Follow-up: what to do after the stomach bug

In my post about gastroenteritis, I discussed what to do when you're sick and how to prevent spreading your germs, but I neglected a very important point: what to do after you've recovered. To many, the notion that there is anything at all to do besides go back to normal living is probably foreign. What I'm talking about is probiotics.

I am not one to promote dietary supplements willy nilly. For the most part, I think people who do have an agenda and are usually out to profit from others' naive trust and willingness to pay for products that some self-professed "expert" recommends. As the title of my blog suggests, I only ever recommend supplements that have substantial scientific evidence supporting their efficacy. I also don't sell any such supplements or receive any funds whatsoever (unfortunately) from anyone who does.

Now that I've gotten that disclosure out of the way, here's the point I'm getting to: after a bout of diarrhea, whether it is from food poisoning, a virus, a course of antibiotics, or even radiation therapy, the "good" bacteria in your gut are lost along with any pathogens. It is important to replace these beneficial microbes in order to maintain a healthy gut immune system. Doing so may help you get back to feeling normal more quickly.

The following are examples of possible beneficial effects of probiotic supplements, as suggested by research studies:

- decrease the incidence, severity, or duration of infectious diarrhea in children

- prevent or treat diarrhea caused by E.coli, Shigella, and Salmonella (main causes of travelers' diarrhea)

- reduce risk of contracting rotavirus infection in children

- prevent and treat radiation-induced diarrhea in cancer patients

- protect against C.diff-associated diarrhea

- improve symptoms of irritable bowel syndrome; specifically, bloating, abdominal pain, and flatulence

I take a probiotic supplement daily, in hopes of preventing GI infections in the first place. But whether or not you care enough to add probiotics to your daily regimen, you should most definitely consider them when traveling, taking antibiotics, or recovering from an illness.

Once you've decided to take probiotics, however, you will undoubtedly be overwhelmed with the choices you have. Here are some guidelines for choosing a probiotic supplement*:

- A large selection of probiotics can be found at natural foods stores (e.g. Whole Foods Market or small local stores)

- Choose a product that is in the refrigerated section

- Look for a high number of "organisms" or "CFU" per capsule; I aim for at least 1 billion.

- Look for products that contain multiple strains of Bifidobacterium and Lactobacillus

- The number of organisms or "potency" should be guaranteed through the expiration date rather than "at date of manufacture." You will notice a statement about this on the bottle or package.

*These tips are based on my own opinion, not on systematic research

Reference

Collado MC, Isolauri E, Salminen S, Sanz Y. The impact of probiotic on gut health. Curr Drug Metab. 2009; 10:68-78