Lactobacillus Rhamnosus Complex
Also known as: Lactobacillus rhamnosus GG, LGG, probiotic Lactobacillus strain, Lactobacillus rhamnosus
Overview
Lactobacillus rhamnosus is a species of Gram-positive, facultative anaerobic bacteria naturally found in the human gastrointestinal tract, oral cavity, and vagina. The GG strain (LGG) is a particularly well-studied probiotic isolated from human intestinal flora. It is primarily used as a probiotic to prevent and treat gastrointestinal disorders such as antibiotic-associated diarrhea and acute gastroenteritis in children, and to promote immune tolerance in food allergies, notably cow’s milk allergy. LGG is known for its ability to survive gastric acidity and bile salts, adhere to intestinal mucosa, and modulate immune responses. Research on LGG is extensive, with numerous randomized controlled trials, systematic reviews, and meta-analyses supporting its efficacy, indicating a high level of research maturity and moderate to high quality of available evidence.
Benefits
Lactobacillus rhamnosus GG (LGG) offers several evidence-based benefits. It effectively prevents antibiotic-associated diarrhea in both children and adults, as confirmed by meta-analyses. For acute gastroenteritis in children, LGG significantly reduces the duration of diarrhea by approximately 0.85 days and can shorten hospitalization, with effectiveness being dose-dependent (≥10^10 CFU/day) and more pronounced in European populations. Furthermore, LGG has been shown to promote immune tolerance in children with cow’s milk allergy, significantly increasing tolerance acquisition with a relative risk of 2.22. While less conclusive, there is ongoing research into its potential to reduce infantile colic symptoms and modulate the gut microbiota and immune system more broadly. The benefits are particularly significant for children, especially concerning gastroenteritis and allergy tolerance, and for adults in preventing antibiotic-associated diarrhea. Clinical benefits for diarrhea are typically observed within days, while allergy tolerance effects may take months to manifest.
How it works
Lactobacillus rhamnosus GG (LGG) exerts its beneficial effects primarily within the gastrointestinal tract. It competes with pathogenic bacteria for adhesion sites on the intestinal mucosa, preventing harmful colonization. LGG also produces antimicrobial substances, such as lactic acid, which inhibit the growth of various pathogens. Beyond direct antimicrobial action, LGG modulates host immune responses by enhancing the activity of regulatory T cells and promoting oral tolerance, particularly relevant in allergic conditions. While not absorbed systemically, LGG survives passage through the stomach and bile, allowing it to transiently colonize the intestine and interact with intestinal epithelial cells, dendritic cells, and T cells involved in immune regulation.
Side effects
Lactobacillus rhamnosus GG (LGG) is generally recognized as safe (GRAS) and has a strong safety record in both children and adults. Common side effects are mild and infrequent, primarily involving gastrointestinal symptoms such as bloating or gas. Uncommon side effects (1-5%) may include rare allergic reactions or intolerance. Very rare side effects (<1%) include cases of bacteremia or sepsis, predominantly reported in severely immunocompromised individuals or those with central venous catheters. There are no significant reported drug interactions. However, caution is advised for severely immunocompromised patients or those with central venous catheters due to the extremely rare risk of systemic infection. LGG is considered safe for pediatric populations, but its use in critically ill or immunosuppressed patients should be approached with caution.
Dosage
For optimal efficacy, the recommended dosage of Lactobacillus rhamnosus GG (LGG) generally ranges from 10^9 to 10^10 colony-forming units (CFU) per day. A minimum effective dose of ≥10^10 CFU per day is specifically noted for the treatment of acute gastroenteritis. Higher doses within the optimal range may offer increased effectiveness. There is no established maximum safe dose, with doses up to 10^10 CFU daily being well tolerated. For diarrhea prevention, LGG should be administered concurrently with antibiotic treatment. In cases of acute gastroenteritis, early administration is beneficial. LGG is available in various forms, including capsules, powders, and fermented dairy products. Its ability to survive gastric acidity is crucial, and formulations with protective coatings may further enhance the viability of the bacteria. No specific cofactors are required, but concurrent prebiotics may potentially enhance its efficacy.
FAQs
Is Lactobacillus rhamnosus GG safe for children?
Yes, Lactobacillus rhamnosus GG (LGG) is well-studied and considered safe for pediatric use, including infants, with a strong safety record.
How quickly does it work for diarrhea?
LGG typically reduces the duration of acute diarrhea by approximately 0.85 days, with effects often observed within days of starting supplementation.
Can it prevent antibiotic-associated diarrhea?
Yes, LGG significantly reduces the risk of antibiotic-associated diarrhea when taken concurrently with antibiotic treatment.
Is it effective for all types of diarrhea?
Most evidence supports LGG's effectiveness in antibiotic-associated diarrhea and acute infectious diarrhea, particularly in children.
Does it cure food allergies?
LGG promotes immune tolerance in conditions like cow's milk allergy, but it does not provide an outright cure for food allergies.
Are there any risks?
Risks are minimal in healthy individuals. Caution is advised for severely immunocompromised patients due to an extremely rare risk of systemic infection.
Research Sources
- https://pubmed.ncbi.nlm.nih.gov/26365389/ – This meta-analysis by Szajewska et al. (2015) demonstrated the efficacy of Lactobacillus rhamnosus GG (LGG) in preventing antibiotic-associated diarrhea in both children and adults. The study found a significant reduction in the incidence of diarrhea, drawing conclusions from multiple randomized controlled trials with robust methodology.
- https://pubmed.ncbi.nlm.nih.gov/31025399/ – A systematic review and meta-analysis by Szajewska et al. (2019), involving 18 RCTs and over 4200 children, concluded that LGG reduced the duration of acute gastroenteritis by 0.85 days and shortened hospitalization. The study noted that the effect was stronger at doses of ≥10^10 CFU and in European populations, while also acknowledging some heterogeneity and methodological limitations.
- https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.727127/full – This meta-analysis by Tan et al. (2021) included five RCTs with 565 children diagnosed with cow’s milk allergy. The findings indicated that LGG significantly increased the acquisition of immune tolerance, with a relative risk of 2.22, providing moderate-quality evidence for its benefit in promoting allergy tolerance.
Supplements Containing Lactobacillus Rhamnosus Complex
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