Probiotics, prebiotics, and synbiotics in childhood diarrhea

Abstract

Acute diarrhea is the second leading cause of morbidity and mortality attributed to infections in children under five years of age worldwide, with 1.7 million annual estimated cases and more than 500,000 deaths. Although hydroelectrolytic replacement is the gold standard in treating diarrhea, it does not interfere with the restoration of the intestinal microbiota. Several studies have searched for an adequate alternative in restructuring intestinal homeostasis, finding that treatments based on probiotics, prebiotics, and synbiotics are effective, which made such treatments increasingly present in clinical practice by reducing illness duration with minimal side effects. However, there are still controversies regarding some unwanted reactions in patients. The diversity of strains and the peculiarities of the pathogens that cause diarrhea require further studies to develop effective protocols for prevention and treatment. Here, we provide a descriptive review of childhood diarrhea, emphasizing treatment with probiotics, prebiotics, and synbiotics.

Figure 1. Cases of acute diarrheal diseases in Brazil according to the age group and year from 2018 to 2022.

Figure 2. Mechanisms of action of probiotics. 1: Competitive exclusion; 2: Stimulation of the innate and adaptive immune response; 3: Increased nutrients bioavailability of nutrients; 4: Synthesis of bacteriocins and antimicrobials.