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Howaru Rhamnosus

Also known as: Lactobacillus rhamnosus GG, LGG, Howaru Rhamnosus, L. rhamnosus GG

Overview

Lactobacillus rhamnosus GG (LGG), often marketed as Howaru Rhamnosus, is a well-studied strain of lactic acid bacteria naturally found in the human gut. As a probiotic supplement, it is primarily used to support gastrointestinal health and modulate immune responses. Research suggests potential benefits in managing acute diarrhea, preventing atopic eczema in children, and alleviating infantile colic and IBS symptoms. LGG is known for its ability to survive gastric acidity, adhere to the intestinal mucosa, and influence the gut microbiota composition. It is available in various forms, including capsules, powders, and fermented dairy products. Extensive research, including numerous randomized controlled trials and meta-analyses, supports its use, although the quality of evidence varies across different applications. Overall, LGG is considered safe for consumption, including in infants and children.

Benefits

Lactobacillus rhamnosus GG (LGG) has several evidence-based benefits: * **Acute Diarrhea:** Meta-analyses show LGG reduces the duration of acute diarrhea by approximately 0.85 days, particularly in European populations. It may also reduce hospitalization duration. The evidence is considered moderate. * **Atopic Eczema:** LGG significantly reduces the incidence of atopic eczema in children up to 7 years of age. The evidence is considered moderate to low. * **Infantile Colic:** Some meta-analyses suggest potential benefits in reducing symptoms of infantile colic, but the results are heterogeneous and require cautious interpretation. The evidence is considered low. * **Irritable Bowel Syndrome (IBS) in Children:** Preliminary meta-analyses suggest some benefit in IBS symptom management, but data remain limited and heterogeneous. The evidence is considered very low. Effect sizes for diarrhea and eczema are clinically meaningful, with diarrhea effects being acute and eczema prevention benefits observed over years.

How it works

Lactobacillus rhamnosus GG (LGG) exerts its effects through several mechanisms. It modulates the composition of the gut microbiota, enhancing the function of the mucosal barrier. LGG interacts with intestinal epithelial cells and immune cells, promoting regulatory T-cell responses and reducing pro-inflammatory cytokines. These interactions influence the immune system, leading to anti-inflammatory effects. As a live probiotic, LGG transiently colonizes the gut, and its effects depend on its viability and the dose delivered. These biological pathways contribute to its benefits in managing gastrointestinal issues and atopic conditions.

Side effects

Lactobacillus rhamnosus GG (LGG) is generally recognized as safe for consumption across diverse populations, including infants and children. The most common side effects are mild gastrointestinal symptoms such as bloating or gas, which are infrequent. Serious adverse events are rare, but caution is advised for immunocompromised individuals. No significant drug interactions have been reported. Probiotic use may be contraindicated in cases of severe immunodeficiency or critical illness. LGG is considered safe for pediatric use, including in infants, but healthcare provider consultation is recommended for individuals with underlying health conditions or compromised immune systems.

Dosage

The recommended dosage of Lactobacillus rhamnosus GG (LGG) typically ranges from 10^9 to 10^10 CFU/day, depending on the specific indication. For acute diarrhea, evidence suggests that doses ≥10^10 CFU/day are effective. There is no established upper limit, and doses up to 10^11 CFU/day have been used safely. LGG is often administered during or shortly after the onset of symptoms for diarrhea. For eczema prevention, prophylactic use should start early in life. LGG is available in capsules, powders, and fermented dairy products. Viability is critical, and formulations must protect the bacteria from gastric acid. Prebiotics may enhance colonization but are not required.

FAQs

Is Howaru Rhamnosus effective for all types of diarrhea?

Evidence supports efficacy mainly for acute gastroenteritis-related diarrhea in children. It may not be as effective for other types of diarrhea.

Can it prevent eczema?

Yes, especially when administered early in life. However, the benefits tend to diminish after 7 years of age.

Is it safe for infants?

Yes, Lactobacillus rhamnosus GG is widely used in pediatric populations and is generally considered safe for infants.

How soon will benefits appear?

For diarrhea, a reduction in duration may be observed within days. Eczema prevention is a long-term effect that requires consistent use.

Are there any risks associated with taking it?

The risks are minimal in healthy individuals. However, caution is advised for those who are immunocompromised or critically ill.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/31025399/ – This systematic review and meta-analysis of 18 RCTs (n=4208 children) found that L. rhamnosus GG reduced diarrhea duration by 0.85 days and hospitalization duration in acute gastroenteritis. The effect was more pronounced in European populations. The study noted heterogeneity and methodological variability among trials as limitations.
https://pubmed.ncbi.nlm.nih.gov/36161401/ – This systematic review and meta-analysis of 11 RCTs demonstrated a significant reduction in atopic eczema incidence in children up to 7 years old with L. rhamnosus GG supplementation. The evidence quality was rated as moderate to low due to attrition and imprecision. No significant effects were observed beyond 7 years of age.
https://tp.amegroups.org/article/view/128126/html – This systematic review and meta-analysis indicated a potential benefit of LGG in reducing colic symptoms in infants. However, the high heterogeneity (I²=89%) and sensitivity analyses suggest that the results should be interpreted cautiously. The authors call for more high-quality RCTs to confirm these findings.
https://www.termedia.pl/Lactobacillus-rhamnosus-for-treating-irritable-bowel-syndrome-in-children-a-systematic-review-with-meta-analysis,127,52536,1,1.html – This systematic review with meta-analysis explores the use of Lactobacillus rhamnosus for treating irritable bowel syndrome in children. While the abstract suggests potential benefits, access to the full text is needed to provide a more detailed summary of the findings and limitations.
https://www.wjgnet.com/2308-3840/full/v3/i2/97.htm – This paper discusses the mechanisms of action of probiotics, including Lactobacillus rhamnosus GG, in the context of inflammatory bowel disease (IBD). It highlights the probiotic's ability to modulate the gut microbiota, enhance mucosal barrier function, and influence immune system regulation, contributing to its therapeutic effects.