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Cystic Fibrosis : interest of probiotics, prebiotics

What are the dietetic approaches about probiotics & prebiotics in cystic fibrosis (for baby, child, teenager, adult), given that there are different types depending on whether the patient can chew or not, eat more vegetables, or meat, is on antibiotics etc ... ?

We heard about the use of probiotics for diarrhea, and especially after antibiotics courses that kill both the bad bacteria and the good ones

By digging the topic, we see the importance of a healthy intestinal flora for the immune system, in the digestion and assimilation of nutrients, production of some vitamins and help for digestion.

What advice can you give?
The balance of intestinal flora in humans is important because these microorganisms of the digestive tract (in large numbers) are involved in the fermentation of sugars, amino acids, in the development of the immune system, and the synthesis of some vitamins such as vitamin K.
In cystic fibrosis, frequent or continuous antibiotic therapy, may unbalance this flora.
The use of prebiotics (non digestible food promoting bacterial growth) or more frequently of probiotics (living microorganism, bacteria or yeast that colonizes the gut, such as Bifidobacterium, Lactobacillus or Saccharomyces boulardii) has been studied in non CF population. These studies seem to support some interest, especially in treatment of infectious diarrhea and prevention of diarrhea due to antibiotics.
Yoghurts, fermented milks are the main natural source of probiotics and some infant milks are supplemented with pre-or probiotics.
Publications in patients with cystic fibrosis are recent, limited, often involving small cohorts with short duration of use and the results are still preliminary. In addition, the long-term effects have not been evaluated, as well as on fat absorption or nutritional status.
There is currently no recommendation for a large use of probiotics in cystic fibrosis population. Their occasional use during long antibiotic therapy can be discussed, but there is no consensus about it.
Best regards,
Dr Michèle Gérardin