Probiotics and other Complementary and Alternative Medicines

I first heard a useful audi digest medicine tape a year ago out of California.  The topic was 'probiotics' and the researcher had discussed the pros and cons.  The principle problem was that whatever benefits were gained by change in bowel flora this didn't appear to last.
Further, a major problem with the 'alternative health care' products is lack of 'standardization'.  There is very little 'quality control' in the "health food industry' because they have generally refused accept the rigorous and costly evaluation process that the pharmaceutical industry deals with.  Hence when a 'product' is said to be beneficial all manner of questionable 'knock offs' occur.  The desire of physicians generally is that we have access to the products from reputable sources such as the Germans have where alternative health care products like St. John's Wart for instance are subjected to the same 'quality control' regimens other 'medicinal compounds' are subjected to. Right now the mayhem in the Canadian 'health food industry' has been highly lucrative for the manufacturers though not at all beneficial for consumers and those of us who want to prescribe compounds proven to be benefical.
 
Professional's Handbook of Complementary and Alternative Medicines, third edition, by C.W. Fetrow Pharm D and Juan R. Avila Pharm D, Lippincott Williams and Wilkins, 2004 was the best resource for my as a physician. Each product is listed with the standard information but with any of the 'scientific evidence' and listing and discussion of studies, double blind or other regarding products.  Previously I'd enjoyed "Tyler's Honest Herbal, A Sensible Guide to the Use of Herbs and Related Remedies, by Steven Foster and Varro E. Tyler , PhD, the Haworth Herbal Press, New York, 2000.  Both and newer studies show products of benefit but the problem is being able to find the equivalent compounds in the local stores given so much quackery and snake oil masquerading as 'real stuff'.  It's been with this history I read the Medical Post today and was delighted to read in the Nutrition section the probiotics article.  Get it.

Dr. Gregor Reid, Professor of Microbiology and Immunology and Surgery, at the University of Western Ontario, London has published a superb article Probiotics, The Medical Post, April 19, 2011.  In this article he delineates each of the various products.  He admits that the clinical scientific evidence is limited but in general puts forward which products by name and specifically are beneficial in a number of clinical conditions. Probiotics have been shown to be benefical in collick, diarrhea conditions, urogenitial infections, even ulcerative colitis (VSL#E, Ferring Pharma, Dried formula in Sachets and Mutaforlor, Medical Futures Inc. Capsules,) .  I was even pleased to see a yogurt I like, Yoplait is beneficial as an adjunct when using antibiotics for Helicobacter pylori.  There is further information on irritable bowel syndrome,  inflammatory bowel disease and vaginosis. Great article.  Well done Dr. Gregor Reid!