Understanding Live Vaccines and Vaccine Shedding

Best Probiotics For IBS, According To Experts

"Before starting any probiotic supplement, it's important to consult with a health care provider, such as a gastroenterologist," says Dr. Berookim. "They can assess your specific symptoms, medical history and individual needs to provide personalized recommendations."

When looking at potential products to buy, read the label to see the product's ingredients, suggests Dr. Quigley. From there, it requires a bit of work on your end to look into the quality, viability and evidence of efficacy of those ingredients, he says.

Dr. Berookim recommends looking for products with Bifidobacterium infantis and Lactobacillus acidophilus, which "are two strains that have shown to improve overall IBS symptoms" as well as "multi-strain formulas [which may offer synergistic effects and broader benefits for gut health] that include strains with evidence supporting their efficacy for IBS," he says.

"Consider factors such as shelf stability and whether the product requires refrigeration, especially if you plan to travel frequently or have difficulty remembering to refrigerate supplements," adds Dr. Hanouneh.

Additionally, since many probiotics are classified as dietary supplements, they are not as strictly regulated by the FDA as medications. To help ensure the supplement you're taking is free from contaminants, opt for a product that has been third-party tested.

Part of the equation is also how well you can keep up with a regular routine, says Dr. Berookim. For example, if you don't like taking pills, you can consider increasing your intake of fermented foods.

Diarrhea Outbreak In Pesisir Selatan, Residents' Water Sources Have High Content Of "E Coli"

KOMPAS/YOLA SASTRA

A mother gave mineral water to a toddler patient with an extraordinary incident of diarrhea in the emergency ward of the pediatric ward at RSUD Dr Muhammad Zein Painan Hospital, Pesisir Selatan Regency, West Sumatra on Wednesday (8/5/2024).

PADANG, KOMPAS — Water sources used by extraordinary events or outbreaks of diarrhea patients in Pesisir Selatan, West Sumatra, confirmed high levels of Escherichia coli (E coli) bacteria. Residents are still allowed to take water from these sources, but must cook it until it boils before consuming it.

Acting Head South Coast Health Service Intan Novia Fatma Nanda, Thursday (9/5/2024), said that the department had received the research results from the Andalas University Laboratory. Examination of diarrhea patients' feces was positive for containing E coli bacteria, as well as residents' water sources.

"The results of testing samples of water used by the community at the Pincuran Langit spring and several refill gallon water depots showed that overall it was high in E coli. In Pincuran Langit, the level of E coli was 6,300 per 250 ml of water. "At gallon water depots, 400 per 250 ml of water," said Intan.

Also read: Dozens of Diarrhea Patients in Pesisir Selatan Treated, Unlicensed Gallon Water Depot Highlighted

Based on government regulations, drinking water must be free of E coli bacteria. This is stated in Ministerial Regulation Health Number 2 of 2023 that the maximum permitted level of E coli bacteria is 0 per 100 ml of water.

Intan continued, the high content of E coli bacteria and the habit of consuming water without boiling it made residents vulnerable to diarrhea. The health department together with other policy makers is trying to educate the public to boil water before consuming it.

KOMPAS/YOLA SASTRA

Diarrhea outbreak situation in the children's ward hallway of Dr Muhammad Zein Painan Hospital, Pesisir Selatan Regency, West Sumatra, Wednesday (8/5/2024).

According to Intan, as of May 8, 2024, the number of diarrhea cases in this outbreak has reached 238 cases, with 62 percent of them experienced by children aged 0-5 years (toddlers). Five (5) children have died, 152 have recovered, 65 are still being treated in health facilities, and the rest are undergoing outpatient treatment under the supervision of medical personnel.

The symptoms experienced by the patients are slimy and watery diarrhea, some accompanied by vomiting, fever, and cramps. The most cases of diarrhea were found in Sutera District, including in Lansano, Taratak, Pasa Surantiah, and Gunung Malelo villages.

Also read: Hundreds of Residents Experience Mass Diarrhea on the South Coast, Four People Die

"The high death rate is because people are reluctant to seek treatment when they have diarrhea. "Some people only sought treatment after experiencing dehydration for two days after being swept by health workers," he said.

Intan added that officers were still carrying out sweeping in the last two days and many cases were still being found. People are reluctant to seek treatment at health facilities even though they are experiencing symptoms of diarrhea.

DISKOMINFO PESISIR SELATAN

The head of the One-Stop Licensing and Integrated Service Agency of Pesisir Selatan Regency, Nuzirwan (left), visited a refillable gallon water depot in the Surantiah District, Pesisir Selatan, West Sumatra, on Tuesday (7/5/2024).

Separately, the Head of the South Coast Communications and Information Service, Wendi, said that based on a meeting between the regional government and local community leaders, residents were still allowed to use water from these sources even though the E coli bacteria content was high.

"Residents can still take the water on condition that it must be cooked until it boils for 10-15 minutes so that the E coli bacteria die," he said.

Appeals have also been posted at water sources so that people boil the water before consuming it, including at Pincuran Langit.

According to Wendi, residents have been directly consuming water from Pincuran Langit. The water is sold for Rp 5,000 per jerry can with a capacity of 35 liters. Upon arrival at home, the water is immediately poured into a teapot and consumed without being boiled because it is clear and considered clean.

"The contamination of water sources is suspected to be due to the floods and landslides on March 7-8. Many livestock and other animals died. Bacteria from the unburied animal carcasses may have spread. Further research is being conducted to determine if it is due to the floods or other factors," he said.

KOMPAS/YOLA SASTRA

A doctor checks the condition of a toddler patient during an extraordinary event in the children's ward of the Dr. Muhammad Zein Painan Regional General Hospital in Pesisir Selatan Regency, West Sumatra, on Wednesday (8/5/2024).

Apart from being sold in jerrycans, the spring is also a source of water for several refillable gallon water depots in Sutera District. The problem is that most of these water depots do not have permits from the local health department, so there is no regular quality testing of the water.

Wendi continued, regarding refillable gallon water depots, the local government has sent a team consisting of permit agencies, public order officers, sub-district government, village government, and others to investigate. "It was found that there are 34 unauthorized refillable gallon water depots," he said.

Regarding the findings, according to Wendi, the team urges and requests the owners of the depot to obtain permits facilitated by the district government and licensing agency. "So that the depot standards can be followed," he said.

The area recently experienced flooding (March 7-8). It could be that the water source is contaminated.

Head of POM Padang Center Abdul Rahim said that examination of water samples suspected to be the source of the diarrhea outbreak was still in progress since Monday (6/5/2024). The examination lasted a week.

KOMPAS/YOLA SASTRA

The atmosphere in one of the treatment rooms for toddler patients during an extraordinary diarrhea outbreak in the pediatric ward of RSUD Dr. Muhammad Zein Painan hospital, in South Pesisir Regency, West Sumatra, on Wednesday (8/5/2024).

Rahim highlights the proliferation of unlicensed water gallon refill stations, which are used by some diarrhoea outbreak patients. As they are unlicensed, these stations do not routinely test the quality of their water.

"They should routinely test the water quality in laboratories, every three months, every six months, something like that. So, maybe, that's one of the causes," said Rahim.

Next, according to Rahim, the hygiene habits of the community around the location are relatively poor. There are water sources that are directly taken from mountains/hills, collected in gallons, then some are directly sold to the community, and some of the gallons are already covered in moss.

"Meaning, poor hygiene practices while the area recently experienced floods (on March 7-8). It's possible that the water source has been contaminated. The flood sometimes brings dead animals which have the potential of bacterial contamination. If children drink it, they may develop diarrhea, dehydration, and even death," he said.

What Is E. Coli? What To Know About Bacteria Tied To Recalls Of Ground Beef, Walnuts

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