Tests of the action of kefir with lactulose (Department of Children's Diseases)

Tests of the effect of kefir enriched with lactulose "Laktusan" on the function and microecology of the intestine

(Department of Children's Diseases of the Peoples' Friendship University of Russia, Department 24 of the Morozov Children's City Clinical Hospital).

Previous tests at the department of lactulose concentrate "Lactusan" (syrup, consisting of 70% in terms of dry matter from lactulose, produced by Felicata Holding LLC) showed that this biologically active food supplement can be used for intestinal dysfunction and dysbacteriosis, often associated with serious diseases children.

To create a healthy and functional diet enriched with bifidus factors, it is advisable to rely on traditional food products. As such, kefir was chosen, which not only satisfies good taste, but is also known as a means of improving bowel function. The purpose of the tests was to compare the effectiveness of ordinary kefir produced according to traditional technology, without any additives, and kefir with the addition of lactulose "Laktusan" (OST 49 29-84 "Kefir", change No. 7 to OST 49 29 -84 "Kefir with lactulose).

The tests were carried out with two groups of children, one of which is considered as a control (receives kefir without additives), and the other as an experimental one (receives kefir with the addition of 0.5% by weight of lactulose syrup "Lactusan"). A mixture of kefir with "Lactusan" was prepared at VNIMI according to the following technology: first, kefir was prepared according to the appropriate technology, then "Lactusan" syrup was added. The homogeneous mixture was poured into molds with a capacity of 200 ml and hermetically sealed with aluminum foil. Control samples were prepared in the same way, but without the addition of lactulose.

Each child received one packet of product per day. Thus, the daily dose was 200 g, and the study course lasted 20 days. Before and after the course, a bacteriological analysis of feces was performed.

Children aged from 1 to 15 years were selected for the test, mainly with impaired bowel function, expressed in the form of constipation or irregular stools with mucus, with pain in the abdomen. In some cases, children also had diseases such as atopic dermatitis, infectious diseases and others. The treatment was carried out on an outpatient basis, but the patients were under constant supervision of the doctors of the Morozov hospital.

This report presents data on the results of a study of 30 children who, in addition to clinical observation, have analysis data for dysbacteriosis before and after admission: 10 in control and 20 who received kefir with lactulose "Lactusan". To evaluate the results, we used clinical data obtained by direct observation of patients by a doctor, as well as by interviewing parents of sick children, and bacteriological analysis data. Bacteriological analysis was carried out in the laboratory of the Morozov hospital according to the method adopted in Russia. The results are shown in tables No. 1 (control group) and No. 2 (experimental group).

Explanations for tables. According to the Russian standard, the following indicators are the norm for children over 1 year old (the abbreviations used in the table are entered in brackets): bifidobacteria (B) - 108 and more, lactobacilli (L) - 106-108, escherichia (ESh) - 107-108, of which lactose-negative (LNESH) - 10%, hemolytic (HESH) - 2%, enterococci (EN) - 105-106, Klebsiela (Cl) - <104, staphylococci (ST) - <104, yeast-like fungi (DG) - <103. The table contains only those data that differ from the given values, or show dynamics, as in the case of lactobacilli.

The chair is characterized by the following terms: "norm" - regular stool, normal consistency, "sheep feces" - a manifestation of constipation.

To characterize the microflora of feces, measurements were carried out according to 12 of the above indicators. The tables contain data on those indicators that go beyond the above norms or that undergo changes due to the intake of kefir. Those indicators of bakanaliza, which fit into the norm, are not included in the table. The designation “ots (3)” is used when there is no culture of microbes at dilutions for lg KOE = 3.

In the control group of 10 children, 7 (70 %) had impaired bowel function in the form of constipation. One of them has a stool with mucus. After a course of kefir (without lactulose), the stool returned to normal in 5 children and partially in 2 children. Stool bacterial analyzes showed reduced levels of bifidobacteria (up to log COE = 7) and lactobacilli (up to 5-6) in four children. After taking kefir, the level of bifidobacteria increased in two children. The level of lactobacilli increased in two, but dropped sharply in four children. Other changes in the composition of the microflora in the control group were rare and insignificant.

Table No. 1 Deviations from the norm or changes in the microflora and the shape of the stool in children who took ordinary kefir (control group). Dose 200 g per day, course 20 days.

In the second group, where kefir was taken with a 0.5% lactulose supplement "Lactusan", there were 20 children from 1 to 12 years old. In 9 children (47 %) in the experimental group, the level of bifidoflora after the course of kefir with lactulose "Lactusan" increased, but in three children (15 %), who suffered viral and other diseases during the intake, it decreased by 1 log unit. An increase in the level of lactobacilli was observed in 13 children (65 %), and in three (15 %) a slight decrease was observed. Against the background of taking kefir with lactulose, there was a noticeable cleansing of the intestines from opportunistic flora (hemolytic, low-fermenting and other forms, as well as Proteus, Klebsiella, staphylococci and others).

Table No. 2 Deviations from the norm or changes in the microflora and stool shape in children who took kefir with a 0.5% lactulose supplement "Lactusan" (experimental group). Dose 200 g per day, course 20 days.

GV, 1 year old, had dysbacteriosis of the 2nd degree and at low levels of lacto- and bifidobacteria, had a markedly high level of Klebsiella (lg COE = 6). This child was treated with phage, but there was no improvement. The course of treatment with kefir with "Lactusan" led to the disappearance of Klebsiella and an increase in the number of bifido- and lactoflora. Significant improvements were observed in the clinic, when the disturbances in the intestinal function disappeared and the stool returned to normal. In two other cases, when children before treatment had a reduced level of bifido- and lactoflora (K.K., 7 years old and Ch.M., 7 years old), complete normalization of the microflora was achieved, and the tendency to constipation disappeared and the stool returned to normal.

In some cases, the effect of kefir turned out to be insufficient and an additional course of kefir with lactulose "Lactusan" was required. In the child K.K., 7 years old, kefir contributed to the elimination of constipation, however, its effect on the composition of the microflora was not sufficiently effective, because. lactobacilli remained at a very low level. After a course of kefir with lactulose, the level of lactoflora increased from < 5 to 6. In another child (M.E., 3.5 years old), a course of kefir led to constipation, and this child was transferred to the experimental group receiving kefir with lactulose "Lactusan ". Achieved normalization of stool and improvement of microflora composition.

Three children had atopic dermatitis. After a course of kefir with lactulose, its manifestations decreased sharply. In one child (P.D., 6 years old), after a course of kefir with "Lactusan", there was an increase in the level of proteus (up to lg KOE = 8), which is explained by the postponement of bronchitis at the end of treatment and antibiotic treatment. Similarly, in a child (A.A., 4 years old) due to food poisoning at the end of the course, the level of Escherichia increased (up to lg COE = 8) by 100% due to hemolytic forms. However, in all these cases, the general condition of the child improved, the stool returned to normal, and the main indicators of bacillary tests were at the level of normal values.

The beneficial effect of kefir with lactulose "Lactusan" in comparison with kefir without additives can be judged by the content of bifidus and lactobacilli in feces (Table 3). For a complete correctness of the comparison of the action of kefir made according to traditional technology, and kefir enriched with lactulose, other equal conditions should be observed. For a correct comparison, the statistics did not take into account the data of the bacteriological examination of children who had diseases (ARVI, food poisoning, and others) while taking the products whose effect is being studied, because. it was the past diseases that could make unfavorable adjustments to the composition of the microflora. Table 3 compares the data of children, all other things being equal.

Table 3. Changes in the level of bifido- and lactobacilli in children who received ordinary kefir (control group) and kefir enriched with lactulose "Lactusan" (experimental group).

If in the control group an increase in the level of bifidobacteria was only in 20 % children, then in the experimental group, who took kefir with lactulose, it was in 47 %. In the change in the level of lactobacilli, the difference is even greater - 20 % versus 65 %, respectively. Ordinary kefir caused a decrease in lactobacilli in 50 % children, which sometimes exceeded 100-fold, while kefir with lactulose - only in 1 person (5 %). At the same time, the stool in the experimental group returned to normal in all (100 %) children.

General conclusion on clinical studies of kefir with lactulose produced according to OST 49 29-84, change No. 7:

Kefir with lactulose, unlike ordinary kefir, has pronounced bifidogenic properties.

Kefir with lactulose very markedly increased the level of lactobacilli, which was not observed in the group taking regular kefir.

When taking kefir with lactulose, suppression of pathogenic and conditionally pathogenic microflora is observed.

Kefir with lactulose has a positive effect on intestinal function, eliminates constipation and other intestinal disorders in children.

The use of kefir with lactulose improves the clinical picture: reduces the manifestations of atopic dermatitis, improves appetite, improves the condition after an intestinal infection, improves the general condition of the body and intestinal function after antibiotic therapy.

Conclusion: kefir enriched with lactulose "Laktusan" according to OST 49 29-84, change No. 7, has a more favorable effect on the intestinal microflora than ordinary kefir.

We recommend kefir with lactulose (OST 49 29-84, change No. 7) as a mass product for the prevention of diseases of the gastrointestinal tract, including dysbacteriosis and intestinal dysfunction.

From the Department of Children's Diseases of the People's Friendship University of Russia (24 departments of the Morozov Children's City Clinical Hospital):

Head of Department, Doctor of Medical Sciences,

Professor L. T. Kuzmenko

assistant, candidate of medical sciences N.I. Petruk

From the Department of Urology and Operative Nephrology of the Peoples' Friendship University of Russia (Clinical Hospital 64 in Moscow):

Head of Department, Doctor of Medical Sciences,

Professor, Academician of the Academy of Sciences of Higher Education V. E. Rodoman

Chief Researcher, Doctor of Biology V.I. Maksimov

I certify the signatures of employees of the Peoples' Friendship University of Russia.

Scientific Secretary of the Academic Council Candidate of Chemical Sciences A.P. Krapivko