- Efficacy confirmed for the following indications:
Bacterial acute diarrhea in children (treatment)
- Efficacy possible for the following indications:
Allergies in newborn (prevention)
Bacterial acute diarrhea in adult (treatment)
Cold/flu in chldren 3 to 5 years old (prevention)
Diarrhea associated to chemotherapy (treatment)
Diarrhea associated with antibiotic (prevention)
Eczema in children (prevention and treatment)
Pouchitis and ulcerative colitis (prevention)
Recurrence of C. difficile infection (prevention)
Symptoms associated with irritable bowel syndrome (treatement)
Traveller's diarrhea (prevention)
Vaginal infections (treatment)
- Efficacy unproven, is also used for other indications:
Boosting the immune system
Diarrhea acquired in hospital (prevention)
Diarrhea associated to HIV (treatment)
Diarrhea associated to radiotherapy (treatment)
Digestive symptoms associated with stress (treatment)
Symptoms associated with lactose intolerance
Ulcerative colitis (inducing remission)
- Potential for drug interactions: Low
- Adverse effects: Low
When we talk about probiotics, we generally refer to supplements that contain bacteria or active yeasts that may or may not already be present in the normal flora. They might be beneficial in treatment or prevention when ingested in large enough quantities. Unlike the pathogenic bacteria which are responsible for infections, good bacteria assist the body in its natural functions. It would also seem that probiotics help stimulate the body's own defense mechanisms.
|Each indication is specific to some probiotics. To know which species and doses are used for the various indications, ask your pharmacist.|
Fermented dairy products, like yogurt, contain lactic bacteria. Strengths of live and active bacterias may vary considerably from one product to another. Therefore, in some indications, it is more appropriate to take probiotic as a capsule or therapeutic yogurt with optimal formulation and strains.
Direction of use
- Preventing diarrhea:
Taking certain strains of probiotics may reduce the risk of developing diarrhea or its duration.
- Antibiotic-associated diarrhea:
To prevent antibiotic-associated diarrhea, probiotics should be taken during and for three days to two weeks after completing the course of antibiotics.
- Traveller's diarrhea :
Probiotics may help prevent traveller's diarrhea in those who visit high risk areas. They whould be started a few days before the risk period and stopped a few days after return.
- Antibiotic-associated diarrhea:
- Treating diarrhea:
Probiotics are used to treat diarrhea by restoring the intestinal flora. Probiotics should not be taken without medical advice, in the presence of nausea, vomiting, fever, diarrhea with blood or severe abdominal pain.
- Treating infectious diarrhea:
In the event of infectious diarrhea, probiotics may reduce the duration of the diarrhea, especially if it is caused by a virus.
- Treating infectious diarrhea:
- Preventing the recurrence of C. difficile:
In addition to antibiotic therapy, it may help prevent the recurrence of C. difficile.
- Side effects
Flatulence is the most common adverse effect associated with probiotics. It is usually temporary and gradually increasing the dose can help prevent it. Discontinue use and consult your health care professional if digestive symptoms (e.g., diarrhea) develop or worsen beyond 3 days.
Patients whose immune system is compromised should not use probiotics (e.g., cancer, graft, some medications). Ask your health care professional.
- Pregnancy and breastfeeding
There is not much data on use in pregnant or breastfeeding women. Ask your health care professional.
Those taking medications aimed at suppressing the immune system should use probiotics under medical supervision only as they could cause an infection. Antibiotics may decrease the effectiveness of probiotics. So, it is recommended to take probiotics at least 2 hours before or after the antibiotic.
- Allergy and intolerance
Certain products are safe for lactose-intolerant individuals, as well as those allergic to milk protein. Ask your health care professional.
- It is important to check the expiry date and follow the manufacturer's recommendations with regards to storing the product. Some products must be stored in the refrigerator.
- You will also find prebiotics on the market. It is important not to confuse prebiotics and probiotics. Prebiotics are made up of fibre and certain sugars that are used as nutrients for probiotics.
In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.
Medicinal plant contents vary naturally from plant to plant - just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.
For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.
- Passeport Santé. Ils préviennent et traitent la diarrhée. www.passeportsante.net
- Lemay R. Les probiotiques : aspects pratiques en pharmacie. Québec Pharmacie, juin 2017
- Probiotics. Pharmacist's Letter, No. 310709 juillet 2015
- Barbeau, G. Les probiotiques. L'actualité Pharmaceutique, sept 2004, formation continue
- Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2010
- Passeport Santé. Les probiotiques. www.passeportsante.net
- Savino, F et al. Lactobacillus reuteri Versus Simethicone in the Treatment of Infantile Colic: A Prospective Randomized Study, Pediatrics Vol. 119 No. 1 January 2007
- Probiotics. Pharmacist's Letter, No. 250908 September 2009
- Natural Therapeutics Pocket Guide, 2000-2001
- The Review of Natural Products, 6th Edition, 2010
- Health Canada, Natural Products Database
- World Gastroenterology Organisation Practice Guidelines, Prebiotic and Probiotic, 2008
- Baribeau, H. Mise à jour sur les probiotiques, Actualité Pharmaceutique, October 2009
- Thomas, DW et al. Clinical Report - Probiotics and Prebiotics in Pediatrics, Pediatrics Vol.126 No.6 December 2010
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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.