Not all probiotics are the same – genera, species and strain are important and so is clinical evidence

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Not all probiotics are the same – genera, species and strain are important and so is clinical evidence

An exclusive interview with Dr. Flavia Indrio, a researcher and a gastroenterologist visited Pakistan to deliver lectures on the role of Probiotics in gut comfort.

Q – Infantile colic is a self-limited condition, in your opinion does this  condition require treatment?

Ans – Infantile colic is a clinical self-limiting condition that deserves treatment for many reasons. The most important is that colic represent an early traumatic insult to the intestine and that could create a state of pathological intestinal inflammation and may act as a high predisposition to develop visceral hypersensitivity late in life.  This condition also represents a frustrating problem for parents and care givers because it is difficult to treat and may result in significant psychosocial consequences.

Q – What is the pathophysiology of infantile colic,  and lifelong effects  it may have on the child’s health?

Ans – Despite forty years of research, the etiology of infantile colic remains elusive. The current literature suggests several causative mechanisms such as behavioral, food allergy and hypersensitivity, immaturity of gut function and dysmotility. Recently, the composition of intestinal microflora has been addressed as an independent risk factor for infantile colic. Studies indicate that inadequate lactobacilli in the first few months of life may affect intestinal fatty acid profile favoring the development of infantile colic. Coliform bacteria have also been found more abundantly in colicky infants and it is speculated that altering the intestinal microflora composition may positively influence the management of affected infants. The role of early life events in FGIDs  effecting  later life is still controversial, even though some noxious stimulation at birth (i.e., gastric suction, alteration of intestinal microbiota) might promote the development of long-term visceral hypersensitivity and cognitive hyper-vigilance leading to functional intestinal disorders.

Q – Which probiotic is most recommended in colic?

Ans  – The probiotic that has shown therapeutic effect in colic is Lactobacillus reuteri.  Lactobacillus reuteri significantly decreases the rate (minutes/day) of crying and has no short term safety concerns.  L. reuteri has also been tested in other gut disorders: regurgitation, constipation, viral diarrhea feeding intolerance, NEC and Candida infection in newborn

Q – Is there any role of probiotics in diarrhea?

Ans – Probiotics may aid in the management  and reduction of acute diarrhea.  Evidence shows that probiotics reduced the duration of acute non bacterial diarrhea by approximately 1 day. Several clinical trials also have reported efficacy of diarrhea in preventing antibiotic associated diarrhea L. reuteri is tested in viral diarrhea  and in antibiotic associated diarrhea.

Q – Are all probiotics same and safe for human consumption ?

Ans – Not all the probiotics are the same. Genera , species and strains are important and so is clinical evidence, GRAS including dosage is also granted for use in infants for specific strains