Impact of Probiotic (Saccharomyces Boulardii) Administration in Prevention and Management of Chronic Diarrhea

Abstract
Background: Diarrheal disease is the second leading cause of death in children under five years old, and is responsible for killing around 525 000 children every year. Though many treatment modalities exist, chronic diarrheal conditions demand a safer alternative modality (with lesser side effects) and thus, role of probiotics in prevention and management of chronic diarrhea merits exploration. Objective: To study the impact of probiotic (Saccharomyces Boulardii) in prevention and management of chronic diarrhea. Methodology: This experimental study comprised of a sample of 178 (chosen via non-probability, consecutive sampling) children aged 2 months to 12 years, presenting to the study setting with chronic diarrhea (from November 05, 2019, to May 04, 2020) to the Dept. of Pediatrics at Liaquat University Hospital, Hyderabad. After taking written consent, data was recorded onto a structured questionnaire containing inquiries about the socio-demographic details, diarrheal disease history, medication history and eventual treatment outcome. The study population was divided into 2 equal groups (S. Boulardii group & Control Group) of 89 each. The active treatment period was 5 days. All study participants were examined on day 0 (inclusion day) and followed up on day 3 and day 6 during active treatment phase and in the following month thereafter for observation. The data obtained was analyzed through SPSS version 20. Results: The mean age of the sample stood at 6.5 (SD ± 1.5) years. Baseline characteristics such as mean age and the average frequency of stools were comparable in S. boulardii and control group at the time of inclusion in the trial. By day 3 it reduced to 2.8 and 4.4 stools per day respectively and by day 6 it reduced to 1.4 (S. boulardii Group) and 3.7 (control group). The duration of diarrhea was 3.2 days in S. boulardii group whereas it was 5.2 day in control group (P = 0.001). In the following month, S. boulardii group had a significantly lower frequency of 0.46 episodes as compared to 1.28 episodes in control group. Conclusion: After careful consideration, it can be concluded that average frequency of stools is significantly reduced and brought down to normal in the S. boulardii group as compared to the control group The drug was well accepted and tolerated. There were no reports of the side effects during treatment period.