Diarrhea: causes, symptoms and treatment. Stop Diarrhea with dietary supplements. MegaEl-Dena- natural synbiotic

BENEFITS OF TAKING MEGAEL-DENA FOR PATIENTS WITH DIARRHEA

Diarrhea may be caused by a variety of factors; two major groups of conditions accompanied by diarrhea are due to various infections of the gastrointestinal tract and disturbances of the intestinal microbiota as a result of antibiotic therapy. Regardless of the exact cause of diarrhea, supplementation with probiotics, defined as “microorganisms that have a favorable influence on the host by improving the indigenous microflora” [1], may have beneficial effects in prevention or reducing the severity of diarrhea. In some cases, beneficial effects of prebiotics (food ingredients that are non-digestible for humans but stimulate the growth of beneficial bacteria (2)) have also been described. Fructooligosaccharides (FOS) are the most widely known prebiotics [2]. MegaEl-Dena contains both prebiotics (FOS) and probiotics, i.e. 8 species of viable beneficial bacteria, including 4 species of Bifidobacterium (B. bifidum, B. breve, B. lactis, and B. longum), 3 species of Lactobacillus (L. acidophilus, L. casei, and L. rhamnosus), and Streptococcus thermophilus. Below we consider in more detail, examples of studies that have documented the benefits of probiotics and prebiotics in patients with diarrhea.

Acute infectious diarrhea (acute gastroenteritis) is a collective name for various infections, which are mainly caused by viruses (particularly noroviruses) but also by bacterial pathogens such as salmonella or Clostridium difficile, and are accompanied by vomiting and abdominal pain. The incidence of acute infectious diarrhea has been estimated as 0.6 episodes per adult person per year in the USA and Germany and may be fatal, particularly in the elderly [3]. Acute infectious diarrhea is treated with oral rehydration solutions (since diarrhea may lead to dehydration), antibiotics (which however may exacerbate diarrhea; see the next section), and gut motility-suppressing agents [4]. A number of studies have addressed whether probiotics may be helpful for patients with acute diarrhea.

Two pioneering studies, one conducted in Finland [5] and one in the USA [6], found that intake of Lactobacillus rhamnosus (a MegaEl-Dena component) was associated with a reduced incidence of traveler’s diarrhea. Curiously, the Finnish study, which involved 756 subjects who traveled to two different destinations in Turkey, found that the effect was much more pronounced in one destination than in the other [5]; this might indicate that the extent of the beneficial effect of probiotics depends on the pathogen that causes diarrhea.

A later study, which involved 240 children with acute diarrhea caused by rotavirus and other pathogens and used Lactobacillus paracasei (this species is closely related the MegaEl-Dena component L. casei and is considered by some authors as a subspecies of L. casei [7]), found that the probiotic was ineffective against severe diarrhea caused by rotavirus but was beneficial for patients with less severe diarrhea caused by other pathogens [8]. Recent studies found that administration of a mixture containing L. acidophilus, L. rhamnosus, B. longum, and a yeast species had differential effects on different aspects of the disease such as duration of diarrhea, fever, vomiting, and hospitalization [9, 10]. These somewhat contrasting results may indicate that particular probiotic species may be beneficial for patients with diarrhea caused by particular pathogens. If so, taking probiotics that contain a mixture of several bacterial species (such as MegaEl-Dena) might increase the chance of a positive effect. These considerations may be particularly applicable in cases where the exact pathogen remains unknown. In line with this suggestion, administration of L. rhamnosus alone was found to be associated with a smaller reduction in the duration of diarrhea than administration of a mixture of B. bifidum, L. delbrueckii var bulgaricus, L. acidophilus, and S. thermophilus, whereas two other probiotics each containing only one species had no effect [11].

A review of clinical studies and meta-analyses of the studies that used probiotics in patients with acute infectious diarrhea (63 studies in total that involved 8,014 participants, mainly infants and children) concluded that most studies reported a reduced duration of diarrhea and stool frequency in patients who received probiotics, although the extent of the differences with the control varied [4]. No adverse events were attributed to the use of probiotics.

Antibiotic-associated diarrhea

Although antibiotics are intended to kill pathogenic bacteria, they reduce the total number of bacteria and cause changes in microbiota composition (dysbiosis), which are transient in most cases but may occasionally last for several months [12]. These disturbances may lead to antibiotic-associated diarrhea (AAD) and sometimes this leads to the prevalence of harmful bacteria, such as Clostridium difficile (which may cause C. difficile infections, also called C. difficile colitis), which are also accompanied by diarrhea. Antibiotic therapy is one of the three major risk factors for C. difficile infections (the other two being immunosuppression and old age) [13]; therefore, C. difficile infections are often considered together with AAD. Additional risk factors for AAD and associated infections are serious illnesses, old age, immunosuppression, the length of the hospital stay, and exposure to harmful microorganisms in the hospital [14].

An analysis of 16 studies (3,432 participants) concluded that, of several probiotic species tested, administration of L. rhamnosus (a component of MegaEl-Dena) in parallel with antibiotics reduced the risk of AAD onset (15); however, other combinations such as B. lactis and and S. thermophilus (both are components of MegaEl-Dena) may be also beneficial [16]. A randomized double blind placebo-controlled trial that involved elderly hospital patients taking antibiotics found that consumption of a drink containing S. thermophilus, L. casei, and other Lactobacillus species during and after antibiotic therapy was associated with a reduced incidence of AAD/C. difficile-associated diarrhea [17]. As in the case of the use of probiotics in patients with acute infectious diarrhea, no serious adverse effects of probiotics have been reported in AAD patients.

There is also some evidence for beneficial effects of prebiotics and synbiotics in patients with AAD/C. difficile-induced diarrhea. A randomized clinical trial of treatment of C. difficile infection with specific antibiotics conducted in the UK found that taking FOS was associated with increased counts of bifidobacteria and significantly fewer relapses [18]. A placebo-controlled study conducted in Sweden compared the effects of probiotics (L. acidophilus and B. longum) and a corresponding synbiotic (the same bacterial species supplemented with FOS) on healthy volunteers subjected to antibiotic treatment [19]. The authors found that C. difficile could be isolated after antibiotic treatment at a similar rate from the stool of patients who received placebo and probiotics, but at a much lower rate from that of patients who received the synbiotic. The authors also found that L. acidophilus (but not B. longum) efficiently colonized the intestines [19].

A recent meta-analysis of 82 clinical trials that included 11,811 participants concluded that there is a statistically significant association between the intake of probiotics and reduction in AAD, although it is not yet clear which probiotics are associated with the greatest efficacy and what are the best probiotic/antibiotic combinations [20]. An independent meta-analysis of 34 randomized double-blinded placebo-controlled trials (4,138 patients in total) found that the pooled relative risk of AAD was reduced by ~50% by probiotic supplementation [21].

Thus, the available evidence suggests that several components of MegaEl-Dena (both probiotics and prebiotics) have beneficial effects for patients with or at risk of acute diarrhea caused by infections (L. rhamnosus and likely also other components such as L. acidophilus, B. longum, B. bifidum, and/or S. thermophilus) and antibiotic therapy (L. rhamnosus, B. lactis, and S. thermophilus, as well as FOS), whereas no adverse effects of probiotics have been observed.

References

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  5. Oksanen, P.J. et al. Prevention of travellers' diarrhoea by Lactobacillus GG. Ann Med 22, 53-56 (1990).
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