Nirdosh K. Safaya
Consultant Pediatrician, Noida.

Address for Correpondence: Dr Nirdosh K Safaya, T-22, Sector -11, NOIDA,U.P.201301. Email: n_safaya@hotmail.com

"Live and let live", this is no sociologist's sermon but given to us by Mother Nature from the very beginning of life's sustenance and evolution on this green and blue mother earth. It is here on this life- planet, myriad of extinct and evolving living species have existed in symbiosis since beginning of life, so much so that some organelles inside a living cell, like the mitochondria (the indispensable energy unit of a living cell) is believed to be an inclusion of another living organism very early in the living cell's evolution. We have existed and evolved on this fundamental premise of SYMBIOSIS i.e." LIVE AND LET LIVE". This Mother Nature has utilized as the basic principle of viable co-existence of living organisms.

Probiotic bacteria i.e. friendly and protective versus unfriendly and disease causing (pathogenic) are all bugs in the war game of existence. So long as the friendly and protective microflora harbor within us, our internal milieu remains healthy and protected, any disturbance in the vitality or quantum of these friendly micro floras especially in the long gut tract results in many diseases.

Modern evidence based medicine is only now reaffirming this age old premise of coexistence - symbiosis, by picking up some micro flora which help restore the mucosal immunity and protect the host from pathological organisms and their insults.

Probiotics are commensal bacterial species with beneficial physiological and therapeutic activities. Prebiotics are dietary substances which ensure similar benefits.

The use of probiotics and prebiotics as therapeutic agents for gastrointestinal disorders is rapidly moving into the mainstream therapeutics. Mechanism of action explains the therapeutic effects and randomized controlled trials provide the necessary evidence for their incorporation into the therapeutic armamentarium.

Earlier studies established the fact of probiotics, inducing suppression of pathogen growth and /or invasion by competing with pathogenic bacteria for specific binding sites on intestinal epithelial cells , and now the latest studies endorse the role of probiotic bacteria and their secreted products in enhancing and modulating innate and adaptive immune responses in the host by exerting protective function through modulation of immune activity and epithelial function in both large and small intestine.

Gastrointestinal disorders in which use of probiotics is gaining importanceand significantly so, are Helicobacter Pylori infection, Colonic cancer, Irritable bowel syndrome, postoperative complications, pancreatitis, Infectious diarrhea, Clostridium difficile diarrhea, antibiotic- induced diarrhea, non alcoholic fatty liver disease, Inflammatory bowel disease, ulcerative colitis, Crohn's disease and Pouchitis.

Evidence is fast cropping up regarding the use of probiotics to shorten the duration of diarrhea especially in children and prevent recurrence of diarrhea especially in acute infectious diarrhea. Controlled trials also show the same benefit by using Lactobacillus rhhamnosus GG, L. renter, L.casei and B. lactis can shorten the duration of acute rotavirus diarrhea. Bifid bacterium and Lactobacillus appear to promise treatment/prevention of eczema/dermatitis in infants and children.

And yet another intriguing fact is emerging of late which shows oral administration of probiotics results in altered immunity at distant mucosal sites like female genital tract, respiratory tract, the skin, and nasal passages.

Last updated: 1-09-2004 Vol 1 Issue 6 Art # 22