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Perfect example of what is wrong with our healthcare system: Probiotics and Crohn's

Waverunner

Senior Member
Messages
1,079
We make advances everywhere but if you want to know what is wrong with our healthcare system, just look at the following study. They tested a probiotic (S. boulardii) for Crohn's disease.

Is this bad? No, actually it's very good to look for new treatments, which are not only directed at suppressing inflammation. So what is the problem? Well, there are several. First of all SD writes "probiotics do not prevent relapse" but this is untrue because only one probiotic was tested.

Second of all we have 500 to 1,500 different strains of bacteria in our intestines. It is likely, that some of them have a direct influence on disease and many don't. In order to find out the right ones, every sane person would use a trial and error approach, unless he had better alternatives. So by today we actually should have a pretty good understanding of the bacterial strains in our gut, right? Moreover, compared to viruses, these bacteria are really big, so we should have no problem detecting and understanding them, right?

Actually we detected most of them 100 years ago. In contrast to what one might think, our understanding of our microbiome is miserable to say the least. If you ask top notch scientists what probiotics or what diet is good for you, they can't give you an answer. All they say is, that higher microbial diversity probably is better.

So what is done in current studies? They try the same old probiotics for different diseases (e.g. S. boulardii or e. coli Nissle) but they dare to try any of the 1,490 other bacteria. Nearly 100 years after S. boulardii was discovered, we test it for Crohn's disease? Shouldn't these studies have been conducted 50 years ago? In the year 2013 they find out, that S. boulardii doesn't work for Crohn's disease. At this speed we should have finished testing probiotics by the year 2,500...

Why do they always use the old probiotics? Because these probiotics are well tested, they were discovered nearly 100 years ago and there is absolutely no danger, that anything bad might happen. Moreover these probiotics are approved and today absolutely no-one wants to go through the approval process of a new probiotic. It's a huge waste of time, money and nerves, because there are tremendous regulatory requirements. So even if billions of healthy humans have a bacterial strain in their intestine, it still needs to get approved.

The second problem today is, that scientists are highly risk averse. Why try a new probiotic, when you can use an old one and still get the needed funding. This is why scientists are highly reluctant to try new things. They love testing old, approved stuff in humans. Unless this doesn't change, there will be no breakthroughs anytime soon. Even 100 years after we discovered most of the bacterial strains in our body, we still know next to nothing about them.


http://www.sciencedaily.com/releases/2013/08/130814124738.htm
Probiotics Do Not Prevent Relapse in Crohn's Disease Patients

Aug. 14, 2013 — Despite previous data showing beneficial effects, the probiotic Saccharomuces boulardii (S. boulardii) does not prevent clinical relapse in patients with Crohn's disease, according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association.

As more people seek natural or non-drug ways to maintain their health, products containing probiotics have flooded the marketplace. While safe and tolerable, this study discovered that the probiotic S. boulardii does not appear to have any significant beneficial effects for patients with Crohn's disease who are already in remission.
In this randomized, double-blind, placebo-controlled trial, the probiotic yeast S. boulardii was tested as a preventive therapy in patients with moderately severe Crohn's disease who were currently in remission following steroid or salicylate therapies. At the end of the one-year follow-up period, 50 percent of patients had relapsed -- 47.5 percent in the S. boulardii group and, similarly, 53.2 percent in the placebo group. Further, the time-to-relapse was not statistically different between patients treated withS. boulardii or placebo.
While this probiotic showed no positive effects for Crohn's disease patients, further studies are needed to determine the potential therapeutic efficacy of probiotics in other forms of IBD, such as ulcerative colitis, and pouchitis.
Probiotics are living microscopic organisms, or microorganisms, that scientific research has shown to benefit an individual's health. S. boulardii, a probiotic made from a strain of yeast and sold in local drug stores or supermarkets in the form of capsules, has been demonstrated to be effective in the treatment of traveler's diarrhea, diarrhea occurring in subjects infected with the human immunodeficiency virus and the prevention of diarrhea associated with antibiotics.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Most of the mainstream probiotics are ineffective for almost everything and don't lead to any permanent change to the gut (which is probably why they are approved for public consumption by the FDA etc).

It is quite possible that other combinations could have an effect, it is a shame that headlines (and even scientific conclusions) are overgeneralised, when they only apply to a very specific hypothesis.
 

Waverunner

Senior Member
Messages
1,079
Snow Leopard, I fully agree. I don't understand why they have to repeat doing the same studies over and over again. For me it seems, that most breakthroughs in medicine were made in the 1980's and before. Today they test only old drugs or copy the mechanism behind them and sell the new product for a tenfold price. No innovation, no cure, nothing.
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
Hi Waverunner

I enjoyed your take on this study. Have you considered or
did you already give more details on how studies on bacteria
are being conducted ? Maybe write an article for pr so more people will
notice this ? tx ... x
 

Waverunner

Senior Member
Messages
1,079
xchocoholic: Thank you. Maybe I will write a more thorough article in the future. The more you dive into these studies, the more angry you get. Microbiome transplants are becoming more and more popular and this is a perfect example for the fact, that many scientists and doctors have no clue about what they are doing. The first microbiome transplants were conducted by army doctors in 1958 and today we haven't moved one step further. Many c. difficile and ulcerative colitis patients could have been saved by the right probiotic strain. Where are the protestors? In my eyes responsibility plays a very important role for the current problems.

The patient doesn't feel responsible for his health. He just does what the doctor says.
The doctor doesn't feel responsible, he just prescribes what government approved.
The government doesn't feel responsible for developing innovative drugs or curing diseases, it just approves what pharma companies developed.
The pharma companies don't feel responsible, they just do what government requires and they want to make profit. The only way to make profit is to earn more money, than you put into the expensive trials and studies, that were required by government. The best way to do this, is not to cure a disease but to develop a drug that suppresses a symptom and has to be taken by the patient for the rest of his life.

So you see, in this whole scheme, nobody feels responsible for the health of a human. It's no wonder that we are where we are right now.