Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-27T13:17:49.637Z Has data issue: false hasContentIssue false
  • English
  • Français

Probiotics and intestinal health effects: a clinical perspective

Published online by Cambridge University Press:  09 March 2007

P. Marteau ,
P. Seksik  and
R. Jian
P. Marteau*
Affiliation:
Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, 20 rue Leblanc, 75908 Paris CEDEX 15, France
P. Seksik
Affiliation:
Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, 20 rue Leblanc, 75908 Paris CEDEX 15, France
R. Jian
Affiliation:
Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, 20 rue Leblanc, 75908 Paris CEDEX 15, France
*
*Corresponding author: Dr P. Marteau, fax +33 1 5609 3554, email philippe.marteau@egp.ap-hop-paris.fr
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Probiotics are viable non-pathogenic micro-organisms which, when ingested, exert a positive influence on host health or physiology. We have critically analysed the evidence for the efficacy of specific probiotic strains in human gastrointestinal diseases. The best evidence can be obtained with randomised controlled trials which avoid bias. Good evidence has been obtained with several strains in the prevention or treatment of antibiotic-associated disorders, in the treatment (and to a lesser extent prevention) of gastroenteritis and acute diarrhoea and in the alleviation of lactose intolerance. We also analysed the recent randomised controlled trials performed in patients with Clostridium difficile or Helicobacter pylori, inflammatory bowel disease, irritable bowel syndrome, non-ulcer dyspepsia and colon cancer.

Keywords

ProbioticsIntestineGastroenteritisInflammatory bowel diseaseAntibiotic-associated diarrhoea
Type
Research Article
Information
British Journal of Nutrition , Volume 88 , Issue S1 , September 2002 , pp. s51 - s57
Copyright
Copyright © The Nutrition Society 2002

References

Adam, J, Banet, A & Banet-Bellet, C (1977) Essais cliniques contrôlés en double insu de l'Ultralevure lyophylisée (Double-blind controlled trials with Saccharomyces boulardii – Ultralevure). Gazette Médicale de France 84, 2072–2078.Google Scholar
Armuzzi, A, Cremonini, F, Bartolozzi, F, Canducci, F, Candelli, M, Ojetti, V, Cammarota, G, Anti, M, De Lorenzo, A, Pola, P, Gasbarrini, G & Gasbarrini, A (2001) The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Alimentary Pharmacology & Therapeutics 15, 163–169.CrossRefGoogle ScholarPubMed
Arrigoni, E, Marteau, P, Briet, F, Pochart, P, Rambaud, JC & Messing, B (1994) Tolerance and absorption of lactose from milk and yoghurt during short bowel syndrome in man. American Journal of Clinical Nutrition 60, 926–929.CrossRefGoogle Scholar
Arvola, T, Laiho, K, Torkkeli, S, Mykkanen, H, Salminen, S, Maunula, L & Isolauri, E (1999) Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 104, 5, e64.CrossRefGoogle ScholarPubMed
Bergogne-Berezin, E (2000) Treatment and prevention of antibiotic associated diarrhea. International Journal of Antimicrobial Agents 16, 521–526.CrossRefGoogle ScholarPubMed
Borgia, M, Sepe, N, Brancato, V, Costa, G, Simone, P, Borgia, R & Lugli, R (1982) A controlled clinical study on Streptococcus faecium preparation for the prevention of side reactions during long-term antibiotic treatments. Current Therapeutic Research 31, 265–271.Google Scholar
Boutron, MC, Faivre, J, Marteau, P, Couillault, C, Senesse, P & Quipourt, V (1996) Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case–control study. British Journal of Cancer 74, 145–151.CrossRefGoogle ScholarPubMed
Bouvier, M, Méance, S, Bouley, C, Berta, JL & Grimaud, JC (2001) Effects of consumption of a milk fermented with the probiotic strain Bifidobacterium animalis DN-173 010 on colonic transit times in healthy humans. Bioscience and Microflora 20, 43–48.CrossRefGoogle Scholar
Campieri, M, Rizzello, F, Venturi, A, Poggioli, G, Ugolini, F, Helwig, U, Amadini, C, Romboli, E & Gionchetti, P (2000) Combination of antibiotic and probiotic treatment is efficacious in prophylaxis of post-operative recurrence of Crohn's disease: a randomized controlled study vs mesalamine. Gastroenterology 118, G4179CrossRefGoogle Scholar
Canducci, F, Armuzzi, A, Cremonini, F, Cammarota, G, Bartolozzi, F, Pola, P, Gasbarrini, G & Gasbarrini, A (2000) A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Alimentary Pharmacology & Therapeutics 14, 1625–1629.CrossRefGoogle ScholarPubMed
Czerucka, D, Dahan, S, Mograbi, B, Rossi, B & Rampal, P (2000) Saccharomyces boulardii preserves the barrier function and modulates the signal transduction pathway induced in enteropathogenic Escherichia coli-infected T84 cells. Infection and Immunity 68, 5998–6004.CrossRefGoogle ScholarPubMed
Drouault, S, Juste, C, Marteau, P, Renault, P & Corthier, G (2001) Oral treatment with genetically modified Lactococcus lactis expressing Staphylococcus hyicus lipase enhances lipid digestion in pigs with experimental pancreatic insufficiency. Gastroenterology 120, A3642 (abstract).CrossRefGoogle Scholar
Elmer, GW, Surawicz, CM & McFarland, LV (1996) Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. Journal of the American Medical Association 275, 870–876.CrossRefGoogle ScholarPubMed
Felley, CP, Corthesy-Theulaz, I, Rivero, JL, Sipponen, P, Kaufmann, M, Bauerfeind, P, Wiesel, PH, Brassart, D, Pfeifer, A, Blum, AL & Michetti, P (2001) Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. European Journal of Gastroenterology and Hepatology 13, 25–29.CrossRefGoogle ScholarPubMed
Gionchetti, P, Rizzello, F, Venturi, A, Brigidi, P, Matteuzzi, D, Bazzocchi, G, Poggioli, G, Miglioli, M & Campieri, M (2000a) Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 119, 305–309.CrossRefGoogle ScholarPubMed
Gionchetti, P, Rizzello, F, Venturi, A, Helwig, U, Amadini, C, Lammers, KM, Ugolini, F, Poggioli, G & Campieri, M (2000b) Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo controlled trial. Gastroenterology 118, G1214.CrossRefGoogle Scholar
Guandalini, S, Pensabene, L, Zikri, MA, Dias, JA, Casali, LG, Hoekstra, H, Kolacek, S, Massar, K, Micetic-Turk, D, Papadopoulou, A, de Sousa, JS, Sandhu, B, Szajewska, H & Weizman, Z (2000) Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. Journal of Pediatric Gastroenterology and Nutrition 30, 54–60.Google ScholarPubMed
Guslandi, M, Mezzi, G, Sorghi, M & Testoni, PA (2000) Saccharomyces boulardii in maintenance treatment of Crohn's disease. Digestive Disease and Science 45, 1462–1464.CrossRefGoogle ScholarPubMed
Halpern, GM, Prindiville, T, Blanckenburg, M, Hsia, T & Gerschwin, ME (1996) Treatment of irritable bowel syndrome with Lacteol fort: a randomized, double-blind, cross-over trial. American Journal of Gastroenterology 91, 1579–1585.Google Scholar
Hatakka, K, Savilahti, E, Ponka, A, Meurman, JH, Poussa, T, Nase, L, Saxelin, M & Korpela, R (2001) Effect of long term consumption of probiotic milk on infections in children attending day care centres: double-blind, randomised trial. British Medical Journal 322, 1327.CrossRefGoogle ScholarPubMed
Hentschel, C, Bauer, J, Dill, N, Blaut, B, Jahnel, M, Lindner, M, Brinkhaus, B, Shönekäs, H, Kohnen, R, Ernst, E & Hahn, E (1997) Complementary medicine in non-ulcer dyspepsia: is alternative medicine a real alternative? A randomized placebo-controlled double-blind clinical trial with two probiotic agents – HylacŴ and HylacŴ forte. Gastroenterology 112, A146Google Scholar
Hilton, E, Kolakowski, P, Singer, C & Smith, M (1997) Efficacy of Lactobacillus GG as a diarrheal preventive in travellers. Journal of Travel Medicine 4, 41–43.CrossRefGoogle Scholar
Kaila, M, Isolauri, E, Saxelin, M, Arvilommi, H & Vesikari, T (1995) Viable versus inactivated lactobacillus strain GG in acute rotavirus diarrhoea. Archives of Diseases of Childhood 72, 51–53.CrossRefGoogle ScholarPubMed
Kollaritsch von, H, Holst, H, Grobara, P & Wiedermann, G (1993) Prophylaxe der Reisediarrhoe mit Saccharomyces boulardii Prevention of traveler's diarrhea with Saccharomyces boulardii. Ergebnisse einer Plazebokontrollierten Doppelblindstudie (Results of a placebo controlled double-blind study). Forstchritt Medizin 111, 153–156.Google Scholar
Kruis, W, Fric, P & Stolte, M (2001) Maintenance of remission in ulcerative colitis is equally effective with Escherichia coli Nissle 1997 and with standard mesalamine. Gastroenterology 120, A139.CrossRefGoogle Scholar
Kruis, W, Schütz, E, Fric, P, Fixa, B, Judmaier, G & Stolte, M (1997) Double-blind comparison of an oral Escherichia coli preparation and mesalazine in maintaining remission of ulcerative colitis. Alimentary Pharmacology & Therapeutics 1, 853–858.CrossRefGoogle Scholar
Lewis, SJ, Potts, LF & Barry, RE (1998) The lack of therapeutic effect of Saccharomyces boulardii in the prevention of antibiotic-related diarrhoea in elderly patients. Journal of Infection 36, 171–174.CrossRefGoogle ScholarPubMed
Malchow, HA (1997) Crohn's disease and Escherichia coli. A new approach in therapy to maintain remission of colonic Crohn's disease? Journal of Clinical Gastroenterology 25, 653–658.CrossRefGoogle ScholarPubMed
Marteau, P, Flourié, B, Pochart, P, Chastang, C, Desjeux, JF & Rambaud, JC (1990) Role of the microbial lactase (EC 3.2.123) activity from yogurt on the intestinal absorption of lactose: an in vivo study in lactase deficient humans. British Journal of Nutrition 64, 71–79.CrossRefGoogle Scholar
Marteau, P, Pochart, P, Bouhnik, Y & Rambaud, JC (1993) Fate and effects of some transiting microorganisms in the human gastrointestinal tract. World Review of Nutrition and Dietetics 74, 1–21.CrossRefGoogle Scholar
Marteau, P, Vesa, T & Rambaud, JC (1997) Lactose maldigestion. In Probiotics, pp. 65–88 [Fuller, R, editor]. London: Chapman & Hall.CrossRefGoogle Scholar
Marteau, PR, Vrese, MD, Cellier, CJ & Schrezenmeir, J (2001) Protection from gastrointestinal diseases with the use of probiotics. American Journal of Clinical Nutrition 73, Suppl. 2, 430S–436S.CrossRefGoogle ScholarPubMed
Marteau, P, Cuillerier, E, Mèance, S, Gerhardt, MF, Myara, A, Bouvier, M, Bouley, C, Tondu, F, Bommelaer, G & Grimaud, JC (2002) Bifidobacterium animalis strain DN-173 010 shortens the colonic transit time in healthy women: A double-blind randomised controlled study. Alimentary Pharmacology and Therapeutics. In press.CrossRefGoogle Scholar
Mastretta, E, Longa, P, Laccisaglia, A, Balbo, L, Russo, R, Mazzaccara, A & Gianino, P (2002) Rotavirus nosocomal infections in infants: is Lactobacillus GG effective in prevention? Journal of Pediatric Gastroenterology and Nutrition. In press.Google Scholar
McFarland, LV, Surawicz, CM, Greenberg, RN, Fekety, R, Elmer, GW, Moyer, KA, Melcher, SA, Bowen, KE, Cox, JL, Noorani, Z, Harrington, G, Rubin, M & Greenwald, D (1994) A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. Journal of the American Medical Association 271, 1913–1918.CrossRefGoogle ScholarPubMed
McFarland, LV, Surawicz, CM, Greenberg, RN, Elmer, GW, Moyer, KA, Melcher, SA, Brown, KE & Cox, JL (1995) Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. American Journal of Gastroenterology 90, 439–448.Google ScholarPubMed
Méance, S, Cayuela, C, Turchet, P, Raimondi, A, Lucas, C & Antoine, JM (2001) A fermented milk with a Bifidobacterium probiotic strain DN-173 010 shortened oro-fecal gut transit time in elderly. Microbiology and Ecology in Health and Disease. In press.CrossRefGoogle Scholar
Mercenier, A, Muller-Alouf, H & Grangette, C (2000) Lactic acid bacteria as live vaccines. Current Issues of Molecular Biology 2, 17–25.Google ScholarPubMed
Michetti, P, Dorta, G, Wiesel, PH, Brassart, D, Verdu, E, Herranz, M, Felley, C, Porta, N, Rouvet, M, Blum, AL & Corthesy-Theulaz, I (1999) Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans. Digestion 60, 203–209.CrossRefGoogle ScholarPubMed
Michetti, P (2001) Lactobacilli for the management of Helicobacter pylori. Nutrition 17, 268–269.CrossRefGoogle Scholar
Oberhelman, RA, Gilman, RH, Sheen, P, Taylor, DN, Black, RE, Cabrera, L, Lescano, AG, Meza, R & Madico, GA (1999) Placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. Journal of Pediatrics 134, 15–20.CrossRefGoogle ScholarPubMed
Oksanen, PJ, Salminen, S, Saxelin, M, Hamalainen, P, Ihantola-Vormisto, A, Muurasniemi-Isoviita, L, Nikkari, S, Oksanen, T, Porsti, I, Salminen, E, Siitonen, S, Stuckey, H, Toppila, A & Vapaatalo, H (1990) Prevention of traveller's diarrhea by Lactobacillus GG. Annals of Medicine 22, 53–56.CrossRefGoogle ScholarPubMed
O'Sullivan, MA & O'Morain, CA (2000) Bacterial supplementation in the irritable bowel syndrome. A randomised double-blind placebo-controlled crossover study. Digestive and Liver Disease 32, 294–301.CrossRefGoogle ScholarPubMed
Pant, AR, Graham, SM, Allen, SJ, Harikul, S, Sabchareon, A, Cuevas, L & Hart, CA (1996) Lactobacillus GG and acute diarrhoea in young children in the tropics. Journal of Tropical Pediatrics 42, 162–165.CrossRefGoogle ScholarPubMed
Raza, S, Graham, SM, Allen, SJ, Sultana, S, Cuevas, L & Hart, CA (1995) Lactobacillus GG promotes recovery from acute non-bloody diarrhea in Pakistan. Pediatric Infectious Disease Journal 14, 107–111.CrossRefGoogle Scholar
Reid, G, Howard, J & Gan, BS (2001) Can bacterial interference prevent infection? Trends in Microbiology 9, 424–428.CrossRefGoogle ScholarPubMed
Rembacken, BJ, Snelling, AM, Hawkey, PM, Chalmers, DM & Axon, AT (1999) Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet 354, 635–639.CrossRefGoogle ScholarPubMed
Saavedra, JM, Bauman, NA, Oung, I, Perman, JA & Yolken, RH (1994) Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diahrroea and shedding of rotavirus. Lancet 344, 1046–1049.CrossRefGoogle ScholarPubMed
Sartor, RB (1997) Role of the enteric microflora in the pathogenesis of intestinal inflammation and arthritis. Alimentary Pharmacology & Therapeutics 11, Suppl. 3, 17–22.CrossRefGoogle ScholarPubMed
Schrezenmeir, J & de Vrese, M (2001) Probiotics, prebiotics and synbiotics – approaching a definition. American Journal of Clinical Nutrition 73, 2 Suppl, 361s–364s.CrossRefGoogle ScholarPubMed
Shornikova, AV, Casas, IA, Mykkanen, H, Salo, E & Vesikari, T (1997a) Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis. Pediatric Infectious Disease Journal 16, 1103–1107.CrossRefGoogle ScholarPubMed
Shornikova, AV, Isolauri, E, Burkanova, L, Lukovnikova, S & Vesikari, T (1997b) A trial in the Karelian Republic of oral rehydration and Lactobacillus GG for treatment of acute diarrhoea. Acta Paediatrica 86, 460–465.CrossRefGoogle ScholarPubMed
Sugita, T & Togawa, M (1994) Efficacy of lactobacillus preparation biolactis powder in children with rotavirus enteritis. Japanese Journal of Pediatrics 47, 2755–2762.Google Scholar
Surawicz, CM, Elmer, GW, Speelman, P, McFarland, LV, Chinn, J & van Belle, G (1989) Prevention of antibiotic associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterology 96, 981–988.CrossRefGoogle ScholarPubMed
Surawicz, CM, McFarland, LV, Greenberg, RN, Rubin, M, Fekety, R, Mulligan, ME, Garcia, RJ, Brandmarker, S, Bowen, K, Borjal, D & Elmer, GW (2000) The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clinical Infectious Disease 31, 1012–1017.CrossRefGoogle ScholarPubMed
Szajewska, H, Kotowska, M, Mrukowicz, JZ, Armanska, M & Mikolajczyk, W (2001) Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. Journal of Pediatrics 138, 361–365.CrossRefGoogle ScholarPubMed
Thomas, MR, Litin, SC, Osmon, DR, Corr, AP, Weaver, AL & Lohse, CM (2001) Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial. Mayo Clinic Proceedings 76, 883–889.CrossRefGoogle ScholarPubMed
Vanderhoof, JA, Whitney, DB, Antonson, DL, Hanner, TL, Lupo, JV & Young, RJ (1999) Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. Journal of Pediatrics 135, 564–568.CrossRefGoogle ScholarPubMed
Wollowski, I, Rechkemmer, G & Pool-Zobel, BL (2001) Protective role of probiotics and prebiotics in colon cancer. American Journal of Clinical Nutrition 73, Suppl. 2, 451S–455S.CrossRefGoogle ScholarPubMed
Wunderlich, PF, Braun, L, Fumagalli, I, D'Apuzzo, V, Heim, F, Karly, M, Lodi, R, Politta, G, Vonbank, F & Zeltner, L (1989) Double-blind report on the efficacy of lactic acid-producing Enterococcus SF68 in the prevention of antibiotic-associated diarrhoea and in the treatment of acute diarrhoea. Journal of Internal Medicine Research 17, 333–338.Google ScholarPubMed