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Escherichia coli -The Probiotic

Posted by Gerhard Fourie on

Written on the 17 May 2013 by The Compounding Team

What are probiotics?
A simple and modern definition states that probiotics are live microorganisms that may confer a health benefit on the host. The human body plays host to both beneficial and harmful (pathogenic) microorganisms. Probiotics are those bacteria that help maintain the natural balance of organisms (microflora) in the intestines.[1]

The normal human digestive tract contains about 400 types of probiotic bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system. The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus, found in yogurt with live cultures, is the best known. Yeast is also a probiotic substance. Probiotics are also available as dietary supplements.

This article seeks to specifically deal with the Nissle 1917 Escherichia coli strain that is deemed to be beneficial to its host, in this instance, humans. E.coli may arguably be one of the most examined and therapeutically relevant bacterial strains worldwide.

Escherichia coli strain Nissle 1917 was first described in 1917, during World War I. The German physiologist, microbiologist and physician Alfred Nissle (1874–1965) isolated a particular E. coli strain that appeared to provide some protection against the intestinal disorders that were highly prevalent in south-eastern Europe at that time.[2] Escherichia coli Nissle 1917 thus refers to the above person and the year in which it was described.

What are probiotics used for?
Many people use probiotics to prevent side effects of taking anti-biotics, such as diarrhoea, gas and cramping. Antibiotics are rather indiscriminate and kill beneficial bacteria along with the harmful bacteria. A decrease in beneficial bacteria may lead to digestive problems, so taking probiotics may help replace the lost beneficial bacteria.

A decrease in beneficial bacteria could also lead to other infections, such as vaginal yeast and urinary tract infections, and symptoms such as diarrhoea from other intestinal illnesses.

Mutaflor® capsules contain as the active substance, the defined non-pathogenic strain Escherichia coli strain Nissle 1917, designated DSM 6601 in the German Collection for Microorganisms in Brauschweig.

Mutaflor has been on the market for almost a century and has been clinically studied for use in a variety of diseases and disorders of the gastrointestinal tract. A number of European studies on E. coli Nissle 1917 have shown positive results when used in conditions such as ulcerative colitis, Crohn’s Disease, chronic constipation, prolonged diarrhoea and irritable bowel syndrome. Pouchitis (inflammation of the ileal pouch) is usually treated with anti-biotics, but some physicians prescribe pre-biotics.

In Canada, Mutaflor is indicated to normalize stool frequency and consistency in diarrhoea and constipation and to reduce abdominal pain and cramping.[3][4]

Reasons given why Mutaflor® may be for you:
• Gives protection in animal models of inflammatory colitis
• Gives anti-inflammatory and cytoprotective effects, (protecting cells from noxious chemicals or other stimuli), on the bowel mucosa
• Protects T84 monolayers (type of intestinal cells in a single layer), against barrier disruption by enteropathogenic, (capable of causing disease in the intestinal tract), E. coli (EPEC)* infections
• Limits the adherence of harmful pathogens sticking to the bowel
• Enhances intestinal barrier function.
*A bad strain of E.coli.

In addition, Mutaflor® does not contain any gluten, wheat, lactose or milk proteins; specifically formulated for those patients who may suffer from such allergies.
Are probiotics safe?
Most probiotics are similar to what is already present in a person's digestive system. Some probiotics have been used for a very long time throughout history of humankind, as part of a regular diet such as in fermented foods and cultured milk products. These appear not to cause illness, but it is deemed by certain groups that more study should be done on the safety of probiotics in young children, the elderly and people who have weak immune systems.

More Pros than Cons
Escherichia coli strain Nissle 1917 has been well studied and there is substantial information available on the effects of administrating E.coli as a probiotic. The efficacy in treatment and treatment support of various diseases are also well documented.

Advocates of naturopathy and alternative medicines will readily support the use of E.coli Nissle 1917 for specific health conditions.

The use of this medication has been with us now for nearly 100 years. To have come this far, the pros of using this useful bacterium must surely outweigh the cons? It appears that unless an alternative with similar characteristics is found, it will still be a regularly used and prescribed medication for a long time to come.

REFERENCES and suggested Further Reading
5. Clinical use of E. coli Nissle 1917 in inflammatory bowel disease. Inflamm Bowel Dis. 2008 Jul; 14(7):1012-8.
6. Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet. 1999 Aug 21; 354(9179):635-9.
7. Double-blind comparison of an oral Escherichia coli preparation and mesalazine in maintaining remission of ulcerative colitis. Aliment Pharmacol Ther. 1997 Oct; 11(5):853-8.
8. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut. 2004 Nov; 53(11):1617-23.

Always read the label on any medication and use only as directed. Vitamin and other supplements should not replace a balanced diet, unless so instructed by your medical practitioner. If symptoms persist, seek further health advice. The information presented above is not intended to replace the advice of your medical practitioner.

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