Chemistry Reference
In-Depth Information
18.3.1.6 HIV/AIDS-Associated Diarrhea
Diarrhea is a very serious consequence of human immunodeficiency virus (HIV)
infection.
8
The etiology is unknown and effective therapy is not available. However,
Saccharomyces boulardii
has been reported to treat 33 HIV patients with chronic
diarrhea.
53
A ra ndom i ze d , double -bl i nd , cont rol le d t r ia l wit h 77 H I V-i n fe ct e d ch i ld ren
(2 to 12 years), divided into two groups: one receiving probiotics (formula containing
B. bifidum
with
Streptococcus thermophilus
-2.5 × 10
10
colony forming units) and the
other, a standard formula (control group), for 2 months. The CD4 counts (cells mm
-3
)
were collected at the beginning and end of the study. The quality and number of stools
were assessed by a questionnaire (watery to normal stool consistency). There was an
increase in the mean CD4 count in the probiotics group (791 cells mm
-3
) and a small
decrease in the control group (538 cells mm
-3
). The change from baseline in mean
CD4 cell count was +118 cells mm
-3
versus -42 cells mm
-3
for children receiving the
probiotic formula and control formula, respectively (
p
= 0.049). A similar reduction
in liquid stool consistency in both the groups (
p
< 0.06), with a slight enhancement in
the probiotics group, was observed, but without significant difference (
p
< 0.522). The
incidence of loose-soft stools showed a small decrease in both groups (
p
< 0.955) and
there was an increase in the incidence of normal stool consistency in both the groups
(
p
< 0.01). This study showed that probiotics have immunostimulatory properties and
might be helpful in the treatment of children infected with HIV.
54
18.3.1.7 Enteral Feeding-Associated Diarrhea
Patients receiving nasogastric tube feeding frequently develop diarrhea.
8
T h e i n v e s -
tigators postulate that the enteral feeding causes changes in normal flora that result in
altered carbohydrate metabolism and subsequent diarrhea. Two separate studies (both
placebo controlled and double blind) demonstrated a significant reduction in diarrhea
in these patients when they were administered
Saccharomyces boulardii
.
55,56
18.3.1.8 Persistent or Chronic Diarrhea
Persistent diarrhea is diarrhea that starts acutely but lasts for at least 2 weeks.
A beneficial effect of feeding yogurt versus milk was shown in children with per-
sistent diarrhea.
27
In a controlled, randomized, single-blind clinical trial, treatment
of children with chronic diarrhea with a probiotic (Lactipan
®
) promoted complete
remission of intestinal disorders.
57
Feeding fermented milk in children with postgas-
troenteritis syndrome eliminates the disease in 4 days, and was even more beneficial
in patients with malnutrition.
57
18.3.1.9 Sucrase Isomaltase Deficiency
Sucrase isomaltase deficiency is an inherited condition that leads to malabsorption
of sucrose. The resulting bacterial fermentation of sucrose leads to an accumulation
