Probiotics Prevent Complications in Pancreatitis

December 19, 2002—Supplementation with a specific Lactobacillus strain prevented the development of serious complications in people with acute pancreatitis, according to a study in the British Journal of Surgery (2002;89:1103–7). Acute pancreatitis is an inflammatory condition of the pancreas that frequently progresses to infection and death of pancreatic tissue, complications that are associated with an increased risk of death.

In the new study, 45 people with acute pancreatitis were fed an oral nutritional formula twice a day for at least one week. The formula was supplemented with one billion bacteria of a specific Lactobacillus strain, plus oat fiber, which served as “fuel” to enhance the growth and function of the Lactobacilli. Half of the study participants were fed live Lactobacilli, whereas the other half (placebo group) received organisms that had been heat-killed prior to being added to the formula.

Compared with the placebo group, the group treated with live Lactobacilli had an 85% reduction in the number of pancreatic infections severe enough to require surgery. In addition, the average duration of hospital stay was 36% lower in the treated group than in the placebo group.

The rationale for supplementing with “friendly” bacteria (probiotics) is based on the observation that normal intestinal bacteria rapidly disappear in cases of acute pancreatitis and are replaced by potentially disease-causing organisms. Presumably, certain beneficial bacteria could compete with the disease-causing organisms, thereby preventing them from gaining a foothold in the intestines and infecting the inflamed pancreas.

The organism chosen for this study was Lactobacillus plantarum 299, a strain that has previously been shown to prevent severe infections in animals with experimentally induced pancreatitis. In addition to competing with infection-causing bacteria, various strains of Lactobacilli are known to enhance the functioning of the immune system, which might provide additional protection against the development of pancreatic infection.

It should be noted that different probiotic strains have different effects in the body. Therefore, one cannot assume that other commonly used probiotics (such as Lactobacillus acidophilus or Lactobacillus GG) would have the same beneficial actions as Lactobacillus plantarum 299 in people with acute pancreatitis. In addition, as the authors of the study point out, supplementing with the appropriate probiotic strain may not be enough, as probiotic organisms must be also supplied with the food they need to thrive (in this case, oat fiber).

Acute pancreatitis is usually caused by excessive alcohol intake or by gallstones that block the flow of pancreatic secretions. Acute pancreatitis differs from chronic pancreatitis, as the former comes on suddenly and usually resolves after a short period of time, whereas the latter typically does not resolve and results in progressive damage to the pancreas.

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Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.

Matt Brignall, ND is a graduate of the University of Michigan and Bastyr University. He works at the Seattle Cancer Treatment and Wellness Center, where he specializes in complementary medicine approaches to cancer. He has been published in several journals, including Alternative Medicine Review, Coping With Cancer, and the Journal of the National Cancer Institute. Dr. Brignall also teaches clinical nutrition at Bastyr University in Kenmore, WA. He is a regular contributor to Healthnotes, Healthnotes Newswire, and the Healthnotes Quick!Reference series.

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