What is the significance of Lactobacillus (lactic acid bacteria)?

From the Guidelines

Lactobacillus supplements are recommended for general health maintenance and specific conditions like antibiotic-associated diarrhea, with doses ranging from 1-10 billion CFU daily, and higher doses of 10-100 billion CFU for specific conditions, as supported by the most recent and highest quality study 1.

Key Points

• Lactobacillus is a beneficial genus of bacteria that naturally inhabits the human gut, mouth, and vaginal tract, and helps maintain a healthy microbial balance.
• Lactobacillus supplements typically contain strains like L. acidophilus, L. rhamnosus, and L. plantarum.
• The recommended doses range from 1-10 billion CFU (colony-forming units) daily for general health maintenance, and higher doses of 10-100 billion CFU may be beneficial for specific conditions like antibiotic-associated diarrhea.
• Lactobacillus works by producing lactic acid, which lowers the pH in the intestines, inhibiting harmful bacteria growth while strengthening the gut barrier.
• These bacteria also produce antimicrobial substances and compete with pathogens for nutrients and attachment sites in the gut.

Specific Conditions

• For antibiotic-associated diarrhea, higher doses of 10-100 billion CFU may be beneficial, taken during and after antibiotic treatment, as supported by 1 and 1.
• For other conditions like irritable bowel syndrome, inflammatory bowel disease, and pouchitis, the evidence is less clear, and more research is needed, as stated in 1.

Safety and Precautions

• The use of probiotics is generally considered safe, but caution is advised in certain populations, such as premature neonates, immunocompromised patients, and critically ill patients, as noted in 1 and 1.
• It is essential to choose a high-quality probiotic supplement from a reputable manufacturer and follow the recommended dosage and storage instructions, as emphasized in 1.

From the Research

Lactobacillus Overview

• Lactobacillus is a type of bacteria that is commonly found in probiotics, which are live nonpathogenic microorganisms administered to improve microbial balance, particularly in the gastrointestinal tract 2
• Probiotics, including Lactobacillus, have been widely studied in a variety of gastrointestinal diseases, and have been shown to be effective in maintaining immunologic equilibrium in the gastrointestinal tract through direct interaction with immune cells 3

Health Benefits of Lactobacillus

• Lactobacillus has been shown to be effective in reducing the severity of clinical manifestations of irritable bowel syndrome (IBS) and antibiotic-associated diarrhea (AAD) 4
• There is strong evidence that probiotics, including Lactobacillus, are effective in preventing and treating acute diarrhea, particularly in children 5
• Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii have been shown to have the most compelling evidence of efficacy in reducing the duration of acute gastroenteritis 5

Mechanisms of Action

• Lactobacillus exerts its beneficial effects through various mechanisms, including lowering intestinal pH, decreasing colonization and invasion by pathogenic organisms, and modifying the host immune response 2
• The exact mechanisms by which Lactobacillus probiotics exert their effects are not fully understood and require further research 6

Safety and Efficacy

• Probiotics, including Lactobacillus, are generally considered safe and well tolerated, with bloating and flatulence occurring most frequently 2
• The efficacy of Lactobacillus can be species-, dose-, and disease-specific, and the duration of therapy depends on the clinical indication 3