In recent years, probiotics have gained ground in the kits home. Its indication to relieve or reduce the symptoms of gastroenteritis, particularly in children, has been popularized and is becoming more and more frequent their consumption to combat the recurring stomach viruses.

however, this practice could not be justified. Two robust studies published in the latest issue of the journal ‘The New England Journal of Medicine’ show that one of the probiotics most commonly used for this purpose is not effective or to improve the severity of symptoms or to shorten the duration of acute gastroenteritis.

the two investigations that have followed the case of almost 2,000 children in the U.S. and Canada and compared the effects of two products -one based on Lactobacillus rhamnosus R0011 and another in a combination of this bacterium and L. helveticus R0052 – with a placebo.

The results have left no doubt. There were No differences in the evolution of the little ones, whose ages ranged between 3 months and 4 years, whatever the pattern indicated.

“None of the work supports the use of probiotics that contain L. rhamnosus to treat diarrhea of moderate-to-severe in children,” ditch an editorial in the prestigious medical journal, which highlights the rigor and the high methodological quality of the works, directed, respectively, by researchers from the University of Washington (USA) and the University of Calgary (Canada).

Matches at this point Sergio Serrano, a specialist in the microbiome of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and physician and researcher in the Ramón y Cajal hospital of Madrid.

A jug of cold water

“it Is a jug of cold water for this indication, it was that which was more settled,” he says. “But it was necessary for a serious investigation on this subject, because, until now, all the scientific evidence available was quite poor,” he stresses.

This lack of evidence is due, above all, to that, to not be considered drugs, but dietary supplements, probiotics are not evaluated following the same protocol of clinical trials on efficacy should follow the drugs.

that’s why, “there was a lot of ‘noise’ and not data serious about the utility of probiotics”, says Serrano. But “these two trials are methodologically impeccable,” adds the researcher.

any way, both the specialist as the editorial of the medical journal point out that this blow to the L. rhamnosus -one of the most popular – not the means nor the ‘banishment’ of probiotics as health tool or the denial of the possible utility of other bacteria against the gastroenteritis.

“Given the large number of agents probiotics available today and considering their different mechanisms of action and their different abilities to colonize the intestines […], there is the possibility that other probiotics other than the L. rhamnosus gg may be effective against infectious diarrhea in children”, says the text of the magazine.

Not all are created equal

Speaking of probiotics, these microorganisms that promote health benefits, “is not the same as talking about drugs of the same family”, underlines, in this regard,Talía Sainz, specialist of the service of Pediatrics and Infectious Diseases, Hospital La Paz, Madrid. Each of them has specific features, recalls, and its mode of action in front of the different causes that may have gastroenteritis from rotavirus Salmonella bacteria – or, in other indications may also be very different, he says.

“There is evidence that L. rhamnosus, for example, yes it is useful against diarrhea associated with the use of antibiotics,” he continues.

“The microbiome is very complex”, added Serrano, who suggests that what also shows this research is that acting on that community of microorganisms that colonizes our gut it is much more difficult than we thought.

“it Is easy to imagine if we think of it as an ecosystem. The reality is that you can’t expect to put in the Monegros of a amazon rainforest by planting palm trees. Probably with the microbiome the same thing happens, cannot be modified in a simple way”, exemplifies.

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