Preview Mode Links will not work in preview mode

The GP Show


Welcome to The Gp Show podcast "libsyn directory" page!  Please visit my full website; www.thegpshow.com that includes podcasts, the podcast notes with resources, a clinicians bookshelf split into the lifestyle and medical domains with a growing library of online resources (for patients and health professionals) including handouts, courses, apps, books, podcasts and more.

Join me, Dr Sam Manger MD, for real and in-depth conversations with guests, experts and advocates from around the world sharing knowledge, stories, insight and experience on a variety of health-related topics.  This podcast is specifically designed-with-love for health professionals and anybody else interested in health, science and medicine.

Please note: the Information on this site and in these podcasts is designed for informational purposes only and does not replace the relationship between a patient and his/her own physician and is not intended as medical advice. This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you saw or read on The GP Show Podcast and related pages. Always practice within your level of professional capabilities and scope of practice. This podcast does not give you the right to practice beyond your training.

Available on iTunes and all podcast apps.

Enjoy and thank you for listening. 

Mar 11, 2018

Surrounded by the familiar beeps and glow of the hospital surgical theatres I had a thoroughly enjoyable chat with scrubs-donned Dr Johan Van Den Bogaerde Gastroenterologist and researcher.  We discuss probiotics and the various relevant themes around them.  
 
Topics we discuss include:
- What are probiotics and some important principles
- How do they work?
- Evidence for different conditions - IBD, IBS, diarrhoeal disorders, helicobacter pylori, atopic eczema and others
- Research bias 
- Working with real people who are suffering but that don't fit the guidelines = the clinicians dilemma
 
Summary of the POSSIBLE uses:
IBD Ulcerative Colitis and Pouchitis - VSL3, E. coli nissle and saccharomyces boulardi may help for remission.  No clear evidence for chron's disease
IBS - VSL3, bifido infantis - mixed studies, some positive and some only as good as placebo (~50% reduction in pain)
Diarrhoeal disorders (antibiotics associated, childrens diarrhoea, c.dif and preventing travellors diarrhoea) = Lacto. rhamnosus, saccharomyces boulardii and Lacto. reuteri may be of assistance e.g. reduce duration of infectious diarrhoea by <1 day
Helicobacter pylori - Saccharomyces boulardii and Lacto. reuteri - may reduce side effects to antibiotics and improve eradication rate
Atopic eczema - Lacto. rhamonsus and Bifido. lactis reduce rate of atopic eczema in children by 80% if taken by mother during pregnancy and breastfeeding
Atopic eczema - not clear, mixed studies as a treatment of atopic eczema 
Other possible use though studies are limited and early - bacterial vaginosis, major depression disorder, autism spectrum disorder, other CNS disorders, hepatic encephalopathy
 
Doses and duration's vary
 
Risks:
Do not use in critically unwell or marked immunosuppression
Side effects may include - constipation, flatulence, nausea, rash and others
Don't forget the price tag
 
Some of the many references:
IBD - https://www.ncbi.nlm.nih.gov/pubmed?term=20517305https://www.ncbi.nlm.nih.gov/pubmed?term=14684584https://www.ncbi.nlm.nih.gov/pubmed?term=22161412
IBS - https://www.ncbi.nlm.nih.gov/pubmed/25780308
Diarrhoeal disorders - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748908/ , 
H pylori - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588086/
Atopic disease pregnancy - https://www.racgp.org.au/your-practice/guidelines/handi/interventions/children/probiotics-in-pregnancy-for-infant-atopic-eczema/
Eczema in children - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828648/ 

Probiotics and intestinal permeability-- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/

CNS disorders = https://www.ncbi.nlm.nih.gov/pubmed/27413138