Products
Lactobacilli are commercially available in the form of capsules, powders, liquids, vaginal tablets and creams, among others. They are pharmaceuticals, dietary supplements, medical devices and cosmetics. Foods such as yogurts and other dairy products also contain lactobacilli.
Structure and properties
Lactobacilli are Gram-positive, usually rod-shaped, non-spore-forming, and facultatively anaerobic bacteria that belong to the lactic acid bacteria. They are a natural component of the microbiome and are found in humans in the intestinal flora of the digestive tract, in the vaginal flora, in breast milk and on the skin, among other places. They have a symbiotic relationship with humans. Lactobacilli are often present in freeze-dried form in products. After contact with water and nutrients, they begin to multiply. Killed bacteria (lysates) and ferments are also used. Over 200 different species exist. For example, the following species are used in pharmacy and food technology, they differ in their properties.
Effects
Lactobacilli have antimicrobial, antiviral, immunomodulatory and immunostimulatory, anti-inflammatory, digestive and antidiarrheal properties. After ingestion, they enter the intestine, where they attach to the mucosa, settle and normalize the altered composition of the intestinal flora. They exert positive effects on the other bacteria and on the intestinal mucosa, promote the formation of mucus and strengthen the barrier function of the epithelium. Lactobacilli stimulate intestinal movements and counteract constipation, stimulate the immune system and inhibit the growth of pathogenic microorganisms and viral replication. In the vagina, they maintain an acidic environment that protects against infectious diseases. Through lactic acid fermentation, lactobacilli produce lactic acid (lactate) from carbohydrates such as glucose without oxygen. This and other bacterial metabolites are partly responsible for the positive effects. The lactose added as an excipient in the vaginal tablets is also fermented by the bacteria.
Areas of application
Indications for use include (selection): gastrointestinal complaints of various causes:
- Diarrhea, for example, after taking antibiotics, in a traveler’s diarrhea and gastroenteritis.
- Constipation
- Flatulence, abdominal pain
- Irritable bowel
Vaginal disorders:
- Restoration of vaginal flora after treatment with anti-infectives, such as antibiotics.
- Vaginal infections, for example, vaginosis or vaginal fungus.
- Vaginal dryness, vaginal atrophy.
Urinary tract infections:
- Bladder infection
Allergic diseases:
- Hay fever
- Food allergies
Food:
- Lactic acid fermentation has great importance in food production, for example, sour milk products, breads and cheeses.
Dosage
According to the package insert. Lactobacilli are administered perorally and topically (eg, vaginally).
Contraindications
- Hypersensitivity
When used for diarrhea, it is important to note that an oral rehydration solution may need to be administered, for example in young children. Full precautions can be found in the drug information leaflet.
Interactions
Drug-drug interactions are not known.
Adverse effects
Very rarely, gastrointestinal disturbances may occur.
