Skip to main content
SpringerLink
Log in

Probiotika bei Kindern und Jugendlichen mit Darmerkrankung

Probiotics in children and adolescents with gastrointestinal disease

  • Leitthema
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Probiotika werden zunehmend häufiger zur Prävention und Therapie zahlreicher gastroenterologischer Erkrankungen eingesetzt, obwohl ihre Wirksamkeit nur für einige wenige Indikationen gesichert ist. Die in der Pädiatrie bestuntersuchte Indikation ist die Behandlung der infektiösen Diarrhö. Hierbei zeigte sich eine statistisch signifikante Wirksamkeit von moderater klinischer Bedeutung mit einer Diarrhöreduktion um etwa 1 Tag. Die Wirksamkeit ist abhängig vom probiotischen Stamm, einer ausreichend hohen Dosierung sowie einem frühen Therapiebeginn. Bei Erwachsenen konnte zusätzlich die Wirksamkeit von E.-coli-Stamm Nissle 1917 zur Remissionserhaltung der Colitis ulcerosa sowie für VSL#3 in der Therapie der Pouchitis nachgewiesen werden. Vergleichbare Untersuchungen mit pädiatrischen Patienten fehlen bislang.

Abstract

Probiotics are increasingly being used to prevent and treat gastrointestinal diseases, although there is only limited proof of their efficacy. The best studied paediatric indication is the treatment of infectious diarrhoea. Several studies have shown a statistically significant shortening of the duration of diarrhoea by approximately 24 h, which is of moderate clinical benefit. Efficacy depends on the probiotic strain, high doses, and early start of therapy. In adults there is additional proof for E.-coli-Nissle 1917 as maintenance therapy in ulcerative colitis and for VSL#3 for treatment of pouchitis. Comparable studies in children are missing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Allen SJ, Okoko B, Martinez E et al. (2004) Probiotics for treating infectious diarrhoea. Cochrane Database Syst Rev 2: CD003048

    PubMed  Google Scholar 

  2. Banaszkiewicz A, Szajewska H (2005) Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo-controlled randomized trial. J Pediatr 146: 364–369

    Article  PubMed  Google Scholar 

  3. Basu S, Chatterjee M, Ganguly S et al. (2007) Efficacy of Lactobacillus rhamnosus GG in acute watery diarrhoea of Indian children: a randomised controlled trial. J Paediatr Child Health 43: 837–842

    Article  PubMed  Google Scholar 

  4. Bausserman M, Michail S (2005) The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr 147: 197–201

    Article  PubMed  Google Scholar 

  5. Bousvaros A, Guandalini S, Baldassano RN et al. (2005) A randomized, double-blind trial of Lactobacillus GG versus placebo in addition to standard maintenance therapy for children with Crohn’s disease. Inflamm Bowel Dis 11: 833–839

    Article  PubMed  Google Scholar 

  6. Canani RB, Terrin G, Cesarano L (2007) Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations. BMJ 335: 340

    Article  PubMed  Google Scholar 

  7. Costa-Ribeiro H, Ribeiro TC, Mattos AP et al. (2003) Limitations of probiotic therapy in acute, severe dehydrating diarrhea. J Pediatr Gastroenterol Nutr 36: 112–115

    Article  PubMed  Google Scholar 

  8. Day AS (2002) Use of complementary and alternative therapies and probiotic agents by children attending gastroenterology outpatient clinics. J Paediatr Child Health 38: 343–346

    Article  PubMed  CAS  Google Scholar 

  9. Day AS, Whitten KE, Bohane TD (2004) Use of complementary and alternative medicines by children and adolescents with inflammatory bowel disease. J Paediatr Child Health 40: 681–684

    Article  PubMed  CAS  Google Scholar 

  10. Dendukuri N, Costa V, McGregor M et al. (2005) Probiotic therapy for the prevention and treatment of Clostridium difficile-associated diarrhea: a systematic review. CMAJ 173: 167–170

    PubMed  Google Scholar 

  11. Gawrońska A, Dziechciarz P, Horvath A et al. (2007) A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children. Aliment Pharmacol Ther 25: 177–184

    PubMed  Google Scholar 

  12. Gionchetti P, Rizzello F, Helwig U et al. (2003) Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology 124: 1202–1209

    Article  PubMed  Google Scholar 

  13. Glass RI, Lew JF, Gangarosa RE et al. (1991) Estimates of morbidity and mortality rates for diarrheal diseases in American children. J Pediatr 118: S27–S33

    Article  PubMed  CAS  Google Scholar 

  14. Guandalini S, Pensabene L, Zikri MA et al. (2000) Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J Pediatr Gastroenterol Nutr 30: 54–60

    Article  PubMed  CAS  Google Scholar 

  15. Guslandi M, Mezzi G, Sorghi M et al. (2000) Saccharomyces boulardii in maintenance treatment of Crohn’s disease. Dig Dis Sci 45: 1462–1464

    Article  PubMed  CAS  Google Scholar 

  16. Hatakka K, Savilahti E, Pönkä A et al. (2001) Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ 322: 1327

    Article  PubMed  CAS  Google Scholar 

  17. Henker J, Laass M, Blokhin BM et al. (2007) The probiotic Escherichia coli strain Nissle 1917 (EcN) stops acute diarrhoea in infants and toddlers. Eur J Pediatr 166: 311–318

    Article  PubMed  Google Scholar 

  18. Henker J, Laass MW, Blokhin BM (2008) Probiotic Escherichia coli Nissle 1917 versus placebo for treating diarrhea of greater than 4 days duration in infants and toddlers. Pediatr Infect Dis J 27: 494–499

    Article  PubMed  Google Scholar 

  19. Johnston BC, Supina AL, Vohra S (2006) Probiotics for pediatric antibiotic-associated diarrhea: a meta-analysis of randomized placebo-controlled trials. CMAJ 175: 377–383

    PubMed  Google Scholar 

  20. Johnston BC, Supina AL, Ospina M et al. (2007) Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 18: CD004827

    Google Scholar 

  21. Kamtsiuris P, Atzopodien K, Ellert U et al. (2007) Prävalenz von somatischen Erkrankungen bei Kindern und Jugendlichen in Deutschland. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50: 686–700

    Article  CAS  Google Scholar 

  22. Koebnick C, Wagner I, Leitzmann P et al. (2003) Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Can J Gastroenterol 17: 655–659

    PubMed  Google Scholar 

  23. Kruis W, Fric P, Pokrotnieks J et al. (2004) Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut 53: 1617–1623

    Article  PubMed  CAS  Google Scholar 

  24. Mastretta E, Longo P, Laccisaglia A et al. (2002) Effect of Lactobacillus GG and breast-feeding in the prevention of rotavirus nosocomial infection. J Pediatr Gastroenterol Nutr 35: 527–531

    Article  PubMed  Google Scholar 

  25. McFarland LV, Dublin S (2008) Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol 14: 2650–2661

    Article  PubMed  Google Scholar 

  26. Oberhelman RA, Gilman RH, Sheen P et al. (1999) A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr 134: 15–20

    Article  PubMed  CAS  Google Scholar 

  27. Pedone CA, Arnaud CC, Postaire ER et al. (2000) Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract 54: 568–571

    PubMed  CAS  Google Scholar 

  28. Plein K, Hotz J (1993) Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn’s disease with special respect to chronic diarrhea – a pilot study. Z Gastroenterol 31: 129–134

    PubMed  CAS  Google Scholar 

  29. Salazar-Lindo E, Miranda-Langschwager P, Campos-Sanchez M et al. (2004) Lactobacillus casei strain GG in the treatment of infants with acute watery diarrhea: a randomized, double-blind, placebo controlled clinical trial [ISRCTN67363048]. BMC Pediatr 4: 18

    Article  PubMed  Google Scholar 

  30. Sutherland L, Macdonald J (2006) Oral 5-aminosalicylic acid for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2: CD000543

    PubMed  Google Scholar 

  31. Szajewska H, Kotowska M, Mrukowicz JZ et al. (2001) Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr 138: 361–365

    Article  PubMed  CAS  Google Scholar 

  32. Szajewska H, Skorka A, Dylag M (2007) Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther 25: 257–264

    PubMed  CAS  Google Scholar 

  33. Szajewska H, Skórka A, Ruszczyński M et al. (2007) Meta-analysis: Lactobacillus GG for treating acute diarrhoea in children. Aliment Pharmacol Ther 25: 871–881

    Article  PubMed  CAS  Google Scholar 

  34. Thibault H, Aubert-Jacquin C, Goulet O (2004) Effects of long-term consumption of a fermented infant formula (with Bifidobacterium breve c50 and Streptococcus thermophilus 065) on acute diarrhea in healthy infants. J Pediatr Gastroenterol Nutr 39: 147–152

    Article  PubMed  CAS  Google Scholar 

  35. Tissier H (1906) Traitement des infections intestinales par la méthode de la transformation de la flore bactérienne de l’intestin. C R Soc Biol 60: 359–361

    Google Scholar 

  36. Van Niel CW, Feudtner C, Garrison MM et al. (2002) Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 109: 678–684

    Article  Google Scholar 

  37. Weizman Z, Asli G, Alsheikh A (2005) Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 115: 5–9

    PubMed  Google Scholar 

  38. World Health Organization (1999) The world health report. WHO, Genf

Download references

Interessenkonflikt

Der korrespondierte Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Kinder- und Jugendmedizin, Klinikum rechts der Isar, Technische Universität München,Klinikum Schwabing, StKM GmbH, Kölner Platz 1, 80804, München, Deutschland

    S. Liptay & S. Burdach

Authors
  1. S. Liptay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Burdach
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Liptay.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liptay, S., Burdach, S. Probiotika bei Kindern und Jugendlichen mit Darmerkrankung. Monatsschr Kinderheilkd 156, 1076–1083 (2008). https://doi.org/10.1007/s00112-008-1831-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00112-008-1831-7

Schlüsselworte

Keywords

Search

Navigation