Symbioflor® - recommendable or not?

Question

Hello,
for years I have problems with digestion after antibiotic therapies.
A bacterial mis-colonization has been diagnosed several times, after the intake of Xifaxan® (substance rifaximin) the complaints were always much better.
Unfortunately, I get the prescription for this only, if I have run through the complete diagnostic again (including three different breathing tests).
As I would have to be away from work at least for three days for this, this is not an option for me and I life with constant stomach pain.
Now I think of trying Symbioflor® or a similar product. Does this microbiological therapy pose any risks in case of CF and if not, do you think this will be successful?

Answer

Dear questioner,
the intake of antibiotic drugs, especially frequently or long-term therapies, like it is the case with you as CF-patient, can impair the physiological flora of the bowel. Antibiotic drugs can lead to an increase in the number of germs, but also to an over-grow with pathologcial bacteria as e.g. Clostridium difficile, Enterobacter, Proteus, Canida etc. Toxins of these bacteria can lead to diarrhea of the patient. Furthermore, general symptoms such as abdominal pain, cramps of the abdomen, flatulences can occur.
In case of CF-patients with the mentioned difficulties (especially with an exocrine insufficiency of the pancreas) always at first and repeatedly a nutrition counselling with checking of the pancreatic enzyme replacement should be initiated. A right composition of food, as well as lactic acid bacteria or preparations on the basis of bowel bacteria (as e.g. Symbioflor®) can influence positively the symptoms. This has to be considered and decided individually in cooperation with your doctor. Special interactions with other drugs or toxic features are not known according to the instruction leaflet of Symbioflor® 1 (acitve agent: enterococcus faecalis-bacteria), Symbioflor® 2 (active agent: Escherichia coli-bacteria) and Pro-Symbioflor® (acitve agent: Enterococcus faecalis- and Escherichia coli-bacteria) .
I would furthermore like to inform you about the Xifaxan® (active agent rifaximin). Xifaxan® itself is an antibiotic which has the special finding that it is practically not absorbed from the bowel and therefore is only active in the bowel itself. In Germany the drug is licensed for the treatment of the travelling diarrhea caused by non-invasive enteropathogenic bacteria in adults. In other countries (e.g. Austria) there is by now a license for the indication of a mis-colonization of the small bowel. In Germany there is up to now no license for this indication, therefore it is even more important in case of an indication such as yours to always agree on it together with your treating physician.
Yours sincerely,
Dr. Christina Smaczny

25.03.2013