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Dr. Lamm's weekly review of relevant articles and research

There is an increasing amount of information available about the gut.  Here are a few informative articles you may find valuable.


Gastrointestinal Disease and Pregnancy

Gastrointestinal Disease and Pregnancy

Author: Praveen K Roy, MD, AGAF; Chief Editor: David Chelmow, MD   more…


Gastrointestinal (GI) disorders represent some of the most frequent complaints during pregnancy. Some women have GI disorders that are unique to pregnancy. Other pregnant patients present with chronic GI disorders that require special consideration during pregnancy. Understanding the presentation and prevalence of various GI disorders is necessary to optimize care for these patients..[1, 2]  This article focuses on common GI symptoms during pregnancy and the common GI diseases that can be challenging to manage during pregnancy.
For excellent patient education resources, visit eMedicineHealth's Women's Health Center and Pregnancy Center. Also, see eMedicineHealth's patient education articles Pregnancy and Pregnancy, Vomiting.


Probiotics & Heart Disease

Probiotics Help in Congenital Heart Disease
Published: Sep 16, 2013 | Updated: Sep 16, 2013, By Nancy Walsh, Staff Writer, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

The oral administration of probiotic products to infants with cyanotic congenital heart disease was associated with improved outcomes, including better survival, a Turkish randomized study found.

Among 100 infants given Bifidobacterium lactis plus inulin or placebo, 8% of the active treatment group developed sepsis compared with 28% of the placebo group (P=0.01), according to Dilek Dilli, MD, and colleagues from the Dr. Sami Ulus Maternity and Children Research and Training Hospital in Ankara.

Use of the probiotic also appeared protective against necrotizing enterocolitis (NEC), as five cases occurred in the placebo group and none in the active treatment group. Moreover, mortality was almost three times higher in the placebo group (28% versus 10%, P=0.04), the researchers reported online in Pediatrics.

Children with congenital heart disease often have major surgery and long hospital stays that can increase their risk of sepsis, and those with cyanotic heart conditions have a high incidence of necrotizing enterocolitis, possibly because of alterations in mesenteric blood flow.


Probiotics and Prebiotics in Preventing Food Allergy and Eczema

Probiotics and Prebiotics in Preventing Food Allergy and Eczema
Mikael Kuitunen, Curr Opin Allergy Clin Immunol. 2013;13(3):280-286. [http://www.medscape.com/viewpublication/825]


Purpose of review
To describe the current literature on clinical trials of probiotics for eczema and food allergy prevention in view of recent new approaches and long-term follow-ups.

Recent findings
Attempting allergy prevention by probiotic administration has been most successful when assessing atopic eczema, the most prevalent allergic disease at an early age. More than half of the published studies demonstrate a decrease in eczema prevalence until 2 years, whereas the remaining studies fail to show an effect. Effects have been most consistent with combined prenatal and direct postnatal supplementation of the infant and appear strain-specific, with Lactobacillus rhamnosus most often showing an effect. Prenatal-only and postnatal-only studies often fail to show effects. Recent long-time follow-ups have shown promising but not consistent results. A very recent follow-up of a large well conducted cohort shows that long-term effects of eczema prevention persists until age 4 and prevention of respiratory allergies might also be possible.

Prevention of eczema with probiotics seem to work until age 2 years and extended effects until 4 years have been shown in high-risk for allergy cohorts. Effects are strain-specific, with L. rhamnosus showing the most consistent effects especially when combining pre and postnatal administration.

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