent antibiotic-associated diarrhea as well as many other health problems. Studies have included nearly every segment of the population, including premature infants, pregnant women, preschoolers and elderly adults.

People who take some form of probiotic are sick less often, less likely to have allergies, less likely to need antibiotics when they are sick and less likely to experience inflammatory diseases.

What is the best type of probiotic?
The type of probiotic you choose will depend on your personal preferences. Many families enjoy preparing their own fermented foods at home, such as yogurt or sauerkraut. If you don’t have the time or desire to do so, you may choose to purchase foods that contain live, active cultures. Organic yogurts that contain several different bacterial strains are effective, convenient choices that are available at your local grocery store.

If you choose to purchase a probiotic supplement, don’t let the labels confuse you. Many people refer to probiotics as “acidophilus,” but actually L. acidophilus is only one specific species of probiotic bacteria. Other probiotic bacteria that help keep us healthy include L. casei, L. rhamnosus, L. reuteri, B. infantis and B. longum, among many more.

Since a healthy intestinal ecosystem is made up of a diverse variety of organisms, it may be preferable to take a probiotic that contains several different strains as opposed to a product that contains only one or two types of bacteria. Some products specifically state on the label that they are intended to be given to infants or children. That is because the types of bacteria that should live in the tummies of very young children are different from those that should be found in the tummy of an older child or adult. Bifidobacteria are the predominant bacteria in the belly of a breastfed infant.

Consult your healthcare provider before using probiotics if:
• your child has an immune disorder or other health condition that suppresses immune function.
• you have any concerns regarding probiotic safety.
• your child develops blood in his stools, fever or shows signs of dehydration.

Learn more about probiotics and cultured foods
To learn how to make your own cultured foods, read Wild Fermentation: The Flavor, Nutrition and Craft of Live-Culture Foods by Sandor Ellix Katz.

For more details on probiotic safety and health benefits, read the International Food Information Council’s “Food Friendly Bugs Do The Body Good.”

For comprehensive, up-to-date information on activities, research and new developments in the area of probiotics, visit www.usprobiotics.org.

© Christine Climer.

Christine Climer is a registered nurse with experience in pulmonary disease, pediatrics, home health and hospice services. Also trained in early childhood education, she is currently executive director and child care nurse for an early childhood health promotion organization. She lives with her husband and three children (including a set of twins) in Texas and enjoys researching health issues and gardening.

References
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Cremonini F, Di Caro S, Nista EC, et al. “Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea.” Aliment Pharmacol Ther 2002; 16:1461-1467.

Hatakka K, et al., “Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial,” BMJ. 2001;322(7298):1327.

Hoyos AB. “Reduced incidence of necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infantis to neonates in an intensive care unit.” Int J Infect Dis. 1999 Summer;3(4):197-202.

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Mackie RI, Sghir A, Gaskins HR. “Developmental microbial ecology of the neonatal gastrointestinal tract.” Am J Clin Nutr. 1999 May;69(5):1035S-1045S.

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