Children with stomach viruses are often given probiotics to ease symptoms of vomiting and diarrhea. However, a new study has found that commonly used probiotic is not effective in improving symptoms in young patients with gastroenteritis.
The study was led by Washington University School of Medicine in St. Louis and the results were published in The New England Journal of Medicine.
Gastroenteritis accounts for 1.7 million pediatric emergency room visits and more than 70,000 hospitalisations each year.
The study involved nearly 1,000 children aged between three months to four years and provided evidence against the popular and costly use of probiotics -- live microorganisms believed to restore the balance of intestinal bacteria and boost the immune system.
Participants were eligible if they had come to the emergency room with symptoms of gastroenteritis: watery stools, vomiting, diarrhea or other signs of acute intestinal infection. They also had to have not have taken probiotics in the preceding two weeks.
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"Probiotics have become an increasingly popular way to treat children experiencing acute gastroenteritis. Some smaller studies have indicated that probiotics may help, however, such studies had a number of limitations. We sought to provide independent and conclusive evidence for or against probiotic use in infants and toddlers with acute gastroenteritis," said the study author David Schnadower.
A similar study in Canada, also published in the same journal and co-authored by Schnadower, evaluated the effectiveness of a different probiotic in children with gastroenteritis. The findings of that study mirrored those in the US study.
"Probiotics had no effect on the children. Parents are better off saving their money and using it to buy more fresh fruits and vegetables for their children," said US study co-author Phillip I. Tarr.
There are no treatments for pediatric acute gastroenteritis other than giving children fluids to prevent dehydration and, sometimes, medication to relieve nausea. The lack of options has prompted some physicians and parents to give ill children probiotics.
Probiotics generally are considered safe. However, the Food and Drug Administration (FDA) does not regulate dietary supplements such as probiotics as stringently as it does prescription and over-the-counter drugs.
Consumers worldwide spend billions each year on probiotic-enriched foods, as well as over-the-counter supplements in pill and powder form.
"Because of the popularity of probiotics, it was important to make sure their use is worth the cost. In this instance, probiotics added no measurable benefit, and, therefore, they are not worth the added cost," said Schnadower.
Half of the children in the study were randomly assigned to receive the probiotic LGG twice daily for five days, while the others took a similar looking and tasting placebo. Otherwise, the children received standard clinical care.
Regardless of whether the children took a placebo or probiotic, their symptoms and recovery were nearly identical. The data showed that diarrhea in both groups of kids lasted about two days and the kids missed an average of two days of daycare.
"We tested many different scenarios -- infants compared with toddlers, whether the patient had taken antibiotics, whether the gastroenteritis was caused by virus or bacteria, and how long diarrhea had been going on before the treatment was given. We also had the probiotic independently tested for purity and strength. Every time, we reached the same conclusion," Schnadower said.
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