Documented benefits of the LGG® strain in gastrointestinal health
By Scientific advisor Mie Kristensen
The human large intestine is host to a wide variety of bacteria, with lactobacilli being prominent members of this complex ecosystem. The intestinal microbiota serves an important function in maintaining health and the International Life Science Institute (ILSI) Europe concise monograph on ‘Probiotics, Prebiotics and the Gut Microbiota’ states that an increased proportion of bifidobacteria and lactobacilli is thought to represent a ‘healthier’ microbial composition (Binns et al. 2013). Strong evidence for a beneficial effect of defined probiotic strains on supporting the defense against pathogens in the gastrointestinal tract has been established using the LGG® strain (FOA/WHO 2001).
Several clinical studies have shown that the LGG® strain alone, or in combination with other probiotics or other ingredients, is associated with an increase in beneficial bacteria and a reduction in potentially pathogenic bacteria (e.g. Benno et al. 1996; Manley et al. 2007; Szachta et al. 2011). Below is clinical evidence from some of the most researched health areas within gastrointestinal health in infants, children and adults.
GI health in infants and young children
Clinical studies have been conducted for several health areas within gastrointestinal health in infants and young children. The areas where most clinical evidence exists evolves around maintaining a healthy stomach during hospital stays and loose stools, including occasional antibiotic associated loose stools.
LGG® and hospital related stomach health
Evidence from clinical studies have shown positive effects of LGG® intake on maintaining a healthy stomach during hospital stays for children admitted to the hospital for any reason. A study of infants and children (6 months-5 years) divided into two groups found that fewer infants and children in the LGG® supplemented group than in the control group contracted stomach trouble during their hospital stay. A reduced duration of hospital stay was observed in the LGG® group as well as a reduction in stomach trouble in a three months follow-up period (Bruzzese et al. 2016). Likewise, in a study including 742 hospitalized children (> 1 year), the group receiving LGG® showed a better maintenance of respiratory tract and stomach health compared with the control group (Hojsak et al. 2010a). Other studies show similar conclusions (Szajewska et al. 2001; McFarland et al. 2010) and a meta-analysis (Szajewska et al. 2011) including 1092 children concluded that LGG® administration for the duration of a hospital stay was associated with better maintenance of a healthy stomach.
LGG® and loose stools
LGG® has been used to reduce loose stools in several studies. A study looked at 4-45 months old infants and children hospitalized with stomach trouble due to rotavirus (Isolauri et al. 1991). They were given LGG® or a control for 5 days after oral rehydration. The duration of loose stools was observed to be significantly shorter in the LGG® group compared with the control group. Confirming results on loose stools are several other studies (Aggarwal et al. 2014; Sindhu et al. 2014; Basu et al. 2009). Also, a meta-analysis combining data from 11 studies (comprising 2444 children) concluded that LGG® significantly reduced the duration of loose stools compared with placebo or no treatment (Szajewska et al. 2013).
LGG® and occasional antibiotic associated loose stools
The administration of antibiotic agents disturbs the ecological balance between the host and the microbiota (Sullivan et al. 2001). One of the most common uses for probiotics is to affect gastrointestinal discomfort in relation to antibiotic administration. In one study 188 children were treated for various infections with commonly used antibiotics in combination with LGG® or a placebo (Vanderhoof et al. 1999). Significantly fewer daily defecations were reported in the group receiving LGG® than in the placebo group. Furthermore, the stools were more solid in the LGG® group. A recent review looked at studies investigating the effect of probiotics for occasional antibiotic associated loose stools in children. After reviewing the literature, the authors made specific recommendation for the use of LGG® (Mantegazza et al. 2017). The effect on occasional antibiotic associated loose stools has also been investigated and has shown positive outcomes in an adult population, where LGG® is used in several health areas as described below.
GI health in children and adults
Clinical studies have been conducted for several health areas within GI health in children and adults. The main areas being occasional antibiotic associated loose stools, travelers’ loose stools and gastrointestinal discomfort.
LGG® and antibiotics associated loose stools
In a study of healthy adult volunteers reduced loose stools and other stomach trouble were observed when LGG® but not placebo was supplemented to erythromycin administration (Siitonen et al. 1990). Probiotics have been given in parallel with antibiotic administration do to Helicobacter pylori infections in several studies. The most common side effect of Helicobacter pylori treatment is various stomach trouble; several studies have shown LGG® to help reduce these side effects of the Helicobacter pylori treatment (Armuzzi et al. 2001a; Armuzzi et al. 2001b; Cremonini et al. 2002). A recent study investigated LGG® in combination with Bifidobacterium, BB-12® in a study including 804 subjects with Helicobacter pylori infection (Hauser et al. 2015). LGG® and BB-12® helped support cure rate and compliance to antibiotic administration was higher in the probiotic group. Furthermore, several side effects such as loose stools and other stomach trouble were reduced in the probiotic group (Hauser et al. 2015).
LGG® and travelers loose stools
Probiotics are commonly used for travelers’ loose stools. In one study, 820 volunteer tourists were given LGG® or a placebo before their trip to one of two destination with high risk of visitors acquiring loose stools (Oksanen et al. 1990). Probiotic administration showed a reduction in the incidence of loose stools in one of the two destinations. A second study confirms this result; 245 adult participants were randomized to LGG® or placebo and a lower incidence of loose stools was seen in the LGG® group compared with the placebo group (Hilton et al. 1997).
LGG® and gastrointestinal discomfort
Functional gastrointestinal problems occur in both children and adults (Drossman 2016; Lacy et al. 2016). One study enrolled 104 children with functional abdominal problems according to the Rome II criteria (Gawronska et al. 2007). Thirty-three percent of the children with stomach discomfort in the LGG® group had no problems following LGG® supplementation vs. five percent in the control group. Confirming these results are another study including 141 children with functional stomach trouble (Francavilla et al. 2010). A significant reduction of both frequency and severity of stomach problems was seen in the LGG® group but not the control group compared with baseline.
LGG® is the world’s most documented strain and the evidence suggests that LGG® can help induce a beneficial change in the GI tract for both infants, children and adults and support the defense against the pathogens surrounding us.
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