. However, probiotics are like “super” vitamins that improve all aspects of a dog’s health, ranging from enhancing immune system functioning to supporting intestinal absorption of nutrients necessary for keeping all dogs fit, happy and disease-free. A symbiotic combination of inulin plus oligofructose with L. plantarum plus B. bifidum increased the growth of bifidobacteria but inhibited human pathogenic strains of Campylobacter jejuni, E. coli, and Salmonella enteritidis in vitro more than any other carbohydrate tested (122). Probiotics are safe for the vast majority of the population, but may not be the best fit for everyone. During administration of L. casei–containing fermented milk (daily for 2 mo), a lower frequency of diarrhea was observed compared with the administration of conventional yogurt (15.9 vs. 22%; P < 0.05) (41). Beneficial effects on microbial aberrancies, inflammation, and other complaints in connection with inflammatory diseases of the gastrointestinal tract, Effects established in certain target groups. According to these authors, only 2 indigestible oligosaccharides fulfill the criteria for prebiotic classification to date: 1) inulin and inulin-type fructans, produced by partial hydrolysis of inulin or synthetically from the monomers, and 2) (trans-)galactooligosaccharides. (37). Shibolet O, Karmeli F, Eliakim R, Swennen E, Brigidi P, Gionchetti P, Campieri M, Morgenstern S, Rachmilewitz D. Steidler L, Hans W, Schotte L, Neirynck S, Obermeier F, Falk W, Fiers W, Remaut E. Borruel N, Carol M, Casellas F, Antolin M, de Lara F, Espin E, Naval J, Guarner F, Malagelada JR. Malin M, Suomalainen H, Saxelin M, Isolauri E. Gupta P, Andrew H, Kirschner BS, Guandalini S. Rembacken BJ, Snelling AM, Hawkey PM, Chalmers DM, Axon AT. In large part, studies demonstrating positive effects on the prevention and alleviation of infectious diarrhea in healthy human populations have been performed in infants and children. The Side Effects & Benefits of Probiotics. Reports on effects of probiotics in this disorder are still rather contradictory. Bielecka M, Biedrzycka E, Majkowska A. Asahara T, Nomoto K, Shimizu K, Watanuki M, Tanaka R. Bomba A, Nemcova R, Gancarcikova S, Herich R, Guba P, Mudronova D. Videla S, Vilaseca J, Antolin M, Garcia-Lafuente A, Guarner F, Crespo E, Casalots J, Salas A, Malagelada JR. Fukuda M, Kanauchi O, Araki Y, Andoh A, Mitsuyama K, Takagi K, Toyonaga A, Sata M, Fujiyama Y, et al. 1 The meta-analysis portion included 35 trials with a total of 4,555 patients. Probiotics are essentially supposed to provide relief. Vanderhoof JA, Young RJ, Murray N, Kaufman SS. However, because of methodological difficulties and complex interactions between regulatory mechanisms, the correlation with true health effects is not clear, Prevention and/or reduction of duration and complaints of rotavirus-induced diarrhea, Effect well established by clinical studies and accepted by the scientific community, Prevention or alleviation of antibiotic-associated diarrhea, Alleviation of complaints caused by lactose intolerance. Immune Mediated Colitis induced by pembrolizumab. A placebo-controlled trial, Effects of probiotic bacteria on diarrhea, lipid metabolism, and carcinogenesis: a review of papers published between 1988 and 1998, Protection from gastrointestinal diseases using probiotics, Day care centers and diarrhea: a public health perspective, The effect of supplementation with milk fermented by, Multicentric study of the effect of milk fermented by, Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial, Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Not only does manufacturing, processing and production of various probiotic products often kill the bacteria, but our stomach acid can be a hard barrier for it to cross even if live cultures do make their way into our bodies. A reduction in febrile days or in days with respiratory illness was observed only in the L. reuteri group (43). Yogurt is usually more effective (17,18), and, last but not least, primary or adult-type hypolactasia (the reason for lactose malabsorption) is not a disease but actually the normal physiological state. Application of probiotics also significantly decreased the number of relapses after successful treatment of Clostridium difficile infections (72), but the analysis of other trials yielded no clear-cut results because of inconsistent data and the heterogeneity in study design and choice of probiotics (73). In addition, an analysis of 23 research studies and almost 4500 i… All in all fewer symptoms and a higher quality of life of children and adult patients were observed, although mainly in preliminary studies (98). Diarrhea can be due to viral or bacterial infections, food-borne illnesses, allergies, food and particularly lactose intolerance, or the ingestion of laxatives or foods with laxative properties, and it is accompanied by abdominal pain, nausea, and vomiting. Digestive. Probiotics Can Help Prevent Diarrhea in Dogs. Gopal PK, Prasad J, Smart J, Gill HS. Best Probiotics for Diabetes to have in 2021. Frequency of Bowel Movements and Risk of Diverticulitis. 7 minute read. By this last effect prebiotics inhibit certain strains of potentially pathogenic bacteria, especially Clostridium, and prevent diarrhea (121). Although it may seem like diarrhea when the body is excreting waste after a person takes probiotics, it is really the effect of the probiotics doing their job. Some short-term side effects occur early on, but soon his bathroom habits regulate and make for a happier kitty. According to the World Health Organization, diarrhea is defined as “the passage of three or more loose or liquid stools per day, or more frequently than is normal for the individual.” Diarrhea occurs when fluid absorption by the colon is insufficient, e.g., if the colon is damaged or inflamed. They are living bacteria and can die easily if not taken care of properly. Although administration of S. boulardii did reduce the frequency of diarrhea in critically ill tube-fed patients from 20% of enteral feeding days in the placebo to 14% in the treated group (P < 0.01) in a randomized, placebo-controlled study (78), a mixed-strain preparation of L. acidophilus plus L. delbrückii ssp. Cholestyramine, antibiotics, intestinal antiinflammatory agents, probiotics? Hudault S, Lievin V, Bernet-Camard MF, Servin AL. Taking probiotic supplements can cause an overgrowth of bacteria in the small intestine, leading to brain fogginess, bloating, gas, and stomach pains. The same is true for diarrheas during triple therapy for H. pylori eradication. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. C. So, as long as it’s not against doctor’s orders, you could try buying a probiotics that has no prebiotics in it. Although in some trials a positive modulation of the intestinal flora, less motility disorder, and the alleviation of functional diarrhea were found (105–109), a randomized, placebo-controlled study on 362 primary-care female patients with IBS showed an improvement in bowel dysfunction and other symptoms only if 108 cfu of the freeze-dried probiotic bacteria B. infantis spec. Caplan MS, Miller-Catchpole R, Kaup S, Russell T, Lickerman M, Amer M, Xiao Y, Thomson R, Jr. Dieleman LA, Goerres MS, Arends A, Sprengers D, Torrice C, Hoentjen F, Grenther WB, Sartor RB. The use of dietary or medicinal probiotics against other pathogens, in adults, in children in Third-World –countries, and for very severe (dehydrating) diarrhea was less successful. Deutsche Gesellschaft für Ernährung e. V. Efficacy of SF68 in the treatment of acute diarrhea. Yes, But … As we have shown, probiotics can induce diarrhea. However, the effects on humans have been assessed mainly in smaller (n<100) randomized, controlled clinical studies or in open label trials, but large intervention studies and epidemiological investigations of long-term probiotic effects are largely missing. However, once you get past the adjustment phase, it becomes a nonissue. Administration of LGG, Saccharomyces boulardii, and other probiotic strains before and during antibiotic treatment reduced the frequency and/or duration of episodes and the severity of symptoms in many cases (60–68) but was not always effective (69). Brunser O, Gotteland M, Cruchet S, Figueroa G, Garrido D, Steenhout P. Oxford University Press is a department of the University of Oxford. However, they can cause diarrhea in some people. Dendukuri N, Costa V, McGregor M, Brophy JM. In conclusion, accumulating evidence from randomized, controlled, but relatively small clinical studies suggests the potential of probiotics for inducing or maintaining remission in inflammatory bowel diseases. Significantly fewer episodes of flatulence (4 vs. 27), vomiting (0 vs. 10), and fever (5 vs. 13) were observed in the oligofructose group as well (128). Eradication of the gastric pathogen Helicobacter pylori using clarithromycin, amoxicillin, and omeprazol (triple therapy) is a rather mild therapy and leads to diarrheas in only ∼10–20% of cases. Many strains of probiotic microorganisms have been shown to inhibit growth and metabolic activity as well as the adhesion to intestinal cells of enteropathogenic bacteria (Salmonella, Shigella, enterotoxigenic E. coli, or Vibrio cholerae) (1–3) to modulate (temporarily) the intestinal microflora and to have immunostimulatory or -regulatory properties. Elmer GW, Surawicz CM, McFarland LV. However, depending on the definition of “probiotic,” this is not a specific probiotic effect because it does not depend on survival of the bacteria in the small intestine. Galactooligosaccharides, on the other hand, failed to attenuate inflammation in experimental colitis in rats (127). Probiotic supplements essentially provide your gut with more of the good digestive bacteria. Keep scrolling for more details on the best probiotics for diarrhea you can buy. Search for other works by this author on: Antibacterial effect of the adhering human, Antagonistic activity exerted in vitro and in vivo by, Probiotic supplementation reduces the risk of bacterial translocation in experimental short bowel syndrome, Econutrition and health maintenance: a new concept to prevent inflammation, ulceration and sepsis, Conjugated linoleic acid biosynthesis by human-derived, Culture-containing dairy products—effect on intestinal microflora, human nutrition and health: current knowledge and future perspectives, Surface binding of aflatoxin B1 by lactic acid bacteria, Binding of aflatoxin B1 to bifidobacteria in vitro, Pathologic and physiologic interactions of bacteria with the gastrointestinal epithelium, Probiotics up-regulate MUC-2 mucin gene expression in a Caco-2 cell-culture model, Probiotics—compensation for lactase insufficiency, [Effects of strain and viability of lactobacilli in fermented milk products on lactose digestion], The role of colonic microbiota in lactose intolerance, Do probiotics reduce adult lactose intolerance? The conventional yogurt brought the mean duration of diarrhea from 8.0 d down to 5 d, and the probiotic product brought it down to 4.3 d (P < 0.01); the incidence of diarrhea was not different between groups (40). All microorganisms tested (Saccharomyces boulardii, L. rhamnosus GG, L. acidophilus, L. delbrückii ssp. Ørskov J, Ørskov F, Gaarslev K, Laulund S. Hilton E, Kolakowski P, Singer C, Smith M. Oksanen PJ, Salminen S, Saxelin M, Hämäläinen P, Ihantola-Vormisto A, Muurasniemi-Isoviita L, Nikkari S, Oksanen T, Pörsti I, et al. Whereas some studies revealed fewer or shorter episodes of diarrhea in subjects consuming the probiotic (47–49), others found no such effect (50). Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. The symptoms range from diarrhea or constipation to gas, and stomach pain. This was confirmed by a recent meta-analysis of the available data from 34 randomized placebo-controlled trials evaluating the efficacy of selected strains of probiotic bacteria in different types of acute diarrhea (51). Probiotics are fragile. Can Probiotics Increase Diarrheas? 3. Copyright © 2010 Elsevier Inc. All rights reserved. Probiotics Can Cause Diarrhea Studies have shown how helpful probiotics can be for infectious diarrhea, traveler's diarrhea, antibiotic-associated diarrhea, and C diff diarrhea. Similarly, the combination of trans-galactooligosaccharides plus bifidobacteria did protect mice against lethal infections with Salmonella enterica serovar typhimurium (123). Changes in the gut microbiota can result in bacteria producing more gas than usual, which can lead to bloating. "can too much probiotic cause diarrhea? Full of live microorganisms, probiotics swarm your cat's gastrointestinal tract to help soothe and calm a cranky bowel. in this issue. Check out this guide if you’re looking for the best probiotic for IBS constipation, diarrhea, or mixed type. The sudden rush of extra bacteria can cause gas…. This is probably just a result of your body adjusting, and will subside within a week’s time. bulgaricus, and other strains) showed similar effects, alone or used in combination. This study was expanded to a randomized, controlled multicenter clinical trial in a total of 928 children (6–24 mo). This negative side effect should pass as your body gets fully adjusted to the new probiotics. Probiotic can increase diarrhea only if it has been consumed in uncontrolled numbers. Is Probiotic Yoghurt Good for Diarrhea? Can Probiotics Cause Diarrhea? Probiotics are most likely to enhance acute or short-term diarrhea rather of triggering it. And 10 g/d oligofructose (given 2 wk before and during a 2-wk journey) was only moderately successful in preventing traveler's diarrhea, reducing the percentage of subjects with diarrhea attacks to 11% compared with 20% in the placebo group (P = 0.08) (132). Kim YG, Moon JT, Lee KM, Chon NR, Park H. Gibson GR, Probert HM, Van Loo JAE, Roberfroid MB. One determining factor is age. Madsen KL, Doyle JS, Jewell LD, Tavernini MM, Fedorak RN. We … Supplementing a dog’s diet with probiotics can reduce the likelihood that the dog suffers diarrhea due to stress, chewing on outside debris or having an older, less vital immune system. Bacterial supplementation in the irritable bowel syndrome. Probiotics have the power to both help and cause diarrhea in your cat. A review released in the November 2010 “Cochrane Database of Systematic Reviews” examined 63 studies consisting of over 8000 participants, and concluded the use of probiotics in acute diarrhea– along with the typical rehydration therapy– minimized the duration of diarrhea by about one day and minimized the frequency of stools by day 2 of probiotic therapy. A 2010 Cochrane systematic review and meta-analysis by Allen et al demonstrated that the addition of probiotics decreased the mean duration of diarrhea by one day (24.76 hours [95% CI; 33.61–15.91]). This is discussed in greater detail in the article by Sheil et al. Despite the promising results of animal experiments, there was no report of a successful preventive or therapeutic use of prebiotics in patients with diarrhea and/or inflammatory diseases of the gut. Marteau P, Cuillerier E, Meance S, Gerhardt MF, Myara A, Bouvier M, Bouley C, Tondu F, Bommelaer G, Grimaud JC. lactis and L. acidophilus 4 wk before and during a H. pylori eradication therapy led to significantly fewer episodes of diarrhea compared with the placebo group (7 vs. 22% of the subjects) (44,71). . Levri KM, Ketvertis K, Deramo M, Merenstein JH, D'Amico F. Isolauri E, Juntunen M, Rautanen T, Sillanaukee P, Koivula T. Saavedra JM, Bauman NA, Oung I, Perman JA, Yolken RH. These are known to be a nourishing source to probiotics and are often added in probiotic supplements. Although their exact causes are not yet fully understood, disturbances of the autochthonous intestinal microflora and the stimulation of proinflammatory immunological mechanisms seem to play a role in a number of inflammatory diseases of the intestine. Whorwell PJ, Altringer L, Morel J, Bond Y, Charbonneau D, O'Mahony L, Kiely B, Shanahan F, Quigley EM. Sen S, Mullan MM, Parker TJ, Woolner JT, Tarry SA, Hunter JO. In a prospective, randomized, controlled French study, 287 children (18.9 ± 6.0 mo) in day-care nurseries were administered daily either unfermented jellied milk, conventional yogurt, or a probiotic yogurt product containing 108 cfu/mL L. casei spec. Protection by probiotic bacteria and yeasts with immunostimulatory properties or the alleviation of symptoms and shortening of acute infections are perhaps the best-documented probiotic effects, and these have been demonstrated many times in the past in clinical studies fulfilling scientific requirements. de Vrese M, Stegelmann A, Richter B, Fenselau S, Laue C, Schrezenmeir J. de Vrese M, Kuhn C, Titze A, Lorenz A, Suhr M, Barth CA, Schrezenmeir J. Zhong Y, Priebe MG, Vonk RJ, Huang CY, Antoine JM, He T, Harmsen HJ, Welling GW. Investigations of the effect of probiotic bacteria on traveler's diarrhea in the past showed inconsistent results (46) because of differences between probiotic strains, the traveled countries, the local microflora, eating habits of the travelers, or time point (before or during travel) and means (i.e., as a capsule or a fermented milk product) of administering the probiotic. There are various reasons behind the side effects of probiotics such as to cause diarrhea, gas or bloating. Szymanski H, Pejcz J, Jawien M, Chmielarczyk A, Strus M, Heczko PB. Fewer children were afflicted with diarrhea, and fewer diarrheal episodes were observed, in the oligofructose compared with the placebo group (0 vs. 3 children and 0 vs. 13 episodes; P < 0.05). Gionchetti P, Rizzello F, Venturi A, Brigidi P, Matteuzzi D, Bazzocchi G, Poggioli G, Miglioli M, Campieri M. Kruis W, Fric P, Pokrotnieks J, Lukas M, Fixa B, Kascak M, Kamm MA, Weismueller J, Beglinger C, et al. Other studies failed to confirm significant effects on stool frequency or consistency (111–113), so further investigations are required to advance from hopeful findings to conclusive results (114–116). Mattar AF, Teitelbaum DH, Drongowski RA, Yongyi F, Harmon CM, Coran AG. Probiotics are typically given to dogs suffering GI tract illnesses, chronic diarrhea or diarrhea associated with antibiotic use. Side effects are more prevalent in the young and the elderly and debilitated patients. Yes, Probiotic yogurt is one of the best sources for these bacteria in the human body. 4 Signs You Are Taking Too Many Probiotics: 3. Probiotics are a type of "good" bacteria found in some foods and supplements.We usually think of bacteria as something that can cause diseases or other problems. Can lactobacillus acidophilus and other probiotics cause gas and bloating? While probiotics are generally well tolerated, including probiotic-rich foods or adding probiotic supplements might infrequently cause side effects. However, some patients take probiotics and feel even worse. For reviews see Fonden et al. You might also have mild diarrhea when you first start taking probiotics. A symbiotic composed of a probiotic L. paracasei strain and oligofructose increased counts of Lactobacillus spp., Bifidobacterium spp., total anaerobes, and total aerobes in the feces of weanling piglets significantly more than a pure L. plantarum preparation and significantly decreased fecal concentrations of Clostridium spp. Taking probiotics for IBS can give your colonic microbiota a boost. Holma R, Juvonen P, Asmawi MZ, Vapaatalo H, Korpela R. Waligora-Dupriet AJ, Campeotto F, Bonet A, Soulaines P, Nicolis I, Dupont C, Butel J. Giannini EG, Mansi C, Dulbecco P, Savarino V. Lewis S, Burmeister S, Cohen S, Brazier J, Awasthi A. Duggan C, Penny ME, Hibberd P, Gil A, Huapaya A, Cooper A, Coletta F, Emenhiser C, Kleinman RE. The interactions between probiotic microrganisms and the GALT or the respective mucosal receptors and signaling pathways as well as the mechanisms of immunomodulation and antiinflammatory probiotic effects are not yet fully understood, but the use of modern techniques such as molecular biology lead to a rapidly growing knowledge of the relations among probiotics, the immune system, and health. Many persons with alleged nonallergenic milk intolerance can digest lactose, and some truely maldigesting persons live without symptoms of intolerance. Is it several soft, semi-formed stools each day? When first using probiotics, some people experience gas, bloating, or diarrhea. But infectious diarrhea is not only a problem of developing countries. Only a few successful approaches to normalizing the small intestinal microflora have been reported (103), e.g., decreased frequency of diarrheas (104) following administration of L. acidophilus and L. casei to patients with small bowel bacterial overgrowth. This is in accordance with a recent review (58) that states that therapeutic effects of probiotics in children with acute diarrhea seem to be 1) moderate, 2) strain- (LGG, L. reuteri, B. lactis Bb12) and 3) dose-dependent, 4) more evident when probiotics are applied early in the episode, and 5) significant only in watery diarrhea and viral gastroenteritis but not in invasive bacterial diarrhea. . Insufficient absorption of osmotically active substances in the gut (e.g., lactose malabsorption in lactase deficiency), Most cases of viral and bacterial enteritis are accompanied by increased secretion or decreased absorption of ions into the gut, Accompanied by exsudation of proteins and blood, Diarrhea with accelerated gastrointestinal motility, By use of antisecretory agents (loperamide, enkephalinase inhibitors) or by measures to avoid liquid stools (argile, fiber). Everyone has diarrhea at one time or another and everyone has their own idea of exactly what diarrhea is. However, earlier reports on the successful use of Enterococcus faecium/faecalis, strains of Escherichia coli, or freshly isolated members of the patients' own intestinal microflora were mostly case reports and open studies rather than well-documented, randomized, double-blind, controlled clinical studies. A systematic review, Improved immunogenecity of oral DxRRV reassortant rotavirus vaccine by, Lactic acid bacteria in the treatment of acute rotavirus gastroenteritis, Beeinflussung der Darmflora durch Ernährung. In conclusion, probiotics promote lactose digestion in lactose malabsorbers no better than conventional yogurt. The harmony (or otherwise) that exists within our GI tract is down to the number and variety of microorganisms that colonise it - a.k.a. The usefulness of probiotics in lowering blood sugar is also well established. They support the intestinal defense against viruses, potentially harmful bacteria, or toxins at all levels, stabilize a balanced composition of the intestinal microbiota, and prevent an excessive overgrowth of commensals and potential harmful bacteria of the autochthonal microbiota. De Keersmaecker SC, Verhoeven TL, Desair J, Vanderleyden J, Nagy I. Eizaguirre I, Urkia NG, Asensio AB, Zubillaga I, Zubillaga P, Vidales C, Garcia-Arenzana JM, Aldazabal P. Mangell P, Nejdfors P, Wang M, Ahrne S, Westrom B, Thorlacius H, Jeppsson B. Coakley M, Ross RP, Nordgren M, Fitzgerald G, Devery R, Stanton C. Fonden R, Mogensen G, Tanaka R, Salminen S. Haskard CA, El-Nezami HS, Kankaanpää PE, Salminen S, Ahokas JT. In conclusion, because of small numbers of patients, poor compliance, and other methodological inadequacies, currently there is not enough evidence from clinical trials to recommend the routine use of certain probiotic strains in the treatment of IBS. Prebiotics – Another Cause of Bloating & Flatulence. Jirapinyo P, Densupsoontorn N, Thamonsiri N, Wongarn R. Vanderhoof JA, Whitney DB, Antonson DL, Hanner TL, Lupo JV, Young RJ. Some forms of fiber, like prebiotics are indigestible by the human body. Isolauri E, Joensuu J, Suolamalainen H, Luomala M, Vesikari T. Majamaa H, Isolauri E, Saxelin M, Vesikari T. Shornikova AV, Casas IA, Isolauri E, Vesikari T. Rechkemmer G, Holzapfel W, Haberer P, Wollowski I, Pool-Zobel BL, Watzl B. Szajewska H, Kotowska M, Mrukowicz JZ, Armanska M, Mikolajczyk W. Rosenfeldt V, Michaelsen KF, Jakobsen M, Larsen CN, Moller PL, Pedersen P, Tvede M, Weyrehter H, Valerius NH, Paerregaard A. Rosenfeldt V, Michaelsen KF, Jakobsen M, Larsen CN, Moller PL, Tvede M, Weyrehter H, Valerius NH, Paerregaard A. Billoo AG, Memon MA, Khaskheli SA, Murtaza G, Iqbal K, Saeed Shekhani M, Siddiqi AQ. Administration of fermented milk products containing between 5 × 105 and 107 cfu/g LGG, CRL438, or LA5 plus BB12 plus S. thermophilus to healthy adults (20–65 y old) significantly reduced severity and frequency of mild, occasional episodes of diarrhea, abdominal pain, bloating, and flatulence compared with chemically acidified milk without bacteria (37,44). Patients with inflammatory bowel diseases (Crohn's disease, ulcerative colitis, diverticulitis, necrotizing enterocolitis, or inflammation of an ileal pouch after colectomy) also showed a positive response to probiotics such as LGG, E. coli Nissle 1917, or a mixed culture preparation containing 4 strains of lactobacilli, 3 strains of bifidobacteria, and Streptococcus thermophilus (VSL#3). [Clinical progression of the first wave of novel coronavirus infection in Ostrava]. Why probiotics can make you feel worse. Diarrhea is a frequent complication in enteral tube feeding. Beneficial effects were a decreased expression of inflammatory markers ex vivo (89), increased immune response (90), improvement of gut barrier function (91), maintenance of remission (92–96), and a lower drug consumption (92,97). Read on to learn more plus more on how to prevent and treat these conditions. Whether regular consumption of probiotics exerts beneficial effects in HIV patients has not been studied up to now, but it has been shown that probiotic products are well tolerated by these patients (83). Established and proposed probiotic health effects. The latter effect depends on the specific strain, concentration, and preparation of the probiotic as well as on the subject's susceptibility to gas and osmotic pressure or, for unknown reasons, the individual responsiveness to probiotics (20). In conclusion, the preventive and curative effects of certain dietary probiotics, particularly LGG, toward (nosocomial) rotavirus infections in children are relatively well supported. In conclusion, the few reported clinical trials are not yet sufficient to recommend the use of probiotics in the treatment of small bowel bacterial overgrowth. Coadministration of S. boulardii during H. pylori eradication did reduce AAD from 11.5 to 6.9% of patients (70).