Families are often surprised to learn my opinion about probiotics. The “truth” about probiotics is that they are poorly regulated/lack rigorous production standards and are mostly ineffective for many of the conditions for which they have been promoted. Even in conditions in which there is some effectiveness (eg. antibiotic-associated diarrhea), the number of persons needed to treat for one person to benefit is fairly high.
In addition, when someone says that they are taking a probiotic, many families do not understand the idea of “strain” specific effects. I tell families that if they see a “dog in yard” sign that they do not know if that is a poodle of a pit bull. With probiotics, similarly you often do not know if you are getting a pit bull or a poodle.
As a consequence, I think negative studies like a recent report (K Wojtyniak et al. J Pediatr 2017; 184: 101-05) are helpful. In this study, the authors examined the effectiveness of Lactobacillus casei rhamnosus Lcr35 (Lcr35) in the management of constipation.
This randomized, double-blind, placebo-controlled trial was conducted in 94 children <5 years of age. Dose: 8 x10 to the 8th CFU twice daily x 4 weeks.
Key findings:
- “Lcr35 as a sole treatment was not more effective than placebo in the management of functional constipation.” In fact, the placebo group had a greater increase in bowel movement frequency than the treatment group.
- Both groups had improvement -more than half in each group (total 52 of 81 who completed study) had reached endpoint of 3 or more BMs/week without soiling.
My take: Probiotics often are ineffective. This study showed that Lcr35 was NOT helpful for pediatric constipation.
Related blog posts:
- Balanced summary of probiotics & Microbiome effects on brain
- Probiotics for Crohn’s Disease –No Beneficial Effects Noted | gutsandgrowth
- Probiotics For Fatty Liver Disease | gutsandgrowth
- “Low quality of evidence; strong recommendation” for Probiotics in Gastroenteritis
- Probiotics for Colic
- Do Probiotics Really Help Crying Infants? | gutsandgrowth
- Pushback on Probiotics
- One More Day Syndrome & Necrotizing Enterocolitis | gutsandgrowth
- Probiotics, Atopy, and Asthma | gutsandgrowth
Claude Monet, La Rue Montorgueil
gutsandgrowth 