Ab Case Study

The health benefits of maintaining bacteria in the gut are a topic of interest. Grocery store shelves are stocked with probiotic goods such

The sheer diversity of the microbiota means that bodily disorders associated with the gut region (encompassing the stomach and intestines) are difficult to diagnose, and even harder to find the source of the disorder. Intestinal Bowel Disease (IBD) is a large category of bodily disorders associated with the gut. IBD most commonly manifests itself in two forms – Crohn’s Disease, and Ulcerative Colitis [1]. Crohn’s disease is arguably a more severe form of the disease, as the diseased tissue tends to go deeper into the intestines. Ulcerative Colitis, while still very detrimental and pain causing, causes inflammation of tissue at more of the surface level. The diseases affects a significant portion of the population, with a high rate of new cases discovered - between 20,000 and 100,000 people are diagnosed with types of IBD annually in North America [1]. The role of the microbiota in inducing intestinal diseases has been suspected.

Health experts know that most antibiotic products interfere with the immune system and the digestive system. Most of these products quell probiotic bacteria

In the article “Poop pills sound gross, but cure serious gut infections” by Newsela, it exclaims how “poop pills” can benefit other infections without the use of antibiotics. Doctors so far have already cured 27 patients with these pills without the use of antibiotics. This could be life changing now and possibly in the future. I say this because many americans die each year from infectious diseases in the gut from louzy antibiotics, these poop pills could change the future of your children or you as a person.

Bousvaros, & E. (2005). A Randomized, Double-blind Trial of Lactobacillus GG Versus Placebo in Addition to Standard Maintenance Therapy for Children with Crohn’s Disease. http://www.hmphanmi.com.cn/hmp/upload/event/study_4/9.pdf

Google Scholar was the final database searched. There are only a few search filters that can be applied in this database (Polit & Beck, 2017). The search words that were used were probiotics, diarrhea, and antibiotics adults. The Boolean “AND” was in the search bar, and the limiter of 2013-present. This search generated 9,900 articles. A disadvantage of Google Scholar is the inability to apply search filters and the reference list is according to the number of times the article is referenced (Polit & Beck, 2017). I manually scrolled through the articles and I found one additional RCT that fit my search criteria for best evidence.

Probiotics are friendly, live bacteria that help maintain a natural balance of organisms in the intestines. Normally, the intestines have about 400 types of probiotic bacteria that serve to reduce harmful bacteria and keep the digestive system healthy. Each child (and adult) has trillions of different microbes living in him, and no two kids have the same mix of bacteria. Two of the most common categories of beneficial bacteria that naturally occur in our body are called Lactobacillus and Bifidobacterium. Whatever the benefit, it's important to note that probiotics' infection-fighting effects are only temporary. This is because the probiotics don't build up in your child's gastrointestinal system.

The study trial clearly focused on the effectiveness that S. boulardii had on the prevention of AAD and Clostridium difficile-associated diarrhea (CDAD) the use of the probiotics to prevent this. The population focus was hospitalized adults. A total of fifteen hospitals were included in the trial. Two thousand four hundred and forty-four patients were initially screen to participate in this study. 1976 participants were deemed to be ineligible, unwilling to participate in the study or there were ethical or operational limitations that resulted in patients not participating. This has the potential to significantly impact external validity. Since the participants were all from large teaching hospitals, the comorbidities and illness of the patient were more complex, therefore it led to issues in the recruitment process. The eligibility criteria could have resulted in only healthy participants being included within the study. The assignment of patients to the intervention group occurred using blocked randomization. An allocation ratio of 1:1 was implemented through a computer method. The sequence for allocation into the groups using a separate statistician and the results were hidden from the participants or the investigators. The trials were stopped early due to futility was noted after four hundred and forty-six patients. A total of four hundred and seventy-seven patients were randomized into

Scott, Lara. (2016) Probiotics and health: Does the evidence support the clinical effectiveness of probiotics in line with current naturopathic prescribing practices? Journal of the Australian Traditional-Medicine Society, Vol. 22, No. 3, 136-138. Retrieved from:

AAD is a prevalent outcome related to antibiotic use, and it can have detrimental impacts on patients. The use of probiotics as preventive measure has been controversial and its efficacy has been questioned. However, this study aimed to compare the effectiveness of the probiotic S. boulardii to the use of placebo or without any intervention to determine if it reduced the incidence of AAD. The research method that was implemented for this study was a systematic review with meta-analysis. A total of twenty-two RCTs or 4780 participants met the criteria for inclusion in this systematic review. The Number Needed to Treat (NNT) was one case of AAD was avoided in ten cases. This meta-analysis included both children and adults. The Grading of Recommendations

Probiotic is part of accessary nutrients. This one is more commonly heard about and is a source for live bacteria that is needed to regulate your digestive system and keep good bacteria in your intestines. With diarrhea many good bacteria may be lost and these are important to intestinal health. Probiotics are also beneficial in regulating your stools which may aid in diminishing diarrhea spells and keeping a more regular stool function. This capsule will include 5 billion cfu’s of Bacillus probiotic per capsule.

The control group received a pill containing starch. They also monitored each person’s macro- and micronutrient intake from their diet. The main outcomes that they were looking for were differences in markers of inflammation and the expanded disability status scale (EDSS) of the participants while also looking for changes in mental health, oxidative stress, and metabolic profiles. After the 12 weeks, they found that probiotic intake had a positive effect on EDSS, mental health (mainly depression), inflammation, insulin resistance, and cholesterol concentrations. It was noted that other areas were unchanged, such as biomarkers of oxidative stress and lipid

Once again, the evidence for the use of probiotics was missing. Perhaps this section could include evidence for the use of probiotics which would will support the clinical reasoning behind the selection of your research question.

A 3×3 Latin square design with 15 d treatment periods was used in this study. Probiotic 2, from the previous experiment, was chosen because the concentrations of SBEC and E. coli K12 concentrations were lower when compared to probiotic 1 and 3. A second reason that probiotic 2 was chosen was because, at an economic standpoint, probiotic 2 is more cost-efficient than probiotic 1 and 3. The three treatments used in this study were defined as: no supplement (CON), recommended dose (REC), and two times the recommended dose (2xREC).

It is important to separate the adult from the pediatric population, as adults have more risk factors to consider as they get older related to co-morbidities (McFarland et al., 2016). Selection bias was controlled with all of the studies having random assignment (Melnyk & Fineout-Overholt, 2015). Validity was enhanced as three of the RCT’s used double blinding, and the study conducted by Ouwehand et al., (2013), used triple blinding. Double blinding occurs when both the participant and the administrator are unaware of who receives the control or the intervention (Polit & Beck, 2017). The intervention of probiotic or placebo were consistent amongst all of the studies, although there were varying strengths of probiotics used. Three of the RCT’s used a probiotic daily dose of four billion colony forming units (CFU’s), and one RCT used a live bacteria probiotic containing four hundred fifty billion CFU’s. The varying forms of probiotics could serve as an extraneous variable. AAD was the outcome measure in all of the studies, though three studies also had an outcome measure of CDI or clostridium difficile associated diarrhea (CDAD).