My mother was healthy, even as she got older, until a hospital-based infection destroyed her. She went to the outpatient department in the local hospital for a routine endoscopy, for a problem she never had, and was infected by Clostridium difficile. The first sign that some thing was wrong was fever, for which she was treated with antibiotics, which propelled the nasty bacteria into overproduction.
Antibiotics can be life saving. They have been greatly overused in the treatment of minor infections, however, including viral infections, for which they are worthless. Even when necessary, they dramatically alter gastrointestinal flora—the zoo of friendly and not-so-friendly bacteria that live in your gut. The occurrence of antibiotic-associated diarrhea (AAD) occurs in about one third of people who take antibiotics. A severe form of AAD is Pseudomembranous colitis, an infection of the large intestine associated with an overgrowth of Clostridium difficile antibiotic resistant bacteria.
Antibiotics Can Cause Bacteria Overgrowth
Clostridium difficile (C. diff) commonly lives in the intestines, where is usually does little harm. When you take antibiotics, however, it may overgrow. This bacterium releases a powerful toxin that causes the lining of the colon to become inflamed and bleed. This, in turn, leads to horrible watery, often bloody diarrhea, which results in dehydration. The abdomen swells and is painful. Fever skyrockets. It ravages the intestines. C. diff mostly preys on people in hospitals, nursing homes, and other medical facilities—the very places patients trust to protect their health—and can be fatal.
A USA Today investigation showed that C. diff is far more prevalent than federal reports suggest. It strikes about a half-million Americans each year, and hospital records indicate it causes more than 30,000 deaths a year in the United States.
In my mother’s case, I immediately made copies of research studies on the use of probiotics for the treatment of C. diff, and gave them to her medical doctor. Based on my recommendation, her doctor ordered FloraStor, a yeast-based probiotic called Saccharomyces boulardii. This simple tropical strain of yeast, first isolated from lychee and mangosteen fruit in 1923 by French scientist Henri Boulard, saved my mother’s life. It is available in the trademark brand or in generic forms.
New Study Shows Probiotics Help
I wanted to know why medical doctors did not know about FloraStor, and why it wasn’t part of first-line treatment when there was good scientific and clinical evidence that it helped. It was also shown to cause no harm, and there was little else to be done for C. diff victims.
My mother’s doctor had no answer, so I called the head of the hospital pharmacy. I was told that FloraStor was stocked in the hospital pharmacy, and was covered by Medicare, but rarely prescribed.
My mother didn’t die from C. diff, but she developed a recurring debilitating form of the disease that destroyed her quality of life. She was in and out of the hospital for two years before she finally succumbed to the consequences of the disease.
Since my mother’s tragic iatrogenic infection and the disappointing mismanagement of her condition, several review articles have been written on the importance of using probiotics during and after taking antibiotics, as well as for the treatment of C. diff.
Results of a new study, just published this month (13 November 2012), bring a hint of good news for patients with C. diff. The evidence the researchers found suggests that preventive treatment with probiotics greatly reduces C. diff AAD without causing other problems. Let’s hope that medical doctors catch on and start using probiotics for their patients.
How Do They Work?
Probiotics help to restore gut ecology during or after antibiotic treatment. They provide assistance through promoting cell receptor competition, encouraging healthy competition for nutrients, inhibiting the adherence of pathogens to the mucosal membrane, lowering colonic pH (a more acidic environment favoring the growth of nonpathogenic species), stimulating of immunity, and producing disease-reducing antimicrobial substances.
Which Ones Are Best?
Though Saccharomyces boulardii is the best studied of probiotics for the treatment of AAD, many common Lactobacillus strains are also effective. Probiotic formulas using multiple strains are more than twice as effective as single strain products.
I typically prescribe a probiotic blend of Saccharomyces boulardii, Lactobacillus rhamnosus, Bifidobacterium bifidum, and Bifidobacterium breve. To be effective, very high doses of at least 15 billion units are necessary several times daily.
There is concern that gastric acid kills probiotics when taken orally. This is true, which is why large dosages are necessary and why they are best taken with food. A tougher strain, Lactobacillus sporogenes, also called Bacillus coagulans, is somewhat antibiotic resistant and is also able to tolerate the acidity of the gastric environment, assuring that more probiotic bacteria reach the intestines.
A probiotic is only functional if it can reach the intestines, establish itself and flourish. Therefore, I typically include L. sporogenes, 1.5 billion units twice daily with food, during antibiotic use, and follow with other strains once the antibiotic course is completed.