One alternative medication that is common is Mexico is to give olive oil, or some other oil to infants to ‘help with their digestion’.  It is firmly entrenched in their folklore and the oil can be found in any drugstore (at least in CA), surreptitiously labeled to get around the FDA rules. The problem with the oil is that infants reflux very easily because of their immature anatomy. While refluxing milk into the lungs will cause an attack of coughing and sputtering, the oil will not. The infants can get an oil pneumonia that is difficult to treat. I took care of one case (he died) about 10 years ago, and was told by the attending that it is much more common in areas of the country with large immigrant populations.

I cared for another young child who was given a folk remedy by his grandmother (I can’t remember what it was or why she decided he must have it), whenever she babysat him, which was apparently often. It caused liver failure, and he died before he could be transplanted.

I don’t believe in probiotics, simply because each of has our own particular world of bacteria in our gut. The probiotic cure is much too simplistic. It would not give you nearly enough of a variety to do any good. It would make much more sense to feed the person a small amount of the stool of a person who has lived in the same household. They are more likely to share most of the same gut flora. I’ll bet you would NEVER get a company to sell something like that. Occasionally, we do have to feed patients a concoction of their own stool matter to replenish their gut flora—-I have yet to see probiotics prescribed in the ICU for the same reason!

I’m just not a big fan of untested therapy, when I give standard medication, I know what the risk vs benefit will be, there is a history of literature and studies. I have NEVER seen an alternative ‘therapy’ list any risk of its ‘medication’ or ‘treatments’.

Visiting those folk remedies on children brings to mind when I was about six, playing with the kids next door and there mother calling them inside.  I followed them and along with them was given a tablespoon of cod liver oil.  OK, it had vitamin D in it, but that fishy taste was torture.  Then in the spring time she gave us all a big tablespoon of molasses and sulfur.  Talk about gag city.  Not only that, what my gut bacteria did with that elemental sulfur was pretty frigntening when it exited my body.

It never occurred for me to tell my parents.  I’m glad we moved away because I don’t know what next folk medicine she would have had us take. 

Occam

I was lucky in that my mother held a firm belief against the administration of cod liver oil, and stood up to my father on this. I’d never had cod liver oil until I was an adult. I finally tasted it when a friend was administering it to her child. She was shocked to hear I’d never tasted it and that my children had never had any either. One taste told me all I needed to know!

asanta - 11 January 2009 07:20 PM

I don’t believe in probiotics, simply because each of has our own particular world of bacteria in our gut. The probiotic cure is much too simplistic. It would not give you nearly enough of a variety to do any good. It would make much more sense to feed the person a small amount of the stool of a person who has lived in the same household. They are more likely to share most of the same gut flora. I’ll bet you would NEVER get a company to sell something like that. Occasionally, we do have to feed patients a concoction of their own stool matter to replenish their gut flora—-I have yet to see probiotics prescribed in the ICU for the same reason!

Yek… But Asanta, can pass such bacteria (probiotics and, ehh (...)) the stomach? Is the acid there not too strong?

GdB

GdB - 13 January 2009 01:40 AM

asanta - 11 January 2009 07:20 PM

I don’t believe in probiotics, simply because each of has our own particular world of bacteria in our gut. The probiotic cure is much too simplistic. It would not give you nearly enough of a variety to do any good. It would make much more sense to feed the person a small amount of the stool of a person who has lived in the same household. They are more likely to share most of the same gut flora. I’ll bet you would NEVER get a company to sell something like that. Occasionally, we do have to feed patients a concoction of their own stool matter to replenish their gut flora—-I have yet to see probiotics prescribed in the ICU for the same reason!

Yek… But Asanta, can pass such bacteria (probiotics and, ehh (...)) the stomach? Is the acid there not too strong?GdB

We don’t put it into the stomach, we bypass the stomach and put it into the jejunum, a much more bacteria friendly place which is another reason why the ‘probiotic’ yogurt is useless.

Yes, it has a high yuk factor, even for nurses <HINT> try not to need a small bowel transplant!

The acid environment in the stomach does kill many bacteria, but not all. Colonies of supposedly probiotic agents have been shown to grow in the small intestine after oral administration, so again the theory isn’t unreasonable. The question is whether it does anything clinically relevant, which bugs we shoul use, how many, etc.

mckenzievmd - 13 January 2009 09:58 AM

The acid environment in the stomach does kill many bacteria, but not all. Colonies of supposedly probiotic agents have been shown to grow in the small intestine after oral administration, so again the theory isn’t unreasonable. The question is whether it does anything clinically relevant, which bugs we shoul use, how many, etc.

I sort of comes down to eating grass for it’s nutrient value….. it WILL nourish you—-eventually, when you eat enough——the entire meadow—-if you don’t starve first!  Even if it works…..it is still an ineffective process!

Here is a great summary of the probiotic question atScience-Based Medicine

The bottom line is:

Taking large amounts of a live bacteria in the immuno-incompetent may not be the best idea.
Probiotics are useful for the prevention of antibiotic associated diarrhea. Probiotics may be helpful in preventing other overgrowth syndromes or diseases associated, perhaps, with perturbations of the gut microbial flora such as IBS and colic.
Probiotics are foreign bacteria that are not a normal part of your gi tract, they do not enhance or immune system and, in normal people to note promote the nebulous bowel health.
If you are a normal human, with a normal diet, save your money. Probiotics have nothing to offer but an increased cost.

asanta - 13 January 2009 02:29 AM

We don’t put it into the stomach, we bypass the stomach and put it into the jejunum, a much more bacteria friendly place…

Whew! I was going to ask if they used a feeding tube/stomach tube to get that poop in there. When you said “feed them” I was thinking, “Gee, I hope they don’t give it to them like Pâté.” I know the old jokes about bad hospital food, but that’s a little much!

mckenzievmd - 18 January 2009 05:12 PM

Here is a great summary of the probiotic question atScience-Based Medicine

That was a good read! I loved the following:

“If you are worried about your normal gut bacteria, be reassured. We are always consuming fecal flora in the food you eat and the water you drink. The food, your spouse, and the world, is covered in a thin patina of gastrointestinal bacteria, so you are always repleting your bacterial flora orally. Bon appetite.”

And he points out that the strains of bacteria in all those supplements are not the strains normally found in the GI tract, and will not continue to live there. (And when some of the products were tested, they turned out to be mislabeled, misleading, or the bacteria was simply dead.)

But the best part of all in his article (blog post?) was his straightforward explanation of how that “Activia” yogurt makes you really have to move your bowels:

“If you inadvertently eat a large amount of bacteria, be it contaminated food or probiotic yogurt, the body gets rid of it with increased transit time. If you really want to increase transit time, take a probiotic laced with Salmonella. That is probably why you get increased transient time with probiotics: the normal inflammatory response attempting to rid the body of a bolus of foreign bacteria. Spin. Take an unimportant and perhaps normal physiologic response to infection and make it a benefit.”

So it’s not really a “gentle digestive aid” as Jamie Lee Curtis would have you pooping your pants over…(see the infamous Saturday Night Live parody of the Activia commercials here) It may be more of your body panicking a bit at foreign, unnatural bacteria in the gut and trying through an inflammatory response to get rid of it. Healthy indeed!

Science Based Medicine is one of my favorite blogs. I saw the probiotics article too, it was posted in a timely manner !
Perhaps the ‘increased transit time’ is the ‘inflammation caused by foods’ that DH was speaking of?