Probiotics Found Unhelpful in Kids With Outpatient Diarrhea

Stephen Freedman MDCM, MSc Alberta Children's Hospital Foundation Professor in Child Health and Wellness Sections of Pediatric Emergency Medicine and Gastroenterology Alberta Children's Hospital & Research Institute University of Calgary Calgary, AB

Dr. Freedman

MedicalResearch.com Interview with:
Stephen Freedman MDCM, MSc
Alberta Children’s Hospital Foundation Professor in Child Health and Wellness
Sections of Pediatric Emergency Medicine and Gastroenterology
Alberta Children’s Hospital & Research Institute
University of Calgary
Calgary, AB

 MedicalResearch.com: What is the background for this study?

Response: Vomiting and diarrhea remain extremely common diseases in children and are the most common reason children are brought for emergency department care in North America.  While we have options to reduce vomiting there historically has been little physicians can offer to reduce the severity of the diarrhea.

Probiotics have recently emerged as an option with some early evidence of benefit in clinical trials but the studies performed to date have been small and few little research has been conducted in North America in outpatient or emergency department children.

The one study to date that was performed in a US emergency department did not find probiotic use to be beneficial.  Given the increasing importance of clarifying this issue we undertook this study.

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Puppies From Commercial Dog Industry Source of Multistate Diarrhea Infections

MedicalResearch.com Interview with:
"Siberian Husky Puppies 2013-05-25" by Jeffrey Beall is licensed under CC BY 2.0Mark Laughlin, DVM

Veterinary Medical Officer
CDC

MedicalResearch.com: What is the background for this study?

How common are Campylobacter infections?  How does a Campylobacter infection typically present? 

Response: Campylobacter is one of the most common causes of diarrheal illness in the United States, causing an estimated 1.3 million illnesses each year. Most people with Campylobacter infection usually have diarrhea (often bloody), fever, and abdominal cramps. The diarrhea may be accompanied by nausea and vomiting. These symptoms usually start within 2 to 5 days after exposure and last about a week.

Most illnesses from Campylobacter likely occur due to eating raw or undercooked poultry, or from eating something that touched raw or undercooked poultry. Some illnesses can occur from contact with contaminated water, contact with animals, or from drinking raw (unpasteurized) milk.

Since 2009, 13 outbreaks of human Campylobacter infections linked to contact with dogs have been reported to CDC. These outbreaks account for a reported 47 illnesses and 2 hospitalizations.

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Salivary Peptide Protects Against E. Coli Diarrhea

MedicalResearch.com Interview with:

Esther Bullitt, Ph.D. Associate Professor Dept. of Physiology & Biophysics Boston University School of Medicine Boston, MA  02118-2526

Dr. Bullitt

Esther Bullitt, Ph.D.
Associate Professor
Dept. of Physiology & Biophysics
Boston University School of Medicine
Boston, MA  02118-2526 

MedicalResearch.com: What is the background for this study?

Response:      We know that saliva has properties that allow us to swallow easily, and to help prevent gum disease and infections in the mouth. But is that really the only use for the 1-2 liters (1-2 quarts) of saliva we produce every day?  We decided to test whether a component of saliva, Histatin-5, can help prevent diarrheal disease (Traveler’s Diarrhea by Enterotoxigenic Escherichia coli (ETEC)) that is caused by bacteria commonly found in contaminated food and water.

ETEC are bacteria that have hundreds of thin hair-like fibers on their surface, called pili. These bacteria bind specifically to the surface of the gut using these pili, and the bacteria need to stay bound long enough to initiate disease. Studies by Mike Levine’s group in the 1970’s showed that pili are necessary for enterotoxigenic Escherichia coli (ETEC) to cause disease. No adhesion, no disease.

One aid to remaining bound is the unwinding and rewinding of the pili. These helical fibers can unwind up to 8 times their original length, acting as shock absorbers during fluid flow.   Continue reading

Bile Acid Diarrhea May Be Helped By New Drug Class

Julian Walters Professor of Gastroenterology Section of Hepatology & Gastroenterology | Imperial College London Consultant Gastroenterologist Imperial College Healthcare Hammersmith Hospital London W12 0HS | UKMedicalResearch.com Interview Invitation
Julian Walters

Professor of Gastroenterology
Section of Hepatology & Gastroenterology | Imperial College London
Consultant Gastroenterologist
Imperial College Healthcare Hammersmith Hospital
London W12 0HS | UK

Medical Research: What is the background for this study?  What is Bile acid diarrhoea (BAD)?

Dr. Walters: Bile acid diarrhoea accounts for about a third of the patients who would otherwise be diagnosed as IBS-D (irritable bowel syndrome – diarrhoea predominant).  We estimate about 1% of the adult population have this primary disorder; others may have it secondary to previous surgery such as ileal resection in Crohn’s disease or post-cholecystectomy.  There are unmet needs to improve diagnosis rates and to improve the current treatment with bile acid sequestrants which can be poorly tolerated and do not address the primary pathology.  We have shown that primary BAD patients have reduced levels of Fibroblast Growth Factor 19 (FGF19) the ileal hormone that regulates bile acid synthesis.
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Are Probiotics Effective in Preventing C.diff diarrhea in Elderly Patients?

Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK.Prof. Steve Allen
Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow
Room 314, The College of Medicine, Swansea University,
Swansea, SA2 8PP, UK.

MedicalResearch.com: What are the main findings of the study?

Answer: Overall, diarrhoea occurred in just over 10% participants and diarrhoea caused by C. difficile in about 1%. These outcomes were equally common in those taking the microbial preparation and those taking placebo.

Other outcomes (e.g. common GI symptoms, length of hospital stay, quality of life) were also much the same in the two groups. So, there was no evidence that the microbial preparation had prevented diarrhoea or had led to any other health benefit.

In agreement with previous research, serious adverse events were also similar in the two groups – so we found no evidence that the microbial preparation caused any harm.
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Probiotics for the prevention of antibiotic-associated diarrhea and C.diff among hospitalized patients

MedicalResearch.com eInterview with: Dr. Reena Pattani MD
Department of Medicine
St. Michael’s Hospital
30 Bond Street, Toronto ON M5B 1W8

MedicalResearch.com: What are the main findings of the study?

Dr. Pattani: We performed a meta-analysis of 16 studies that assessed the effectiveness of probiotics administered concurrently with antibiotics compared to the use of antibiotics alone. The use of probiotics among patients in these trials reduced the risk of antibiotic-associated diarrhea by almost 40% and decreased the rate of Clostridium difficile infection by 63%. On subgroup analysis, the reduction remained statistically significant for the subgroups of good quality trials, trials in which a primarily Lactobacillus-based regimen was used, and those studies which had a follow-up period of less than 4 weeks.
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