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Digestive Wellness- Soft Stools

Protocols Fullscript Protocols
Digestive Wellness- Soft Stools

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence. These are categorized as follows:

Class Qualifying studies Minimum requirements
A Systematic review or meta-analysis of human trials
B Human RDBPC ≥ 2 studies and/or 1 study with ≥ 50
subjects
C Human RDBPC or RCT 1 study < 50 subjects
D Human trials or In-vivo animal trials

RDBPC = Randomized Double-Blind Placebo Controlled
RCT = Randomized Controlled Trials

Please refer to the complete Rating Scale for further information.

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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Digestive Wellness- Soft Stools

Probiotics

2-8 billion CFU, total per day, minimum 3 months4,6

  • Probiotics have been shown to decrease diarrhea in conditions like traveler’s diarrhea and antibiotic-associated diarrhea1,2,3
  • Bacillus coagulans decreased stool frequency in diarrhea-associated irritable bowel syndrome (IBS-D)6
  • A blend of probiotics including Lactobacillus acidophilus and Bifidobacterium bifidum, has shown to decrease daily stool frequency4,5
Probiotics in the Fullscript catalog.

Pectin

24g, total per day, minimum 6 weeks9

  • Fibers reduce diarrhea when patients are receiving enteral nutrition7,8
  • Pectin reduced stool frequency, diarrheal duration, frequency in vomiting, oral rehydration and intravenous fluid in children10
  • Pectin has shown to improve diarrhea-associated irritable bowel syndrome (IBS-D) by balancing the microflora and decreasing systemic inflammation9
Pectin in the Fullscript catalog.

Prebiotics

5.5g, total per day, minimum 1 week12,13

  • Galacto-oligosaccharide was shown to prevent the incidence of traveler’s diarrhea12
  • Prebiotics, specifically oligofructose, were shown to reduce relapse of diarrhea in C-difficile patients11
Prebiotics in the Fullscript catalog.

References

1
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/30189723
2
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868213/
3
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/22570464
7
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/25954112
8
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419079/