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Lactobacillus

What is Lactobacillus?

Lactobacillus is a type of bacterium. There are many different species of Lactobacillus. These are "friendly" bacteria that normally live in the digestive tract, urinary tract and genital system without causing disease. Lactobacillus is also found in some fermented foods such as yogurt and in nutritional supplements. Lactobacillus is used to treat and prevent diarrhea including infectious types such as rotaviral diarrhea in children and traveler's diarrhea. It is also used to treat and prevent diarrhea associated with the use of antibiotics. Some people use Lactobacillus for general digestive problems, irritable bowel syndrome, colic in babies, Crohn's disease, inflammatory bowel disease and necrotizing enteropathy in premature babies. Lactobacillus is also used to treat Helicobacter pylori infections (the type of bacteria that causes stomach ulcers), as well as other types of infections including urinary tract infections and to prevent respiratory infections in children. It is also being tested to prevent serious infections in people on artificial respiration. Lactobacillus is used for skin problems such as cold sores, ulcers, eczema and acne. Lactobacillus is also used for high cholesterol levels, lactose intolerance, Lyme disease, hives and to boost the function of the immune system. Women sometimes use Lactobacillus suppositories to treat vaginal and urinary tract infections.

There are concerns about the quality of some Lactobacillus products. Some products that claim to contain Lactobacillus Acidophilus either do not contain Lactobacillus Acidophilus or contain a different strain of Lactobacillus such as Lactobacillus Bulgaricus. Some other products are contaminated with unhealthy bacteria.

How effective is Lactobacillus?

Lactobacillus is likely to be effective for treating diarrhea in children caused by rotavirus. Children suffering from rotaviral diarrhea who are treated with Lactobacillus seem to get over their diarrhea about half a day earlier than children without treatment. Larger doses of Lactobacillus are more effective than smaller ones. At least 10 billion colony forming units should be used during the first 48 hours.

Lactobacillus may be effective for

  • Preventing diarrhea in children caused by antibiotics. Giving children Lactobacillus GG (Culturelle) along with antibiotics appears to reduce the diarrhea that sometimes occurs in children when they take antibiotics without Lactobacillus.
  • Prevention of diarrhea in adults. Consuming a specific drink containing Lactobacillus Casei, Lactobacillus Bulgaricus and Streptococcus Thermophilus (Actimel, Danone) twice a day during treatment with antibiotics and for a further week after the end of treatment significantly reduces the risk of diarrhea.
  • Prevention of traveler's diarrhea. So-called traveler's diarrhea is caused by bacteria, viruses or parasites to which travelers have not previously been exposed. Taking a specific strain of Lactobacillus Rhamnosus, Lactobacillus GG (Culturelle), appears to help prevent traveler's diarrhea. The effectiveness of Lactobacillus GG can vary greatly from destination to destination due to different bacteria in different locations.
  • Preventing diarrhea due to chemotherapy. A chemotherapy drug called 5-fluorouracil can cause severe diarrhea and other side effects affecting the digestive tract. There is evidence that patients suffering from intestinal or rectal crises suffer less severe diarrhea and stomach discomfort, spend less time in the hospital, and require less frequent reductions in chemotherapy dosage due to side effects affecting the digestive tract if they consume a certain strain of Lactobacillus Rhamnosus, Lactobacillus GG (Culturelle).
  • Colic in babies. Taking a specific Lactobacillus Reuteri product (Probiotic Drops, BioGaia AB) at a dosage of 100 million CFUs once a day for 21 to 28 days reduces colic in breastfed infants. Taking this Lactobacillus Reuteri product appears to be more effective than taking the drug simethicone.
  • Lung infections. Children aged 1 to 6 years who go to nursery seem to get less frequent and less severe lung infections if they drink milk containing Lactobacillus GG or take a specific product containing both Lactobacillus Acidophilus and Bifidobacterium (HOWARU Protect).
  • Treatment of ulcerative colitis. Some research suggests that taking a specific combination product containing Lactobacillus, Bifidobacteria and Streptococcus may relieve symptoms. Taking Lactobacillus appears to help treat pouchitis, a complication that occurs during ulcerative colitis surgery. Continuous treatment with a specific concentrated formula of Lactobacillus, Bifidobacterium and Streptococcus (VSL#3) for one year seems to help most patients.
  • Treatment of irritable bowel syndrome. There is research showing that certain strains of Lactobacillus can reduce irritable bowel syndrome such as bloating and stomach pain, while other strains of Lactobacillus do not.
  • Treatment of bacterial vaginal infections. Clinical studies show that certain Lactobacillus strains can help treat bacterial vaginosis when applied to the vagina. Research has found that Lactobacillus acidophilus suppositories (Vivag, Pharma Vinci A/S, Denmark) and vaginal tablets (Gynoflor, Medinova, Switzerland) may be effective. Scientists have also found that vaginal capsules containing Lactobacillus Gasseri and Lactobacillus Rhamnosus appear to prolong the time between infections.
  • Treatment and prevention of eczema (atopic dermatitis) in infants and children allergic to cow's milk. A combination of freeze-dried Lactobacillus Rhamnosus and Lactobacillus Reuteri appears to reduce eczema symptoms in children between the ages of 1 and 13.
  • Support of prescription medications to treat Helicobacter pylori (H pylori) infection that causes stomach ulcers.
  • Treatment of diarrhea caused by the bacterium Clostridium Difficile.
  • For vaginal yeast infections after taking antibiotics. There is evidence that oral intake of Lactobacillus or consumption of yogurt enriched with Lactobacillus does not prevent vaginal yeast infections after taking antibiotics. However, women with yeast infections who used vaginal suppositories containing 1 billion live Lactobacillus GG bacteria twice daily for 7 days in conjunction with conventional treatment often reported an improvement in symptoms.
  • for Crohn's disease
  • for lactose intolerance
  • To reduce the symptoms of too many bacteria in the digestive tract.

Lactobacillus may be ineffective

There is insufficient scientific data to evaluate the effectiveness of Lactobacillus in the treatment of urinary tract infections. While there is preliminary evidence that vaginal use of some Lactobacillus species may be helpful in preventing urinary tract infections, not all studies agree.

The same applies to the effectiveness of Lactobacillus for general digestive problems, necrotizing enteropathy in premature babies, high cholesterol levels, lactose intolerance, Lyme disease, hives, cold sores, acne, cancer, the common cold, improving the immune system and preventing infections in people on artificial respiration. Further scientific research is needed in this area.

How does Lactobacillus work?

Many bacteria and other organisms live naturally in the human body. "Friendly" bacteria such as Lactobacillus can help the body break down food, absorb nutrients and fight harmful bacteria that can cause illnesses such as diarrhea.

Are there any safety concerns?

Lactobacillus is safe for most people, including babies and children. Side effects are usually mild and most commonly include flatulence or bloating

Lactobacillus is also likely safe for use inside the vagina in women.

Precautions and warnings

  • Pregnancy and lactation: Lactobacillus is probably safe for use during pregnancy and lactation. Lactobacillus GG has been used safely in pregnant and breastfeeding women. However, other types of Lactobacillus have not been studied during pregnancy and lactation, so their safety during this time is not known.
  • Weakened immune system: There are concerns that Lactobacillus from supplements containing live bacteria may grow too well in people with weakened immune systems. This includes people suffering from HIV/AIDS or people taking medication to prevent rejection of a transplanted organ. Lactobacillus has in rare cases caused illness in people with weakened immune systems. For this reason, people with weakened immune systems should discuss the use of Lactobacillus with their doctor.
  • Short bowel syndrome: People with short bowel syndrome have a higher risk of Lactobacillus infections than other people. If you suffer from this condition, you should talk to your doctor before taking Lactobacillus.

Interactions with medication

Care should be taken when combining Lactobacillus with the following medications:

Antibiotics

Antibiotics are used to reduce the amount of harmful bacteria in the body. However, antibiotics can also reduce "friendly" bacteria in the body. Lactobacillus is a "friendly" bacteria. Taking antibiotics in combination with Lactobacillus can reduce the effectiveness of Lactobacillus. To avoid this interaction, Lactobacillus should be taken at least 2 hours before taking antibiotics.

Drugs that reduce the function of the immune system

Lactobacillus contains live bacteria and yeast. The immune system usually controls yeast and bacteria in the body to prevent infections. Medications that reduce the function of the immune system may increase the risk of getting sick from bacteria and yeast. Taking Lactobacillus in combination with drugs that reduce the function of the immune system may increase the risk of illness.

Are there any interactions with medicinal herbs or supplements?

There are no known interactions with medicinal herbs or supplements

Are there any interactions with food?

There are no known interactions with food.

What dosages are used?

The strength of Lactobatillus products is usually indicated by the number of live bacteria per capsule. Typical dosages range from 1 to 10 billion organisms per day divided into 3 to 4 single doses.

Dosage

The following dosages have been scientifically studied:

Oral intake:

  • For children suffering from rotaviral diarrhea: 5 to 18 billion live Lactobacillus GG bacteria in a solution that replaces lost fluid.

  • For the treatment of babies and children with diarrhea:

    • 10 to 100 billion live Lactobacillus Reuteri bacteria daily for up to 5 days. Lower doses may not be effective.
    • A combination of Lactobacillus Rhamnosus and Lactobacillus Reuteri, 10 billion live cells per strain twice daily for 5 days.

  • For the prevention of antibiotic-associated diarrhea in children: A specific strain Lactobacillus Rhamnosus, Lactobacillus GG (Culturelle) at a dosage of 20 billion live organisms per day was used during treatment with antibiotics. A specific drink containing Lactobacillus Casei, Lactobacillus Bulgaricus and Streptococcus Thermophilus (Actimel, Danone, 97 ml) was also used twice daily.

  • For the prevention of diarrhea in infants and children from 1 to 36 months:

    • 6 billion live Lactobacillus GG cells twice daily.
    • A fermented milk product containing a specific Lactobacillus Casei strain DN-114 001 (DanActive, Dannon) was used in doses of 100 grams, 125 grams or 250 grams per day.

  • To prevent and shorten the duration of diarrhea in newborns during the first year of life in rural areas of developing countries: 100 million live Lactobacillus Sporogenes cells per day for a period of one year.

  • For the prevention of respiratory infections in children in nurseries:

    • 260 ml of milk containing 500,000 to 1 million colony-forming units of Lactobacillus GG per ml.
    • A milk product containing 5 billion colony forming units each of Lactobacillus Acidophilus and Bifidobacterium (HOWARU Protect, Danisco) in 120 ml of milk was used twice daily.
    • A dairy product containing 5 trillion colony forming units in 120 ml of milk was used twice daily.

  • For the treatment of recurrent diarrhea caused by Clostridium Difficile: 1.25 billion live Lactobacillus GG cells divided into two doses per day for 2 weeks.

  • For ulcerative colitis: A combination product containing live freeze-dried bacteria species including Lactobacillus, Bifidobacteria and Streptococcus (VSL#3) was used at a dosage of 3 grams daily as part of maintenance therapy.

  • In patients with active mild to moderate ulcerative colitis: VSL#3, three grams once or twice daily in combination with conventional treatment.

  • In children with moderate to severe ulcerative colitis: VSL#3, 450-1800 billion bacteria once daily in combination with mesalamine.

  • For prevention of traveler's diarrhea: Lactobacillus GG, 2 billion organisms daily.

  • For diarrhea due to chemotherapy: A specific strain of Lactobacillus Rhamnosus, Lactobacillus GG (Culturelle) at a dosage of 10-20 billion live organisms daily.

  • For atopic dermatitis: A specific strain of Lactobacillus Rhamnosus, Lactobacillus GG (Culturelle). Lactobacillus Reuteri at a dosage of 100 million live bacteria daily or Lactobacillus Sakei at a dosage of 5 billion live bacteria twice daily have also been used.

  • For irritable bowel syndrome:

    • 10 billion heat-killed Lactobacillus Acidophilus (Lacteol Fort) cells twice daily for 6 weeks.
    • A specific probiotic Lactobacillus combination containing lyphilized bacteria species including Lactobacillus, Bifidobacteria and Streptococcus (VSL#3) at a dosage of 450 billion cells, twice daily.
    • A specific drink containing Lactobacillus Plantarum 299v (ProViva, Skanemejerier, Sweden) twice daily.

  • For the prevention of colds in adults: A mixture of Lactobacillus Plantarum and Lactobacillus Paracasei, 1 billion live bacteria daily.

  • For colic in babies: A specific Lactobacillus Reuteri product (Probiotic Drops, BioGaia AB), 100 million CFUs once daily, 30 minutes after breastfeeding.

  • To prevent necrotizing enteropathy in premature babies: Lactobacillus Rhamnosus GG, 6 billion live bacteria daily.

  • To prevent serious lung infections in adults on artificial respiration: Lactobacillus Rhamnosus GG (Amerifit Brands Nutrition), 2 billion live bacteria twice daily.

Used inside the vagina

  • For the treatment of vaginal infections caused by bacteria:

    • 1-2 vaginal tablets (Gynoflor, Medinova, Switzerland) daily, containing live Lactobacillus Acidophilus cells (10 million colony forming units per tablet) and 0.3 mg estriol, for 6 days.
    • Intravaginal suppositories containing 100 million to 1 billion colony-forming units of Lactobacillus acidophilus (Vivag, Pharma Vinci A/S, Denmark), twice daily for 6 days.
    • Vaginal capsules containing Lactobacillus Gasseri and Lactobacillus Rhamnosus in a dosage of 100 million to 1 billion colony-forming units per capsule (EcoVag Vaginal Capsules, Bifodan A/S, Denmark), following usual treatment for 10 days in three menstrual cycles after infection.

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