Acidophilus – Mayo Clinic

Overview

Acidophilus (Lactobacillus acidophilus), a bacterium found in the mouth, intestine and vagina, is used as a probiotic. Probiotics are good bacteria that are either the same as or very similar to the bacteria that are already in your body. Each type of probiotic supplement — and each strain of each type — can work in different ways.

As a supplement, acidophilus is available as capsules, tablets, wafers, powders and a vaginal suppository. In addition to use as a supplement, acidophilus is found in some dairy products, such as yogurt, and is commercially added to many foods.

People commonly take acidophilus to treat a type of vaginal inflammation (bacterial vaginosis) and digestive disorders, as well as to promote the growth of good bacteria.

Evidence

Research on acidophilus use for specific conditions shows:

• Bacterial vaginosis. Oral use of acidophilus and use of vaginal acidophilus suppositories or application of yogurt containing acidophilus to the vagina has been shown to be effective in treating this type of vaginal inflammation.
• Lung infections. Acidophilus might play a role in reducing the number and severity of respiratory infections children experience.
• Certain types of diarrhea. When taken with antibiotics, a combination of acidophilus and other specific forms of lactobacillus might reduce diarrhea, bloating and cramps caused by a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon (C. difficile infection). The probiotic formulation might also reduce the occurrence of antibiotic-associated diarrhea and C. difficile infection in people who are hospitalized.
• Eczema. Oral use of acidophilus during pregnancy, by breast-feeding mothers and by infants appears to reduce the occurrence of eczema (atopic dermatitis) in infants and young children.

Acidophilus products might contain significant differences in composition, which could cause varying results.

Our take

Generally safe

There’s growing interest in probiotics such as acidophilus. While more research is needed there appears to be little harm in taking acidophilus. However, a balanced diet, including fermented foods such as kefir, might provide you with sufficient “good” bacteria.

Safety and side effects

Possible side effects from acidophilus include:

• Constipation
• Gas
• Bloating
• Increased thirst

If you’re immunocompromised, consider talking to your doctor before taking a product such as acidophilus that contains live bacteria.

If you’re lactose intolerant, be aware that some acidophilus products might contain lactose.

Interactions

There are no known significant interactions for acidophilus.

Nov. 18, 2020

Show references

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5. Auclair J, et al. Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R, and Lactobacillus rhamnosus CLR2 (Bio-K+): Characterization, manufacture, mechanisms of action, and quality control of a specific probiotic combination for primary prevention of Clostridium difficile infection. Clinical Infectious Diseases. 2015;60:S135.
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Lactobacillus acidophilus Information | Mount Sinai

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Acidophilus (Lactobacillus Acidophilus) – Side Effects, Interactions, Uses, Dosage, Warnings

Lactobacillus acidophilus is a bacteria that exists naturally in the body, primarily in the intestines and the vagina. Lactobacillus acidophilus has been used as a probiotic, or “friendly bacteria.”

Lactobacillus acidophilus has been used in alternative medicine as a likely effective aid in treating diarrhea in children with rotavirus.

Lactobacillus acidophilus has been used in alternative medicine as a possibly effective aid (in children or adults) in preventing diarrhea caused by antibiotics, travel, chemotherapy, or hospitalization. Lactobacillus acidophilus is also possibly effective in treating irritable bowel syndrome, bacterial vaginal infection, colic in babies, lung infections in children, skin problems in children who are allergic to milk, and other conditions.

Lactobacillus acidophilus has also been used to treat lactose intolerance, Crohn’s disease, overgrowth of bacteria in the intestines, or vaginal yeast infections caused by antibiotics. However, research has shown that lactobacillus acidophilus may not be effective in treating these conditions.

Other uses not proven with research have included treating indigestion, urinary tract infections, intestinal problems in premature babies, high cholesterol, lyme disease, cold sores, acne, cancer, the common cold, and other conditions.

It is not certain whether lactobacillus acidophilus is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Lactobacillus acidophilus should not be used in place of medication prescribed for you by your doctor.

Lactobacillus acidophilus is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Lactobacillus acidophilus may also be used for other purposes not listed in this product guide.

Benefits, Side Effects, Dosage, and Interactions

Found naturally in your intestines, Lactobacillus acidophilus is one of the best-known probiotics—beneficial microorganisms that may promote health and protect against infections.

Lactobacillus acidophilus balances potentially harmful bacteria that can otherwise flourish in the gut due to illness or antibiotics. It may also help balance flora in the vagina, helping to prevent yeast infections.

Commonly found in yogurt and other fermented foods, it is also available in supplement form.

marekuliasz / Getty Images

Also Known As

• Acidophilus
• L. acidophilus

What Is Lactobacillus Acidophilus Used For?

L. acidophilus belongs to the Lactobacillus family of bacteria. Lactic acid bacteria (or L) converts sugars into lactic acid and hydrogen peroxide, substances that inhibit the growth of undesirable bacteria in the intestines.

In alternative medicine, acidophilus is sometimes used to prevent or treat several health conditions, including:

Some proponents also claim that acidophilus can promote weight loss and strengthen the immune system.

Although acidophilus is one of the more extensively studied probiotics, findings have varied widely due to differences in patient populations, acidophilus strains, and other factors.

Here’s a look at some findings from the available research on the benefits of Lactobacillus acidophilus.

Diarrhea

Acidophilus may be recommended as a potential treatment for diarrhea. In particular, research suggests it may help to prevent C. difficile-associated diarrhea, a type of severe diarrhea that often affects older adults in medical care facilities who require broad-spectrum antibiotic treatment.

In a research review published in the Cochrane Database of Systematic Reviews in 2017, scientists analyzed 31 previously published trials on the use of various types of probiotics to prevent C. difficile-associated diarrhea.

It concluded that short-term, prophylactic use of probiotic supplements while taking broad-spectrum antibiotics is safe and effective for preventing C. diff infections in people who do not have weakened immune systems or are not severely debilitated.

Probiotics have also been found to be potentially useful in treating diarrhea from other causes as well. One study, which focused on probiotic use in children under 2 years of age with rotavirus, found acidophilus and other probiotics significantly reduced the duration of diarrhea compared to a placebo.

An older review of published research found probiotics may be effective in reducing the severity of traveler’s diarrhea, antibiotic-related diarrhea, and acute diarrhea of other causes.

Additional research found acidophilus and other probiotics may reduce diarrhea caused by radiation treatments, a common side effect of pelvic radiotherapy.

Irritable Bowel Syndrome

Probiotics including acidophilus have been touted as a treatment for irritable bowel syndrome (IBS). However, the research is mixed.

One eight-week study of people with IBS found a probiotic combination of L. acidophilus and Bifidobacterium lactis noticeably relieved IBS symptoms at four and eight weeks compared to a placebo. But a six-month clinical trial found a combination of probiotics that included acidophilus had no beneficial effect on diarrhea in people with IBS.

Still another study found the probiotics appear to work best to relieve symptoms of IBS when they are taken in single strain doses of less than 10 billion colony-forming units (CFUs) per day for less than eight weeks.

Vaginal Health

L. acidophilus may be helpful in the prevention and treatment of vaginal infections. According to a 2014 review, Lactobacillus supplements (including acidophilus) taken daily may help prevent and treat bacterial vaginosis, a common vaginal infection that results from an imbalance in the types of bacteria (flora) in the vagina. 

Acidophilus is commonly recommended for the prevention of yeast infections while taking antibiotics. Laboratory research shows the probiotic inhibits the growth of Candida albicans in cell cultures, but little research has been done in humans.

A 2015 clinical trial published in the journal Probiotics and Antimicrobial Proteins found L. acidophilus can help to prevent recurring yeast infections following standard medical treatment.

In the study, 436 women with vaginal candidiasis were treated with the antifungal fenticonazole. Five days later, roughly half the subjects were treated with multiple intravaginal L. acidophilus treatments. Those given the probiotic had a significant reduction in recurring infections.

Immune Health

Acidophilus has antimicrobial and antiviral properties and may help to prevent colds, viruses, and even allergies. There is research to suggest probiotics, including acidophilus, may reduce cold symptoms in children.

A study published in the journal Pediatrics found six months of daily L. acidophilus probiotics reduced fever by 53%, coughing by 41%, antibiotic use by 68%, and days absent from school by 32%. Combining acidophilus with a broad spectrum of probiotics was found to be even more effective.

High Cholesterol

Studies suggest that probiotics may help cut cholesterol levels, and acidophilus appears to be more effective than other species.

A 2015 literature review published in the Annals of Medicine concluded that probiotic supplements containing L. acidophilus were effective in lowering total cholesterol and LDL (“bad”) cholesterol levels.

The review of 15 studies involving 788 subjects also found the probiotic improved factors associated with cardiovascular disease, including body mass index, waist circumference, and inflammatory markers. Compared to other strains, acidophilus was found to be more effective in reducing LDL levels.

These results were confirmed in a review published in the journal Medicine in 2015. Researchers analyzed 30 randomized controlled trials with 1,624 participants and found probiotics lowered total cholesterol and LDL cholesterol by 7.8 mg/dL and 7.3 mg/dL, respectively.

The study authors noted, however, that many studies showing the strongest connection were funded by supplement companies and more independent research is needed.

Weight Loss

Some probiotic proponents claim that supplementing with probiotics like L. acidophilus can promote weight loss, but the research is conflicting. While it shows promise in animal trials, human trials have inconclusive results.

The best researched and seemingly effective probiotic strain for weight loss is Lactobacillus gasseri. In a 2013 study published in The British Journal of Nutrition, 210 adults with abdominal fat were assigned to drink 7 ounces of fermented milk with either 1 billion, 10 billion, or 0 CFU of L. gasseri a day for 12 weeks.

At the end of the study, abdominal fat was reduced by more than 8% in the probiotic groups compared to the control group. Additional measures, such as body mass index, waist-to-hip ratio, and total body fat, were also significantly reduced in those drinking fermented milk with L. gasseri.

Diabetes

Various probiotics are being studied for their potential to reduce blood sugar in people with diabetes. It is believed that the beneficial bacteria may improve carbohydrate metabolism.

A 2016 review of seven published studies of people with type 2 diabetes found those who took probiotics for at least eight weeks decreased fasting blood sugar by 16 mg/dl and A1C levels by 0.53 percentage points compared to placebo groups. Subjects taking a broad spectrum of probiotics experienced a 35 mg/dl drop in fasting glucose levels.

The research focused on various probiotics; it is unclear if acidophilus alone is beneficial for blood sugar management.

Depression

Emerging research suggests probiotics including L. acidophilus may help prevent and treat depression. Scientists have found a link between the gut and emotional health, and taking probiotics may improve intestinal health.

A 2016 literature review published in the journal Nutrients found that probiotics were associated with a significant reduction in depression and should be studied further as a potential preventive strategy for the condition.

Possible Side Effects

Common side effects include digestive complaints, such as gas, bloating, upset stomach, or diarrhea. Although most digestive side effects decrease with use, if they do not improve or worsen, you should discontinue L. acidophilus and consult your healthcare provider.

In addition to this, acidophilus may weaken tooth enamel over time when exposed to teeth.

Serious side effects are rare. However, if you experience hives, skin rash, itching, difficulty breathing, vomiting, or swelling of your face, lips, tongue, or throat, stop using L. acidophilus and seek immediate medical attention.

Special Considerations

If you are pregnant or breastfeeding, speak to your healthcare provider before taking acidophilus.

You should consult your pediatrician before giving acidophilus to children, babies, or infants. Children who are ill, premature infants, and children with weakened immune systems are at a greater risk for adverse events and complications.

There’s some concern that acidophilus can raise the risk of D-lactate toxicity. People who have had gastric bypass surgery or who have any of the following issues may be at greater risk:

Contraindications

People with a weak or impaired immune system due to a medical condition, or immune-suppressing treatment or medication, should not take acidophilus.

Likewise, you should not take acidophilus if you have an artificial heart valve, heart valve disorder, or central venous catheter due to the risk of infection.

You will also need to avoid acidophilus if you have a condition resulting in intestinal damage, due to the risk that the bacteria could escape into other parts of the body and potentially cause serious complications such as bacteremia or sepsis. There have been reports of other Lactobacillus species being involved in infections such as abscesses and meningitis.

Dosage and Preparation

Acidophilus supplements are sold in a variety of forms: capsules, tablets, drinks, pearls, powders, chewable wafers, liquids, and suppositories.

The typical adult dose is 1 to 10 billion living organisms known as colony-forming units (CFUs), taken in up to four divided doses. Follow the directions on the packaging or speak to your healthcare provider about the appropriate dose for you.

If giving L. acidophilus to a child, check with their pediatrician about an appropriate dose or purchase a brand formulated for children and follow the directions on the packaging.

Depending on the manufacturing processes, you may find some probiotics need refrigeration while others are shelf-stable. Be sure to store probiotics as directed on the label and minimize contact with air.  

What to Look For

Lactobacillus acidophilus products are available at health-food stores, supermarkets, drugstores, and online.

Just as there are several forms of acidophilus, there is a variety of formulations as well. You may benefit from reading labels and looking for two things in particular:

• Strains: Some acidophilus products contain a single strain of the bacteria, while others contain a number of different strains or species. There are many different strains of probiotics that have similar health benefits as acidophilus. Look for a broad-spectrum option that includes L. acidophilus.
• Pectin: Some acidophilus supplements contain pectin, a soluble fiber found in citrus and other fruits. Proponents claim that the pectin is a prebiotic (a substance that promotes the growth of probiotic bacteria).

Some probiotic supplements may contain milk allergens or traces of lactose. If you are allergic to milk proteins or lactose intolerant, or if this is of concern because you are vegan, look for a formulation that is labeled “dairy-free.”

Unlike prescription and over-the-counter drugs, the U.S. Food and Drug Administration (FDA) doesn’t regulate probiotics or test them for safety. Some products may contain fewer than the stated number of live organisms. Other products may be contaminated with other bacterial strains or ingredients.

To ensure you are getting a quality product, look for a trusted independent, third-party seal on the label, such as U.S. Pharmacopeia, NSF International, or ConsumerLab, etc. This can at least give you peace of mind that what is on the product label is what is in the product itself.

Food Sources

Lactic acid bacteria are used in the making of many foods, including yogurt, kefir, and buttermilk. Acidophilus, in particular, can be found in yogurt that is made with live acidophilus cultures, as well as other fermented milk products such as kefir.

Other sources of acidophilus include:

• Kimchi (a traditional Korean fermented cabbage dish)
• Kombucha (a fermented tea)
• Sour pickles
• Sauerkraut
• Sourdough bread
• Fermented soy products such as miso and tempeh

The number of live organisms varies greatly from option to option due to differences in processing methods. Look for products sold in the refrigerated section of the grocery or health-food store, which are more likely to contain live cultures than those stored at room temperature.

A Word From Verywell

The current research on acidophilus is inconclusive as most studies have used a unique combination of probiotics or different doses, making it difficult to determine its effectiveness and standardized dosing.

While acidophilus may seem harmless because it is found naturally in the body and in many common foods, supplementation isn’t right for everyone. If you’re considering taking acidophilus for any condition, it’s a good idea to consult with your healthcare provider to confirm if it’s appropriate and safe for you.

a study protocol of a randomised, assessor-blinded, single-centre study

BMJ Open. 2018; 8(10): e023131.

Wen Ji

Department of Gastroenterology, Chongqing University Cancer Hospital &Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China,

Wei-Qing Chen

Department of Gastroenterology, Chongqing University Cancer Hospital &Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China,

Xu Tian

Department of Gastroenterology, Chongqing University Cancer Hospital &Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China,

Department of Gastroenterology, Chongqing University Cancer Hospital &Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China,

^#Contributed equally.

Received 2018 Mar 24; Revised 2018 Sep 8; Accepted 2018 Sep 12.

Copyright © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.This article has been cited by other articles in PMC.

Supplementary Materials

Reviewer comments

GUID: EEBDB278-F399-43B8-BDF9-B826A1DDB53B

Author’s manuscript

GUID: 0921599D-EF93-474C-8BFB-132695665193

Abstract

Introduction

Helicobacter pylori (Hp) is an important pathogenic factor for chronic gastritis, peptic ulcer, gastric cancer, gastric mucosa-associated lymphoid tissue lymphoma and other diseases. In China, the Hp infection rate is high, but the eradication rate is decreasing. A large number of literatures have shown that the addition of Lactobacillus acidophilus can improve the Hp eradication rate and reduce the side effects of antibiotic treatments. At present, the exact mechanism and curative effect of L. acidophilus in the eradication of Hp have not yet been determined, and the conclusions obtained from relevant meta-analyses at home and abroad are different. Thus, it is very necessary and urgent to further complete a high-quality, clinical, randomised controlled trial research. If this study is successful, it can provide a new idea and a plan for Hp eradication therapy.

Methods and analysis

This study is a prospective, randomised controlled, single-blinded, parallel-design trial. We will randomly assign 526 adult patients (≥18 years but <70 years) with Hp confirmed positive by the kit for 14C-urea breath test. Eligible subjects were randomly divided into two groups (group A and group B), with 263 subjects in each group. Group A is a quadruple therapy group, while group B is an L. acidophilus tablets combined with quadruple therapy group. All patients were examined by gastroscopy, and 50 patients in each group will be placed under gastric pH monitor. The Hp eradication rate is the primary outcome. The secondary outcomes include gastric pH situation and adverse drug reactions.

Ethics and dissemination

The study protocol has been approved by the Clinical Research Ethics Committees of Chongqing University Cancer Hospital and Chongqing Cancer Hospital (2018[012]). The results from this trial will be submitted for publication in peer-reviewed journals and will be presented at national and international conferences.

Trial registration number

ChiCTR17014185; Pre-results.

Keywords: helicobacter pylori, lactobacillus acidophilus, antibiotic

Strengths and limitations of this study

• The trial design is prospective, assessor-blinded and randomised controlled, with a large sample size of 526.

• The kit for 14C-urea breath test has the advantages of simplicity, rapidity, accuracy, no pain, no trauma and no cross-infection.

• Lactobacillus acidophilus is expected to become a new method for precisely eradicating Helicobacter pylori.

• In different stages of this study, special personnel will be assigned to take charge of related work.

• The subjects were unable to perform blind methods due to limitations in the characteristics of the study.

Introduction

As we all know, Helicobacter pylori (Hp) is an important pathogenic factor for chronic gastritis, peptic ulcer, gastric cancer, gastric mucosa-associated lymphoid tissue lymphoma and other diseases, and has also been recognised by the WHO as the first type of pathogenic factor for gastric cancer. Hp infection is currently considered an infectious disease¹ and patients should be given eradication therapy.²

Hp is one of the hot spots in the field of gastroenteropathy. It has been a long time for anti-Hp research in our country. In the 1990s, the two or three regimens of Hp eradication treatment experienced a brilliant period of 90% or higher eradication rate. In recent years, however, the eradication rate has been decreasing, especially in many developed areas and urban populations. The triple therapy, once known as the ‘gold standard’, has an eradication rate that can only reach about 70%,³ and had to be removed from the recommended first-line treatment programme. Even with the currently recommended quadruple regimen^{4 5} of proton pump inhibitor (PPI) + colloidal bismuth + two antibiotics, it is difficult to achieve an Hp eradication rate of 85% in many populations (85% is the basic requirement for internationally accepted eradication rates for recommended regimens). From 2013 to 2014, the Hp resistance rate of 740 patients in 11 provinces and cities of China was investigated by the Hp group of the digestive diseases branch of the Chinese Medical Association: the double resistance rate of antibiotics was 23.47% and the triple resistance rate was 12.91%.⁶ The choice and substitution of antibiotics are limited in our country, and it is difficult to select antibiotics rationally in empirical treatment. At present, there is little room for improvement, whether in the number of combined drugs, dosage or the course of treatment. With the increase of Hp resistance to antibiotics, some of the previous Hp eradication rates of the programme will also be reduced. Therefore, it is imperative to develop a new method to precisely eradicate Hp.

Hp is implanted on the surface of the gastric mucosal epithelial cells and covered by a mucus layer, which makes eradication difficult. It is difficult for most antimicrobial agents to penetrate directly through the mucus layer. PPI can effectively kill Hp by inhibiting gastric acid secretion and changing the pH value in the stomach. Therefore, all currently recommended eradication protocols contain PPI. Bismuth can penetrate the mucus layer and act directly on Hp, depositing on the cell wall of the Hp thalli, which leads to the rupture and death of Hp. In general, PPI and bismuth agents play an auxiliary and synergistic role in anti-Hp treatment, while antibiotics still play a central role. Current protocols for the eradication of Hp contain two antibiotics; however, large-dose combination of antibiotics can cause short-term changes in the intestinal flora,^{7 8} which may lead to antibiotic resistance, antibiotic-related diarrhoea and severe Clostridium difficile infection, and the long-term safety of treatment is worrisome.

The acidic environment in the stomach (pH 2.0 or so) inhibited the growth of most bacteria, forming a unique flora structure and microenvironment in the stomach.^{9 10} Once the structure of the flora in the stomach changes, an imbalance of the gastrointestinal microenvironment will lead to a disease.¹¹ Lactobacillus is the main microbial flora in the human stomach, and it can be successfully colonised in the non-acid region of the stomach. However, the infection site of Hp is also a non-acid-producing area, so lactobacillus can be used as natural enemies of Hp, inhibiting their growth.

In the Hp colonisation model experiment established with Mongolian gerbils, Hp colonisation can obviously competitively inhibit the growth of lactic acid bacteria and change the flora structure,¹² and after gastric perfusion with three strains of lactobacillus strains isolated from normal gerbil stomach the lactobacillus strains can clear Hp colonisation in the gerbil stomach in a short time (2 weeks), and the clearance rate reaches about 60%. Yaşar et al
¹³ have reported that Lactobacillus acidophilus combined with triple therapy can increase Hp eradication rates. ‘The fifth consensus report on the treatment of helicobacter pylori infection’ also indicates that studies have shown that supplementation with microecological agents during eradication of Hp may reduce the adverse effects of antibiotics on intestinal microecology.^{14 15} Therefore, L. acidophilus used for anti-Hp treatment may improve the eradication rate of anti-Hp treatment and reduce the side effects of a large number of antibiotic treatment, and is expected to be a new method of accurate eradication of Hp.

At present, the exact mechanism and curative effect of probiotics in the eradication of Hp have not yet been determined, and the conclusions obtained from relevant meta-analyses are different in the world.^{16 17} Whether probiotics (L. acidophilus) could improve the eradication rate of Hp or reduce the gastrointestinal side effects of Hp treatment remains to be confirmed, so it is very necessary and urgent to further complete high-quality clinical research.

There is also one thing worth noting: antibiotics are the core drugs in anti-Hp treatment. The minimal inhibitory concentration (MIC) of many antibiotics (eg, amoxicillin) to Hp depends on the pH value of the stomach, and the MIC increases when the pH decreases. The desired acid strength requires more than 16 hours of intragastric pH >5 within 24 hours. When amoxicillin was included in the regimen, an intragastric pH >6 could achieve better results. pH 5.0–5.5 is also the best pH for L. acidophilus growth. Therefore, it is necessary to accurately detect the pH level in the stomach and explore the most suitable pH range in the process of anti-Hp treatment.

Methods and analysis

We developed this protocol according to the Standard Protocol Items: Recommendations for Interventional Trials.¹⁸ The trial is registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) with identifier ChiCTR-INR-17014185.

Objectives

The purposes of this trial are to explore the clinical value of probiotic preparation compound L. acidophilus as an auxiliary treatment for Hp eradication and to find out the optimal pH value in the stomach for anti-Hp treatment.

Trial design and setting

This study was designed as a parallel control for two groups of equal samples. Group A will be treated with quadruple therapy alone, while group B will be treated with compound L. acidophilus tablets combined with quadruple therapy. This single-centre, double-blinded, randomised controlled trial is designed to evaluate the clinical efficacy and safety of probiotic preparation compound L. acidophilus as a supplementary treatment for Hp eradication and to find out the optimal pH value for anti-Hp treatment. This study will be conducted in the Departments of Gastroenterology of Chongqing University Cancer Hospital and Chongqing Cancer Hospital in China.

Participant selection

Inclusion criteria

Participants will be enrolled if the following criteria were all met: (1) age above 18 and under 70 years; (2) patients with peptic ulcer and chronic gastritis caused by Hp infection were examined using the kit for 14C-urea breath test in the digestive department of Chongqing Cancer Hospital; (3) anti-Hp treatment has not been performed in the past; and (4) have signed the informed consent.

Exclusion criteria

We will exclude patients if any of the following criteria were met: (1) allergic to any one of rabeprazole sodium enteric-coated tablet, amoxicillin capsule, furazolidone tablet, bismuth potassium citrate capsule and compound L. acidophilus tablet; (2) digestive tract occupation or gastrointestinal active bleeding; (3) pregnancy and lactation; (4) those who had used drugs for eradication of Hp and related drugs; (5) gastroscopy contraindications; (6) existence of mental illness, which could make it difficult for the participant to cooperate; and (7) patients without self-judgement ability.

Sample size calculation

In this study, two groups of equal samples were designed for parallel control, and the eradication rate of Hp was proposed as the main outcome index. Therefore, the sample size estimation formula (n1=n2=2[(Zα/2+Zβ)2π(1−π)]/δ2) for comparison of the two sample rates was used as the sample size required for theoretical calculation. In the above formula, n1,n2 are two groups of samples, Zβ is the standard normal distribution of bilateral test boundary value, Zα/2 is a unilateral test boundary value, and δ is the difference between the two groups of the overall probability. According to the published results of a meta analysis,¹⁶ the eradication rate of Hp by probiotics combined with quadruple therapy is about 82.31%, while the eradication rate of Hp by quadruple therapy alone is about 72.08%. The allowable error (α) of the study is set at 0.05, the statistical efficiency (1-β) is 80%, the possible rate of lost to follow-up and the unqualified rate of the subjects during the study are 10%, and the theoretically required sample quantity is about 526 people; 263 people in each group can be obtained based on the EmpowerStats software.

Recruitment, randomisation and blinding

Subjects were recruited from patients confirmed to be Hp-infected by the kit for 14C-urea breath test. Investigators trained in the study will select 526 eligible applicants as subjects, in accordance with the process and with the authorisation of the lead investigator with regard to the inclusion and exclusion criteria. After eligible patients were identified, written informed consents will be obtained from the eligible patients, their next of kin or their legal representatives. At the same time, the investigators will collect the demographic and clinical characteristics of the 526 people, including sex, age, weight, contact information, drug allergy history, medical history (such as hypertension, diabetes and cardiovascular diseases, tumour history and so on), nearly 3 months of medication history and clinical symptoms. In this study, patients will be randomly divided into two groups—group A (quadruple therapy) and group B (probiotic combined quadruple therapy)—based on the random sequence of opaque envelopes generated and sealed by computer. First of all, all patients should be examined by electronic gastroscopy to get a clear diagnosis of peptic ulcer, chronic gastritis, and excluding gastrointestinal space occupation and active bleeding. At the same time, based on a random sequence of non-transparent envelopes generated and sealed by computer, 50 patients were randomly selected from each group. During gastroscopy, the pH monitor will be placed in the stomach and anti-Hp treatment was taken according to groups.

To increase the reliability of the conclusions deduced from the results of the study, the blind method was applied to endoscopic surgeons and data processing and analysis staff on the basis of a comprehensive evaluation of the feasibility of the study. However, due to the limitation in the nature of the study, the subjects could not apply the blind method.

Study protocol

Five hundred and twenty-six patients with peptic ulcer or chronic gastritis who were positive in the kit for 14C-urea breath test were randomly divided into group A or group B, with 263 patients in each group. All patients who participated in the study underwent electronic gastroscopy to clarify the diagnosis of peptic ulcer and chronic gastritis, while excluding digestive tract occupancy and active bleeding. Fifty patients in the two groups were randomly selected to be placed under gastric pH monitor to monitor gastric pH status. Then anti-Hp treatment will be carried out, and the specific medicine-taking methods in the different groups comprise the following steps:

• Group A (quadruple therapy): 20 mg rabeprazole sodium enteric-coated tablets were orally taken 1 hour before breakfast and dinner, 2 capsules of bismuth potassium citrate were orally taken 0.5 hours before breakfast and dinner, and 0.1 g furazolidone tablets and 1000 mg amoxicillin capsules were orally taken 0.5 hours before breakfast and dinner, respectively. The above medicines need to be taken continuously for 14 days. Patients with peptic ulcer should continue to take 20 mg rabeprazole sodium enteric-coated tablets before breakfast every day for 4 weeks. When all the drugs have been stopped for 1 month, the kit for 14C-urea breath test will be reviewed.

• Group B (probiotic combined quadruple therapy): 20 mg rabeprazole sodium enteric-coated tablets were orally taken 1 hour before breakfast and dinner, 2 capsules of bismuth potassium citrate were orally taken 0.5 hours before breakfast and dinner, and 0.1 g furazolidone tablets and 1000 mg amoxicillin capsules were orally taken 0.5 hours before breakfast and dinner, respectively. Take compound L. acidophilus tablets 1.0 g (L. acidophilus tablet is a compound tablet which contains 5×10⁶ L. acidophilus) after breakfast, lunch and dinner, respectively. It is worth noting to take compound L. acidophilus tablets and antibacterial drugs with at least 2-hour interval. The above medicines need to be taken continuously for 14 days. Patients with peptic ulcer should continue to take 20 mg rabeprazole sodium enteric-coated tablets before breakfast every day for 4 weeks. When all the drugs have been stopped for 1 month, the kit for 14C-urea breath test will be reviewed.

During the trial, the investigators need to maintain close contact with the patient to dynamically master patient performance and provide guidance to the patient.

Study endpoints

Primary outcome

The main evaluation index is the eradication rate of Hp. The kit for 14C-urea breath test will be reviewed after anti-Hp treatment, and a negative result (<25) indicated that Hp had been eradicated. Eradication rate=number of negative cases/total cases × 100%.

Secondary outcomes

We will also measure intragastric pH: the capsule part of the pH detector is fixed on the gastric mucosa through the clamping seat, which can continuously record the gastric pH value, which is more than 96 hours during the anti-Hp treatment. Patients’ symptoms are also an evaluation index: the investigators will record patients’ symptoms such as nausea, vomiting, taste abnormalities, hiccups, abdominal pain, abdominal distension, diarrhoea, rash or increased symptoms during anti-Hp treatment.

Safety assessments

The investigator will record all adverse events related to anti-Hp therapy, such as nausea, vomiting, taste abnormalities, hiccups, abdominal pain, abdominal distension, diarrhoea, rash or increased symptoms on the case report form. That is to say, when an adverse event occurs, the investigator will record the symptoms and signs of the adverse reaction, duration (start and end date), severity, course, outcome, significance and any action taken in relation to the adverse event.

Data management

All original data will be recorded on the case report forms accordingly and signed by direct investigators. The completed case report forms will be sent to the head investigator (W-QC). Data collation is carried out independently by two persons with rich experience in data collation and analysis, and cross-checked by project and stage. Data entry will be doubly performed by two persons using the Excel V.2010 tool. More importantly, all processes associated with data access and analysis will be supervised by the Clinical Research Ethics Committees of Chongqing University Cancer Hospital and Chongqing Cancer Hospital.

Statistical analysis

In this study, the demographic and clinical characteristics of the patients will be summarised with mean, median and SD. The results of Hp eradication and safety are expressed in terms of the number of cases and percentage. The classification outcome indicators will be compared by non-parametric statistical analysis. If the relationship between Hp eradication rate and gastric pH value meets the bivariate normal distribution, Pearson’s correlation analysis is selected, and if it is a non-bivariate normal distribution Spearman’s correlation analysis is used. Non-parametric statistical analysis was used to compare the eradication rates of Hp with different pH values. Subgroup analysis will also be performed according to the specific disease type (peptic ulcer or chronic gastritis) included in the study, and a p value of <0.05 will be considered significant. All statistical analyses will be performed by blinded professional statisticians using SPSS V.13.0 for Windows.

Patient and public involvement

Patients/public were first involved in the research during the recruitment stage of the research process, and they can participate in the study voluntarily. Patients/public are not involved in the design of the study. They will not be asked to assess the burden of the intervention and the time required to participate in the research. In the randomised controlled trial, the burden of intervention and major research indicators need not be assessed by the patients themselves, but the safety (adverse reactions) of the patients during treatment needs timely feedback. Because it is a double-blinded experiment, our main research indicators are also measured by instruments, so experience and preferences will not affect the development of research problems and measurement of the results. At the end of the experiment, the final results will be fed back to the patient in the form of a report.

Discussion

Hp infection is a chronic disease and is the main cause of chronic gastritis, with the highest infection rate in China. It initiates a series of pathogenic events, leading to atrophic gastritis, metaplasia, dysplasia and ultimately gastric cancer. Eradication of Hp can prevent the occurrence and development of gastric precancerous changes (atrophic gastritis, intestinal metaplasia). Removal of Hp infection in the stomach can greatly reduce the risk of precancerous lesions and gastric cancer. Hp is very stubborn; once infected, it is difficult to cure, unless with regular treatment. The Maastricht V consensus and the fifth report on Hp infection management consensus in China recommended quadruple therapy containing PPI, bismuth and two antibiotics as a first-line treatment regimen for Hp eradication. At least two antibiotics are included in the currently recommended Hp eradication treatment regimen, at the same time, and the treatment course reaches 14 days. The application of the antibiotics can cause short-term change in the intestinal flora.^{18 19} In Hp eradication treatment, the combination of two antibiotics in large doses may lead to intestinal flora imbalance, which may cause antibiotic-related diarrhoea, and if serious can cause C. difficile infection. A meta-analysis¹⁹ of 1671 patients showed that approximately 5%–30% of the patients who received Hp eradication therapy were discontinued due to adverse reactions. L. acidophilus as a probiotic can reduce the secretion of micropathogenic bacteria toxin on the surface of the host mucosa, promote mucosal repair and help reduce the adverse reactions in Hp eradication therapy. Some studies²⁰ also show that L. acidophilus can inhibit Hp infection through competitive colonisation, which may improve the eradication rate of Hp.

In this study, we will compare the eradication rate of Hp and the incidence of adverse reactions between the compound L. acidophilus tablets combined with quadruple therapy and a simple quadruple therapy, and observe the relationship between pH value in the stomach and Hp eradication rate, explore the clinical value of probiotic compound L. acidophilus as an auxiliary scheme of Hp eradication therapy, find out the most suitable pH value of the stomach for anti-Hp therapy, and hope to explore a new method of precise eradication of Hp.

Ethics and dissemination

To guarantee the rights of all eligible patients during the study period, we will strictly follow the Declaration of Helsinki and the Chinese guidelines for good clinical practice.

During screening and recruitment, investigators must provide qualified candidates with the details of the study, such as the purpose, procedures and potential benefits and risks of the experiment, as well as the results of the study. At the same time, the investigator must let each participant know that he/she has the right to withdraw at any time during the study. Each patient or his authorised agent must give the written informed consent prior to participating in the practice. All written informed consent forms will be retained as part of the partial clinical trial documentation.

All participants will be informed that their personal information will only be used in this study and that all such information will not be used for other purposes. All processes will be performed according to the Chinese guidelines for good clinical practice. The results of the study will be submitted to peer-reviewed academic journals and will be presented at national and international conferences.

Acknowledgments

The authors would like to thank the patient advisers for participation in the study.

Footnotes

WJ and W-QC contributed equally.

Contributors: WJ, W-QC, XT contributed to the protocol design and writing of the manuscript. W-QC is responsible for monitoring the processes of the trial. WJ, XT, W-QC are responsible for writing the manuscript and also managing and supervising the clinical research. All authors approved the final manuscript.

Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests: None declared.

Patient consent: Obtained.

Ethics approval: The study protocol has been approved by the Clinical Research Ethics Committees of the Chongqing University Cancer Hospital and Chongqing Cancer Hospital (2018[012]).

Provenance and peer review: Not commissioned; externally peer reviewed.

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lactobacillus acidophilus | Michigan Medicine

What is the most important information I should know about lactobacillus acidophilus?

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is lactobacillus acidophilus?

Lactobacillus acidophilus is a bacteria that exists naturally in the body, primarily in the intestines and the vagina. Lactobacillus acidophilus has been used as a probiotic, or “friendly bacteria.”

Lactobacillus acidophilus has been used in alternative medicine as a likely effective aid in treating diarrhea in children with rotavirus.

Lactobacillus acidophilus has been used in alternative medicine as a possibly effective aid (in children or adults) in preventing diarrhea caused by antibiotics, travel, chemotherapy, or hospitalization. Lactobacillus acidophilus is also possibly effective in treating irritable bowel syndrome, bacterial vaginal infection, colic in babies, lung infections in children, skin problems in children who are allergic to milk, and other conditions.

Lactobacillus acidophilus has also been used to treat lactose intolerance, Crohn’s disease, overgrowth of bacteria in the intestines, or vaginal yeast infections caused by antibiotics. However, research has shown that lactobacillus acidophilus may not be effective in treating these conditions.

Other uses not proven with research have included treating indigestion, urinary tract infections, intestinal problems in premature babies, high cholesterol, lyme disease, cold sores, acne, cancer, the common cold, and other conditions.

It is not certain whether lactobacillus acidophilus is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Lactobacillus acidophilus should not be used in place of medication prescribed for you by your doctor.

Lactobacillus acidophilus is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Lactobacillus acidophilus may also be used for other purposes not listed in this product guide.

What should I discuss with my healthcare provider before taking lactobacillus acidophilus?

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

• short bowel syndrome; or
• a weak immune system (caused by disease or by using certain medicine).

Ask a doctor before using this product if you are pregnant or breast-feeding.

Do not give any herbal/health supplement to a child without medical advice.

How should I take lactobacillus acidophilus?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use lactobacillus acidophilus, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Lactobacillus acidophilus is available in capsule and tablet form, or as a vaginal suppository. Powder or liquid forms may also be available. Some dairy products, especially yogurt, also contain lactobacillus acidophilus.

The chewable tablet must be chewed before you swallow it.

Do not use different forms of lactobacillus acidophilus at the same time without medical advice. Using different formulations together increases the risk of an overdose.

Call your doctor if the condition you are treating with lactobacillus acidophilus does not improve, or if it gets worse while using this product.

Store lactobacillus acidophilus in a sealed container as directed on the product label, away from moisture, heat, and light.

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra lactobacillus acidophilus to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking lactobacillus acidophilus?

Avoid taking lactobacillus acidophilus within 2 hours after you take any type of antibiotic medicine.

What are the possible side effects of lactobacillus acidophilus?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Although not all side effects are known, lactobacillus acidophilus is thought to be likely safe when taken for a short period of time.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect lactobacillus acidophilus?

Do not take lactobacillus acidophilus without medical advice if you are using any medications that can weaken your immune system, such as:

• medicine to prevent organ transplant rejection; or
• steroid medicine (prednisone, dexamethasone, methylprednisolone, and others).

This list is not complete. Other drugs may interact with lactobacillus acidophilus, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this product guide.

Where can I get more information?

Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2021 Cerner Multum, Inc. Version: 3.07. Revision date: 6/9/2017.

What is Acidophilus? | Optibac Probiotics

When you mention friendly bacteria, acidophilus is often the first name that springs to mind. ‘Acidophilus’ has become synonymous with live cultures and many people just ask for an ‘acidophilus supplement’ when choosing a friendly bacteria supplement. However, it is important to note that acidophilus is just one of many different species of good bacteria. It’s even more important to understand that within each species, there are many different strains, all with unique properties. 

Read more about the difference between species and strains, or read on to find out everything you need to know about acidophilus bacteria and supplements.

Taxonomy diagram

What is ‘acidophilus’?

Acidophilus is a species of bacteria from the Lactobacillus genus: its full name is written as Lactobacillus acidophilus, sometimes abbreviated to L. acidophilus. It is a naturally occurring bacteria found in the gut, mouth and vagina and has been incredibly well-researched in studies focusing on a number of different areas of health. Due to its numerous health benefits L. acidophilus is commonly found in live cultures supplements, such as our own.

Within the acidophilus ‘species’, there are a large number of specific ‘strains’ (types). One example is Lactobacillus acidophilus NCFM^®, which is perhaps one of the most widely researched strains of bacteria in the world, and certainly the most extensively researched strain of L. acidophilus.

You can find this strain in our Every Day EXTRA and Every Day MAX. Other L. acidophilus superstars include Lactobacillus acidophilus Rosell-52 (in our Every Day, For travelling abroad and For Those On Antibiotics), Lactobacillus acidophilus La-05^®, and Lactobacillus acidophilus La-14^®   (in our Pregnancy).

Key fact:

Acidophilus is a species of bacteria that sits within the Lactobacillus genus. Within the species, there are many different individual ‘strains’.

L. acidophilus under microscope

Are all strains of 

L. acidophilus the same?

All strains of L. acidophilus are part of a genus (or ‘family’) of lactic-acid-producing bacteria called Lactobacillus. Strains from this genus tend to be the most widely used in live cultures supplements due to their versatile nature. But not all strains within the L. acidophilus species have the same properties, so when looking at live cultures supplements, it is best to compare them at strain level, as opposed to merely species or genus level.

Key fact:

Different strains within the same species have different modes of action in the body, so it is important to find the strain that is most suitable for you.

Healthcare practitioners can find out more about L. acidophilus on the Probiotics Database, on the Probiotic Professionals site.

What is acidophilus used for?

Lactobacillus acidophilus is a species of lactic acid-producing bacteria. Once they have colonised the gut, they prefer to use carbohydrates and sugars such as lactose as their fermentation substrate. This means that they break down these sugars as they pass through our intestine, which is why they are often used by those with lactose intolerances. People with lactose intolerance lack sufficient digestive enzymes to digest lactose (a sugar found in milk and dairy products) but strains of L. acidophilus bacteria can help to break lactose down into a more digestible form. L. acidophilus strains produce lactic and acetic acids as a by-product of fermentation. These acids lower the pH of the intestines, discouraging the over-growth of bad bacteria, known as pathogens, and encouraging the growth of ‘good’ or ‘friendly’ bacteria in the gut. In this way acidophilus is beneficial in maintaining a healthy balance of gut flora.

Beyond these characteristics, which are common to all bacteria within the acidophilus species, most of the known benefits of L. acidophilus are found at ‘strain’ level. For example, Lactobacillus acidophilus NCFM^® has very different characteristics and health benefits to Lactobacillus acidophilus La-14^®.

Key fact:

When choosing the best acidophilus supplement for your needs, look at the L. acidophilus strains which have been researched for the specific health condition or symptom you wish to support. 

How do I find the best acidophilus?

This really depends on what is meant by ‘best’! In terms of suitability, it’s a case of finding the right strain to suit you, and your own specific health requirements, which can involve some research.

• Firstly, it should have sufficient scientific evidence to support its safety and ability to survive in the gut.
• Secondly, opt for ‘quality over quantity’. Don’t be drawn in solely by huge billion counts of a supplement. Higher billions do not necessarily equal higher product quality – it’s much more important to get the most researched strains, even if they’re in lower quantities. It’s definitely a case of ‘quality over quantity’ when it comes to friendly bacteria supplements.
• Lastly, check the product has a ‘time of expiry’ guarantee as opposed to a ‘time of manufacture’ guarantee, as this means the product strength is guaranteed until the supplement goes out of date, rather than just at the time of manufacture (as numbers decrease after this point).

One of the most highly researched strains of acidophilus is Lactobacillus acidophilus NCFM^®, which can be found in our supplements Every Day EXTRA and Every Day MAX, both of which satisfy the above mentioned product quality criteria.

Key fact:

Do your homework before buying an L. acidophilus supplement. Choose one containing high quality, well-researched strains which meet your own individual health needs, whilst also satisfying the above quality criteria.

How much acidophilus should I take?

This question is a little tricky to answer, as different health symptoms require not only different strains of acidophilus, but potentially different acidophilus dosages. As a general rule I would advise following the clinical trial data as closely as possible. So, if a double-blind, placebo-controlled clinical trial shows efficacy for supporting a condition or symptom that is of relevance to you, I would recommend taking as close to the same daily dosage that was used in the trial as you can. Wherever possible our acidophilus supplements are formulated in this way too, using data and dosage information from the most efficacious clinical trials.

Live cultures come in different ‘formats’: you can choose from acidophilus powders, acidophilus tablets, acidophilus capsules and even acidophilus in liquid format. The majority of products on the market are in capsule format, as these are generally found to be easier to swallow than tablets, and have better shelf-stability, and less risk of contamination than loose powders (powders portioned in to individual sachets also avoid the risks associated with loose powders).

Some manufacturers of live cultures use enterically coated capsules, which are said to protect the bacteria inside them from the harsh acidic conditions of the stomach. We however, use robust strains of friendly bacteria that are known to survive at a low pH anyway, so we have no need for enteric coating. This means that our capsules can be opened, and the contents sprinkled on to food or drinks (so long as they are not hot or too acidic) with no loss to product integrity. Even if you open up our acidophilus capsule in this way, you can still be sure that the bacteria will survive and you are getting the full dose. You may like to read the following FAQ: Can I open live cultures capsules?

Key fact:

Different conditions may require different doses, where possible take a similar CFU (billions) count to that used in clinical trials relating to your specific health condition.

Are there any side effects from taking acidophilus?

In general live cultures, including those from the acidophilus species, have very few side effects. The majority of people do not experience any negative symptoms from taking an acidophilus supplement. However, everybody is different, and therefore everyone reacts to things differently.

With the introduction of any new live cultures supplement, some people may initially experience mild digestive symptoms, such as: bloating or excess gas. In most cases these symptoms do not last for longer than a few days, and are simply the result of a shift in microbial population and diversity. Mild acidophilus side-effects can simply be a sign that changes are taking place within the eco-system of their gut. 

Whilst mild symptoms may be bothersome, they are for the most part, a positive sign that the ‘friendly’ bacteria are doing their ‘job’, crowding out pathogenic strains of bacteria and competing for space on the gut wall lining.

However, if any side effect is troubling you, or lasts for longer than described, I would always recommend stopping taking the product and contacting the manufacturer for advice. It could be other ingredients in the product that are causing issues, such as a prebiotic fibre. Or, it could just be that the strain of acidophilus is not compatible with your individual microbiome at that time. Always listen to your own body, and respect its uniqueness.

Read our FAQ ‘Do live cultures have side effects?’ to find out more.

Key fact:

L. acidophilus may occasionally cause mild abdominal discomfort and/or bloating in some people, but this typically only lasts for a few days and indicates that the bacteria are reaching the gut. If symptoms persist speak to the manufacturer for advice.

How long does acidophilus take to work?

This is a question that everyone wants to know the answer to, but frustratingly there is no ‘one size fits all’ here either! With everyone’s microbiome being as unique to them as their fingerprint, it is impossible to know for certain how long it will take to feel the benefits of taking acidophilus supplements.

We receive wonderful feedback and product reviews from our customers. For some people our supplements have an almost instant effect, whereas for others it can take several weeks or more. It depends partly on the state of a persons’ health to start with and also their compliance with taking the product. Diet, lifestyle and any medications being taken are other factors to consider. In general, I would advise patience. The benefits are well worth it, and your health will thank you for it in the longer term.

Key fact:

Everybody responds differently, and at different speeds, when starting a new live cultures supplement. Don’t be disappointed if results take a little while, they will be worth it in the longer term.

Shop for acidophilus.

For further research in to L.acidophilus and specific strains within this species healthcare professionals might like to take a look at The Probiotics Database.

Authors: Dr Aisling Dwyer MB BCh BAO (Medicine, Surgery and Obstetrics), MSc (Personalised Nutrition)​, Dr Kate Stephens PhD Food and Microbial Sciences; Gut Microbiology (University of Reading), BSc Medical Microbiology

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Vitamins and supplements for well-being

Vitamins and nutritional supplements for wellness

Probably, each of us could confirm that well-being significantly improves the quality of our life: then we can more easily achieve our goals, cope with stressful situations and just enjoy our daily life. Nevertheless, during a busy rhythm of life, the body often begins to lack various substances – wanting not to experience any unpleasant consequences, vitamins and nutritional supplements are very useful for good health .Consider them and find the ones that suit you!

The Best Supplements and Vitamins for Wellness: How to Choose?

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I would like the vitamins for older people (or anyone else) to be not only effective, but also have a good price. Their cost depends on the abundance of ingredients, and on the quantity of products, and on the manufacturer – the range of prices is very wide, therefore, based on your budget, it is easy to find the most suitable nutritional supplements that ensure well-being.If you designate it in advance, you will save a little time.

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Gynoflor E instructions for use: indications, contraindications, side effects – description Gynoflor E Vaginal tablets (23244)

Active substances that make up the preparation Gynoflor ^® E, estriol and lactobacilli acidophilic, participate in the maintenance of normal biological mechanism vagina.

Lactobacillus acidophilus – one of the dominant microorganisms in the vagina of a healthy woman, with antagonistic activity against pathogenic and opportunistic microorganisms.

Estriol – female sex hormone, short-acting estrogen, has a protective trophic effect on the vaginal epithelium and has no systemic effect on the woman’s body. The proliferating mature vaginal epithelium accumulates glycogen, which is necessary for the functioning of lactobacilli, which, in turn, produce lactic acid, maintaining the acidic environment of the vagina (pH 3.8-4.5), which creates unfavorable conditions for the colonization and development of pathogenic microorganisms. In addition to lactic acid, acidophilic lactobacilli produce hydrogen peroxide and bacteriocins, which also inhibit the development of pathogenic and opportunistic microorganisms.

A change in the physiological flora of the vagina occurs due to various factors: local or systemic use of antibacterial drugs, incl. due to vaginal infections, systemic diseases, non-compliance with hygiene rules.In these cases, the number of lactobacilli can be significantly reduced. Intravaginal use of Gynoflor ^® E improves the condition of the vaginal epithelium and restores its normal flora. Lactose, which is found in vaginal tablets as a filler, can also be fermented by lactobacilli into lactic acid.

The vaginal epithelium becomes thinner and can be damaged by hormonal disorders, and therefore Gynoflor ^® E can be used in postmenopausal women to relieve local symptoms (itching, burning, vaginal dryness, soreness during intercourse), contributing to the normalization of the epithelium vagina and urethra, reducing the frequency of degenerative inflammatory conditions.

In vitro showed that acidophilic lactobacilli lead to the necessary decrease in pH within a few hours. Estriol, with a treatment duration of 6-12 days, provides a proliferative trophic effect on the vaginal epithelium.

GINOFLOR E N6 TABL VAG

Acipol – instructions for use

Trade name: Acipol®

International non-proprietary or group name: lactobacillus acidophilus + kefir fungi.

Dosage form: capsules

Composition for one capsule.

Active ingredients: Lactobacillus acidophilus live * – not less than 107 CFU

Inactivated kefir fungus biomass – 0.4 mg **

Excipients:

Hard gelatin capsules No. 3 – 48.0 mg

Body and cover:

Titanium dioxide (E 171) – 1.0%

Iron oxide red (E 172) – 0.3%

Iron oxide yellow (E 172) – 0.1%

Gelatin – up to 100%

* – the active substance is a lyophilisate containing lactobacillus Lactobacillus acidophilus;
** – the determination is carried out according to the polysaccharide content of kefir fungi; “Inactivated kefir fungus biomass” is a lyophilisate with a calculated weight of 2.0 mg “;

Description: hard gelatin capsules No. 3 orange.The contents of the capsule are light cream to light brown powder with a fermented milk smell.

Pharmacotherapeutic group: eubiotic

ATX code: A07FA51

Pharmacological properties

Pharmacodynamics

The therapeutic effect of Acipol® is determined by the live acidophilic lactobacilli and the polysaccharide of kefir fungi contained in it. According to the mechanism of action, Acipol® is a multifactorial therapeutic agent, has antagonistic activity against pathogenic and opportunistic microorganisms, has a corrective effect on the intestinal microflora, increases the body’s immunological reactivity.

Pharmacokinetics

The components of the drug are not absorbed from the gastrointestinal tract (GIT) and do not have a systemic effect.

Indications for use

Acipol is used in adults and children from 3 months in the complex treatment of intestinal dysbiosis against a background of:

• acute intestinal infections;
• chronic diseases of the gastrointestinal tract, such as colitis, enterocolitis of infectious and non-infectious origin;
• long-term antibiotic therapy.

Prevention of dysbiosis:

• increase in the general resistance of the organism.

Contraindications

Hypersensitivity to the components of the drug, children under 3 months of age.

Application during pregnancy and during breastfeeding

The components of the drug act in the lumen of the gastrointestinal tract and are not absorbed into the systemic circulation, therefore, the use of the drug during pregnancy and breastfeeding is not contraindicated and is possible in consultation with the attending physician.

Method of administration and dosage

Inside.

Adults and children over 3 years old – capsules should be taken without chewing, washed down with boiled water.

For children aged 3 months to 3 years, Acipol® should be taken with food, after opening the capsule and dissolving its contents in milk or boiled water.

For the treatment of dysbiosis Acipol® is prescribed :

• Children aged 3 months to 3 years – 1 capsule 2-3 times a day, with food.
• Children over 3 years old and adults – 1 capsule 3-4 times a day, write 30 minutes before taking.

The duration of the course of therapy for dysbiosis in acute intestinal infections is 5-8 days. Longer courses are possible as prescribed by a doctor in the chronic course of diseases accompanied by dysbiosis.

For the prevention of dysbiosis Acipol® is prescribed: 1 capsule 1 time per day for 10-15 days.

Repeated courses of therapy and prevention are carried out no earlier than 1 month after the end of the previous course.

If after treatment there is no improvement or symptoms worsen or new symptoms appear, you should consult your doctor. Use the drug only according to the indications, the route of administration and the doses indicated in the instructions.

Side effects

Allergic reactions are possible.

If you have any side effects indicated in the instructions or they are aggravated, or you notice any other side effects not listed in the instructions, inform your doctor.

Overdose

No cases of overdose were registered.

Interaction with other medicinal products

Simultaneous use with antibacterial, antiviral and immunomodulatory drugs is possible.

Special instructions

It is necessary to observe the scheme recommended in the instructions and the duration of the drug intake. Changing the daily dose and duration of treatment is possible as prescribed by the doctor, depending on the patient’s age, severity and duration of the disease.

If the symptoms of the disease persist or the condition worsens while using the drug within 3 days, you should inform your doctor about it.

Influence on the ability to drive vehicles, mechanisms

The drug does not affect the ability to perform potentially hazardous activities requiring increased concentration of attention and speed of psychomotor reactions (including driving, working with moving mechanisms).

Form of issue

Capsules.

There are 20 or 30 capsules in a polypropylene bottle, sealed with a high-pressure polyethylene lid with silica gel and first opening control, or in a blown polypropylene can with a stretch high-pressure polyethylene lid with silica gel and a cardboard insert with first opening control.

A self-adhesive label is attached to the bottle or jar.

1 bottle or jar together with instructions for use is placed in a carton box.

Storage conditions

At a temperature from 2 to 8 ° C.

Keep out of reach of children.

Expiry date

2 years.

Do not use after the expiration date.

Vacation conditions

Available without a prescription.

Marketing authorization holder / organization accepting consumer claims
OTCPharm JSC, Russia,
123112, St.Moscow, st. Testovskaya,
, 10, fl. 12, pom. II, room. 29
Tel .: +7 (800) 775-98-19
Fax: +7 (495) 221-18-02
www.otcpharm.ru

Manufacturer
CJSC “LEKKO”, Russia
601125, Vladimir region, Petushinsky district, pos. Volginsky st. Zavodskaya, p. 277,
601125, Vladimir region, Petushinsky district, pos. Volginsky st. Zavodskaya, p. 279,
tel./fax (49 243) 71 5 52.

Tender 0321300143121000001: Medicines for children under 3 years old

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Preparations for women’s health | Territory of femininity

Indications for use

1. Restoration of normal vaginal microflora after local and / or systemic use of antibiotics or antimicrobial drugs (including vaginal infections: bacterial vaginosis, nonspecific vulvovaginitis; urogenital infections and sexually transmitted diseases).
2. Estrogen-dependent atrophic vaginitis in postmenopausal women, including in combination with hormone replacement therapy (HRT).

A change in the physiological flora of the vagina occurs due to various factors: local or systemic use of antibacterial drugs, incl. due to vaginal infections, systemic diseases, non-compliance with hygiene rules. In these cases, the number of lactobacilli can be significantly reduced. Intravaginal use of Gynoflor® E improves the condition of the vaginal epithelium and restores its normal flora.Lactose, which is found in vaginal tablets as a filler, can also be fermented by lactobacilli into lactic acid. The vaginal epithelium becomes thinner and can be damaged by hormonal disorders, and therefore Gynoflor® E can be used in postmenopausal women to relieve local symptoms (itching, burning, vaginal dryness, soreness during intercourse), contributing to the normalization of the state of the vaginal epithelium and urethra , reducing the frequency of dystrophic inflammatory conditions.The active substances that make up the preparation Gynoflor® E estriol and lactobacilli acidophilic participate in the physiological mechanism of maintaining the normal biocenosis of the vagina.

Lactobacillus acidophilic – one of the dominant microorganisms in the vagina of a healthy woman, with antagonistic activity against pathogenic and opportunistic microorganisms.

Estriol – is a female sex hormone, a short-acting estrogen, has a protective trophic effect on the vaginal epithelium and has no systemic effect on the woman’s body.

It is possible to use the drug Gynoflor® E in the II-III trimesters of pregnancy and during breastfeeding

How to take the drug:

Vaginal tablets must be inserted deep into the vagina in the evening before going to bed, preferably in the supine position, with the knees slightly bent.

To restore normal vaginal microflora after local and / or systemic use of antibiotics or other antimicrobial drugs (including for vaginal infections: bacterial vaginosis, nonspecific vulvovaginitis, urogenital infections and sexually transmitted diseases): 1-2 vaginal tablets daily for 6-12 days.