Probiotics help diarrhea
Pro Research Analysisby 
Searched over 200M research papers
The Role of Probiotics in Managing Diarrhea
Probiotics and Antibiotic-Associated Diarrhea (AAD)
Prevention of AAD in Children
Probiotics have shown significant promise in preventing antibiotic-associated diarrhea (AAD) in children. The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition recommends using specific probiotic strains such as Lactobacillus rhamnosus GG and Saccharomyces boulardii for this purpose. These recommendations are based on moderate quality evidence from multiple randomized controlled trials1. A comprehensive review of 33 studies involving 6,352 participants also supports the efficacy of probiotics in reducing the incidence of AAD. The incidence of AAD was significantly lower in the probiotic group (8%) compared to the control group (19%)2.
High-Dose Probiotics
The effectiveness of probiotics in preventing AAD appears to be dose-dependent. High doses (≥ 5 billion CFUs per day) are more effective than lower doses. For high-dose studies, the incidence of AAD in the probiotic group was 8% compared to 23% in the control group2. This suggests that higher doses of probiotics may offer better protection against AAD.
Probiotics and Clostridium difficile-Associated Diarrhea (CDAD)
Efficacy in Adults and Children
Probiotics are also effective in preventing Clostridium difficile-associated diarrhea (CDAD). A meta-analysis of 31 trials with 8,672 participants found that probiotics reduced the risk of CDAD by 60%. The incidence of CDAD was 1.5% in the probiotic group compared to 4.0% in the control group3. This protective effect was particularly notable in trials with a baseline CDAD risk greater than 5%, where probiotics reduced the risk by 70%3.
Probiotics for Acute Infectious Diarrhea
Reduction in Duration and Severity
Probiotics can also be beneficial in treating acute infectious diarrhea. A meta-analysis of 63 studies involving 8,014 participants found that probiotics reduced the duration of diarrhea by approximately 24.76 hours and decreased stool frequency on the second day of treatment7. Another review confirmed that probiotics reduced the mean duration of diarrhea by 30.48 hours and the risk of diarrhea lasting more than three days6.
Specific Strains and Mechanisms
Different probiotic strains, including Lactobacillus rhamnosus GG, Saccharomyces boulardii, and Lactobacillus casei, have been shown to be effective in managing diarrhea. These probiotics work by modulating gut microbiota and reducing intestinal inflammation. For instance, Lactobacillus casei has been found to increase fecal IgA levels and decrease inflammatory markers like lactoferrin and calprotectin, thereby improving gut health and reducing diarrhea severity8.
Limitations and Safety Concerns
Limited Efficacy in Severe Cases
While probiotics are generally effective, their benefits may be limited in cases of severe dehydrating diarrhea. A study on children with moderate to severe dehydration found no significant reduction in diarrhea duration or stool output with probiotic treatment10. This suggests that probiotics may be more effective as a preventive measure rather than a treatment for severe cases.
Safety Profile
Probiotics are generally safe with low rates of adverse events. Common side effects include mild gastrointestinal symptoms such as gas and bloating. No serious adverse events have been directly attributed to probiotic use in the studies reviewed2 3.
Conclusion
Probiotics, particularly strains like Lactobacillus rhamnosus GG and Saccharomyces boulardii, are effective in preventing and managing various forms of diarrhea, including antibiotic-associated and Clostridium difficile-associated diarrhea. They also reduce the duration and severity of acute infectious diarrhea. However, their efficacy may be limited in severe cases, and high doses are generally more effective. Probiotics are safe for most populations, making them a valuable adjunct in diarrhea management.
Sources and full results
Most relevant research papers on this topic
Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children.
Probiotics, particularly Lactobacillus rhamnosus GG and Saccharomyces boulardii, can help prevent antibiotic-associated diarrhea in children.
Systematic Review
Highly CitedProbiotics for the prevention of pediatric antibiotic-associated diarrhea.
Probiotics effectively reduce the incidence of antibiotic-associated diarrhea in children compared to placebo or no treatment control.
Meta-Analysis
Very Rigorous JournalProbiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.
Probiotics show potential in preventing Clostridium difficile-associated diarrhea in adults and children, but more research is needed to confirm their effectiveness and safety.
Meta-AnalysisVery Rigorous JournalHighly CitedProbiotics and antibiotic-associated diarrhea in children: A review and new evidence on Lactobacillus rhamnosus GG during and after antibiotic treatment.
Probiotics, specifically Lactobacillus Rhamnosus GG and Saccharomyces boulardii, show potential in preventing and treating antibiotic-associated diarrhea in children, but safety concerns remain.
Systematic Review
Rigorous JournalHighly CitedEfficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials.
Probiotics significantly reduce antibiotic-associated diarrhoea, travelers' diarrhoea, and acute diarrhoea of diverse causes, with varying effects depending on age and strain used.
Meta-AnalysisHighly CitedProbiotics for treating infectious diarrhoea.
Probiotics may be a useful adjunct to rehydration therapy in treating acute, infectious diarrhoea in adults and children.
Meta-AnalysisHighly CitedProbiotics for treating acute infectious diarrhoea
Probiotics, when used alongside rehydration therapy, appear to be safe and have clear beneficial effects in shortening the duration and reducing stool frequency in acute infectious diarrhoea.
Meta-AnalysisVery Rigorous JournalHighly CitedProbiotic Lactobacillus casei: Effective for Managing Childhood Diarrhea by Altering Gut Microbiota and Attenuating Fecal Inflammatory Markers
Probiotic Lactobacillus casei may help reduce clinical severity and intestinal inflammation in children with acute diarrhea by altering gut microbiota and reducing fecal inflammatory markers.
RCTVery Rigorous JournalHighly CitedProbiotics for treating acute infectious diarrhoea
Probiotics show no significant difference in reducing the duration of acute infectious diarrhoea compared to placebo or no probiotic in a low-risk, very low-certainty study.
Meta-AnalysisVery Rigorous JournalHighly CitedLimitations of Probiotic Therapy in Acute, Severe Dehydrating Diarrhea
Probiotics show limited benefits in treating short-duration diarrheal illnesses like viral enteritis, with their benefits likely being limited to prophylactic usage in high-risk populations.
RCTHighly Cited