Tag Archive for: gastroenteritis

The Bottom Line on Preschoolers, Probiotics, and Gastroenteritis

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“These studies are likely to have significant impact towards eliminating use of medications that don't seem to work.”

That’s a quote from a physician interviewed by NPR who wrote a commentary accompanying the two research papers on probiotic use for gastroenteritis or GE (1). I think it perfectly illustrates the fallacy of the pharmaceutical model of research on nutrition and its impact on health:

Nutrients are not medications.

They may come in pill form, they can be administered like medications, but they’re nutrients nonetheless.
Questions About the Studies
The . . .

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Did Probiotics Help Preschoolers with Gastroenteritis?

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The use of probiotics to stop diarrhea and vomiting for preschoolers with gastroenteritis (GE) was studied in two major studies published in the New England Journal of Medicine. In the U.S. study, 55 of the 468 subjects who got the probiotics had scores of nine or greater on the scale while 60 of 475 in the placebo group has scores of nine or greater for the two weeks after the study began. This was a 20-point scale and the higher the score, the worse the GE symptoms. No significant differences.

In the Canadian study, 108 of the 414 subjects in the probiotics group and 102 of the 413 subjects in the placebo group had scores of nine or greater for the two weeks after the study began. Again no significant differences were found.

This led both research groups to conclude that the probiotics used in the studies were ineffective in preventing negative GE outcomes compared to those who received the placebo.

The press releases and follow-up interviews were much harsher in their criticism of probiotics. One of the study leaders concluded that “These two probiotics did not work. They should not be used for GE.” I would emphasize “period!” was implied. But is that true? If you’re a regular Memo reader, I’ll bet you have an idea where this is going; I’ll explain on Saturday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.

 

Preschoolers, Probiotics, and Gastroenteritis

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Estimates are that close to two million preschool children will be taken to the emergency room for vomiting and diarrhea every year; the term generally used is gastroenteritis (GE). Two research groups, one from the U.S. and one from Canada, conducted studies to see if probiotics would have any impact on the course of GE from the time of the ER visit for at least two weeks after. Here’s what they did.

Researchers in Canada recruited close to 900 children and researchers in the U.S. had close to a thousand; all the children had symptoms of GE. The subjects were randomly assigned to a placebo or experimental group. The subjects in the experimental groups were given a five-day course of probiotics; the Canadian group used two strains and the U.S. used one strain. The subjects were then tracked to see whether there was a difference in the severity of the GE between those kids getting the placebo and the ones getting probiotics. Both research groups used the same GE symptom scale to monitor the severity of the GE.

Did the probiotics have any impact on the severity of the GE? We’ll check out the results on Thursday.

What are you prepared to do today?

Dr. Chet

 

References:
1. N Engl J Med 2018; 379:2015-2026. DOI: 10.1056/NEJMoa1802597.
2. N Engl J Med 2018; 379:2002-2014. DOI: 10.1056/NEJMoa1802598.