Probiotic Treatment of Small Intestinal Bacterial Overgrowth by Lactobacillus fermentum KLD

Abstract

The principle of using harmless bacteria for conquering pathogens has been used for many years. It has been used prophylaclically against travellers' diarrhoea and for protection of recurrent pseudomembranous colitis. The aim of this study was to treat a chronic infectious condition, small intestinal bacterial overgrowth, by oral administration of a certain strain of Lactobacillus. 17 patients with long-standing bacterial overgrowth of the small intestine were included. The study was designed as a double-blind cross-over, where the patients were their own controls. The study was divided into 4 parts. (A) For the first 2 weeks placebo was given b.i.d. (B) For the next 4 weeks patients received either placebo or 10¹⁰ Lactobacillus fermentum KLD b.i.d. (C) A wash-out period of 4 weeks followed. (D) Finally, for the second 4 week treatment period patients were crossed over to receive either lactobacilli or placebo. A hydrogen breath test with 50 g glucose was performed at the start and at the end of each period. Symptom scores were recorded on the last week of each period. The study was completed by 14 patients. Lactobacillus treatment showed no significant difference compared to placebo with respect to the results of the hydrogen breath test: 29 (3-95) vs 14 (3-129) ppm, (median and 10th and 90th percentiles), stool frequency: 14 (8-40) vs 12 (7-31) defecations/week, or symptom score: 12 (5-46) vs 17 (6-42) scores/week). High numbers of L. fermentum KLD in faecal samples were only seen in 2 patients. In conclusion, dosage with L. fermentum KLD in this study did not significantly alter the parameters investigated