Probiotics could prevent and treat atopic eczema in children

Does your child suffer from inflamed skin, red patches, crusted or leaking lesions, and itching that may even keep him or her from sleeping at night? Atopic eczema is the most common form of chronic eczema, affecting 15% to 30% of children appearing before age 5 in 90% of cases.

Among infants, atopic eczema usually appears on the cheeks, shoulders, chest, and scalp, and on the thumb for those who suck their thumb. Among children over the age of 2, it often appears in the bends of joints (elbows, wrists, knees, and ankles).

The first symptoms are frequently seen in infants under the age of 18 months, and most often between the ages of 2 and 6 months. Children who also suffer from allergies (food allergies, hay fever, urticaria, etc.) and children whose parents suffer from atopic eczema or allergies are at higher risk of developing eczema. Studies also show that children who suffer from allergies often have deficiencies in their intestinal flora.

Therefore, healthy intestinal flora can help to prevent atopic eczema. Here are three examples:

1. Taking probiotics during pregnancy has a beneficial effect on the child’s intestinal flora.
2. The same is true when breastfeeding.
3. Giving children a probiotic supplement is very effective in re-establishing and maintaining intestinal flora, because the comprehensive formula ensures complete intestinal tract coverage.

Unfortunately, there are no medications available to prevent or cure atopic eczema. Cortisone-based creams can be used to ease the discomfort, but they are not recommended for long-term use, and more studies are required in order to confirm that probiotics can prevent or cure atopic eczema. However, this is a worthwhile and promising avenue to explore, and probiotics are safe to use, so why not try your luck?

Annie Jolicoeur
Dietician-Nutritionist

References

1. Kirjavainen PV, Arvola T, Salminen SJ, Isolauri E. Aberrant composition of gut microbiota of allergic infants: a target of bifidobacterial therapy at weaning? Gut. 2002 Jul;51(1):51-5. PubMed PMID: 12077091; PubMed Central PMCID: PMC1773282.
2. Doege K, Grajecki D, Zyriax BC, Detinkina E, Zu Eulenburg C, Buhling KJ. Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood - a meta-analysis. Br J Nutr. 2011 Jul 26:1-6. [Epub ahead of print] PubMed PMID: 21787448.

Pharmacist Jean-Yves Dionne talks about the advantage of taking a Multi-strain Probiotic Supplement.

There is a big debate about probiotics. On one hand, some will say it is better to take a well documented single bacterial strain because we know from studies what this single strain can do. On the other hand, some say that it is better to take a synergistic combination of different types of probiotic bacteria because they will have the ability to work together by enhancing each other's growth, colonizing different area of the GI, and eventually pushing out the bad pathogens from the intestine. Each probiotic bacteria produces specific molecules that inhibit the growth of their competitors, the pathogenic bad bacteria. But each good bacteria is specific to a few enemy bacteria. Having a well designed synergistic probiotic with both lactobacilli and Bifidobacteria is your best team work effort to promote a healthy GI flora.

Ulcerative colitis

Ulcerative colitis is a chronic disease that involves inflammation and sores(or ulcers) in the inner lining of the large intestine, the colon and the rectum. It is one of the two main forms of inflammatory bowel disease (IBD), the other one being Crohn’s disease. Colitis’ main symptoms are diarrhea and abdominal discomfort, even pain.

The inflammation associated with IBD hampers the large intestine in performing its main function: absorbing water and turning liquid stools solid. It also leads to a loss of inner lining in the colon that in turn may cause bleeding and mucus and pus production. Even if its exact causes have yet to be discovered, we know that ulcerative colitis is always accompanied by a change in gut flora (also called microbiota). No single pathogen or harmful bacteria has been found responsible, but part of the microbiota’s protective bacteria called bifidobacteria are replaced by inflammation producing bacteria including E. coli and Clostridia. These are not pathogens per se (most people carry them) but the good/bad bacteria ratio is reversed: more inflammation producing ones, less good ones.

Medical treatment
Always consult a physician as colitis is a condition requiring medical attention. The medical treatment for ulcerative colitis involves anti-inflammatory and immune modulating drugs. Although they may reduce your suffering, these medications are not without side effects.

Your best ally
Probiotics are your best ally against ulcerative colitis. Even if these supplements have not been shown to cure colitis, both human and animal trials have proven them to reduce symptoms and flare ups. In the colon, bifidobacteria compete with bad bacteria for food, prevent their growth and their attachment to the lining. Most importantly, while bad bacteria promote inflammation, bifidobacteria secrete compounds that reduce inflammation and promote a healthy intestinal inner lining. Since bifidobacteria are your main protective bacteria in the large intestine, choose a probiotic formula that contains more bifidobacteria than other strains and preferably several different bifidobacteria strains.

By Jean-Yves Dionne, pharmacist

1. Colitis, definitionhttp://en.wikipedia.org/wiki/Colitis
2. Hammer HF. Gut microbiota and inflammatoryboweldisease. Dig Dis. 2011;29(6):550-3. PubMedPMID: 22179210.
3. Hedin C, Whelan K, Lindsay JO. Evidence for the use of probiotics and prebiotics in inflammatoryboweldisease: a review of clinical trials. Proc Nutr Soc. 2007 Aug;66(3):307-15. Review. PubMedPMID: 17637082.
4. Kanauchi O, Mitsuyama K, Andoh A. The therapeutic impact of manipulatingmicrobiota in inflammatoryboweldisease. CurrPharm Des. 2009;15(18):2074-86. Review. PubMedPMID: 19519445.

Irritable Bowel Syndrome

What is IBS?

Irritable bowel syndrome (IBS) is a complex condition. It is considered a functional disorder because it does not involve a lesion or a disease per se. Symptoms of IBS include abdominal pain (cramps) and discomfort, bloating, diarrhoea and/or constipation. These symptoms may come and go. Of course, you should always have a medical exam to make sure the symptoms you have are not caused by a condition requiring medical attention. Although IBS’s cause remains unclear, some parameters are common in all individuals with this syndrome: brain-gut signalling problems, increased intestinal inflammation, motility disruption, abdominal hypersensitivity and dysbiosis.

About dysbiosis

Dysbiosis happens when friendly bacteria are replaced by not-so-friendly bacteria in your gastrointestinal tract (GI tract). The newcomers may not really be pathogenic (they do not cause infection) but they hamper the essential work of the good bacteria. Friendly microorganisms are there to protect you, secrete vitamins and other substances, assist in food digestion, support your immune system, promote regular bowel movement, etc. They should be strong enough to prevent the growth of bad (or not-so-good) bacteria. When the good bacteria (mostly lactobacilli and bifidobacteria) are too weak, your GI system cannot work properly. Inflammation may develop, causing pain and cramps. Changes in bowel movement may also happen. So, when friendly bacteria stop doing a proper job, conditions such as IBS may appear.

Probiotics to the rescue

Probiotics are friendly bacteria in a capsule. Taking a good probiotic formula that contains high quality strains of both lactobacilli and bifidobacteria supplies your GI tract with the protective bacteria you need to dislodge the harmful ones. Normally, bifidobacteria are the most abundant in your large intestine and they also are the most affected when dysbiosis strikes. Always make sure that a good amount of bifidobacteria is included in your probiotic supplement to get a better fighting chance against IBS.

By Jean-Yves Dionne, pharmacist

1. Irritable bowel syndrome, definitionhttp://en.wikipedia.org/wiki/Irritable_bowel_syndrome
2. Dahlqvist G, Piessevaux H. Irritable bowel syndrome: the role of the intestinal microbiota, pathogenesis and therapeutictargets. Acta GastroenterolBelg. 2011 Sep;74(3):375-80. Review. PubMedPMID: 22103040.
3. Clarke G, CryanJF, Dinan TG, Quigley EM. Review article: probiotics for the treatment of irritable bowel syndrome - focus on lacticacidbacteria. Aliment PharmacolTher. 2012 Jan 5. doi: 10.1111/j.1365-2036.2011.04965.x. [Epubahead of print] PubMedPMID: 22225517.
4. Bixquert Jiménez M. Treatment of irritable bowel syndrome withprobiotics. An etiopathogenicapproachat last? Rev Esp EnfermDig. 2009 Aug;101(8):553-64. Review. PubMedPMID: 19785495.




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Probiotics: A weapon in the fight against C. difficile

Clostridium difficile, which is most often called C. difficile, is a bacteria that causes mild to severe diarrhea and other intestinal conditions, such as inflammation of the colon. The toxins produced by the C. difficile bacteria disrupt the balance of “beneficial” bacteria in the intestine. This can cause other symptoms besides diarrhea, such as fever, loss of appetite, abdominal pains, and cramping. We see frequent news reports about C. difficile outbreaks in healthcare institutions in North America.

Healthy people are not usually affected by C. difficile. In fact, approximately 5% of the population carries the C. difficile bacteria without experiencing any symptoms. On the other hand, the elderly and the approximately 15% to 20% of individuals who suffer from illnesses that necessitate long-term treatment with antibiotics are at risk from the C. difficile bacteria. For many people, this makes any stay at the hospital or in a long-term care facility all the more worrisome.

An ounce of prevention…

It would not be possible to abolish antibiotics in healthcare institutions, and therefore, it is important to work on restoring intestinal flora. In addition to washing your hands frequently, one of the most effective ways of preventing the transmission of the C. difficile bacteria is the use of probiotics. According to studies, probiotic treatment should begin as quickly as possible following the beginning of treatment with antibiotics, and should continue for two weeks after the antibiotic treatment is completed.

Annie Jolicoeur Dietician-Nutritionist

References:

1. Hickson M., Probiotics in the prevention of antibiotic-associated dirrhoea and Clostridium difficile infection. Ther Adv Gastroenterol 2011.4 (3): 185-97.
2. McFarland L.V., Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol 2010; 16(18): 2202-22.
3. Sunenshine R. H, McDonald L. C., Clostridium difficile-associated disease: New challenges from an established pathogen. Cleve Clin J Med 2006; 73: 187-97.
4. McFarland L. V., Meta-Analysis of probiotics for the prevention of antibiotic-associated diarrhea and the treatment of Clostridium difficile disease. Am I Gastroenterol 2006; 101: 812-22.
5. Warny M., Pepin J., Fang A. et al, Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 2005; 366: 1079-84.
6. Qamar A., Aboudola S., Warny M. et al, Saccharomyces boulardii stimulates intestinal immunoglobulin A immune response to Clostridium difficile toxin A in mice. Infect Immun 2001 69: 2762-65.
7. Szajewska H., Mrukowicz J., Meta-analysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated dirrhoea. Aliment Pharmacol Ther 2005 22: 365-72.
8. Poutanen S. M., Simor A. E., Clostridium difficile-associated diarrhea in adults. CMAJ 2004 171 (1): 51-58.
9. Pépin J., Valiquette L., Alary M. E. et al, Clostridium difficile-associated diarrhea in a region of Québec from 1991 to 2003: a changing pattern of disease severity. JAMC 2004 171 (5): 466-72.
10. D’Souza A. L., Rajkumar C., Cooke J. et al, Probiotics in prevention of antibiotic dirrhoea: meta-analysis. BMJ 2002 321: 16.
11. Surawicz C. M., McFarland L. V., Greenberg R. N. et al, The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose Vancomycin combined with Saccharomyces boulardii. Clinical Infectious diseases 2000; 31: 1012-17.
12. Clostridium difficile (C. difficile) information sheets. Public Health Agency of Canada, 2011.
13. La santé par les probiotiques (Health through probiotics). http://www.jydionne.com/la-santé-par-les-probiotiques. 2010.
14. C. difficile. MayoClinic.com. 2010.
15. Probiotiques et diarrhées à C. difficile ( Probiotics and C. difficile diarrhea); Study by Dr. P. J. Maziade, Hôpital Le Gardeur, June 2008.
16. La bactérie et l’hôpital, c’est difficile… (Bacteria and hospitals, it’s difficult….), Blog, Christian Lamontagne. 2007.
17. C. difficile (Clostridium difficile). Health Canada. 2006.
18. Les probiotiques : solution naturelle pour C. difficile (Probiotics: The natural solution for C. difficile). Santé Canoë. 2004.
19. Bactérie C. difficile : un probiotique à la rescousse? (C. difficile bacteria: Probiotics to the rescue?). Passeportsanté.net. 2004.
20. Dubé M.-H., Probiotiques et Clostridium difficile : une combinaison gagnante? (Probiotics and Clostridium difficile: A winning combination?). Centre d’information sur le médicament, 2004.