Dysbiosis, a loss of balance between resident bacterial communities and their host, is associated with multiple diseases, including inflammatory bowel diseases (nonspecific chronic ulcerative colitis and Crohn’s disease), and digestive functional disorders. Probiotics, prebiotics, synbiotic organisms and, more recently, pharmabiotics, have been shown to modulate the human microbiota. In this review, we provide an overview of the key concepts relating to probiotics, prebiotics, synbiotic organisms, and pharmabiotics, with a focus on available clinical evidence regarding the specific use of a unique pharmabiotic, the strain Lactobacillus acidophilus LB ( Lactobacillus boucardii), for the management of gastrointestinal disorders. Since it does not contain living organisms, the administration of L. acidophilus LB is effective and safe as an adjuvant in the treatment of acute diarrhea, chronic diarrhea, and antibiotic-associated diarrhea, even in the presence of immunosuppression.

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Introduction: The pathoetiology and treatment of levator ani syndrome (LAS) remains unclear. Methods: We evaluated pathophysiology using translumbosacral motor evoked potentials (MEP), and anorectal manometry in LAS patients and compared with healthy controls. A cohort underwent Translumbosacral Neuromodulation Therapy (TNT). Results: Lumbar and sacral MEP latencies were prolonged in 32 LAS patients compared to 31 controls (p<0.013), with higher prevalence of anal neuropathy (p=0.026). TNT improved anorectal pain (p=0.003), and neuropathy (p<0.02) in 13 LAS patients. Conclusions: LAS patients demonstrate significant lumbo-sacral neuropathy that may cause anorectal pain. TNT improved anorectal pain and neuropathy, providing a novel therapeutic option.

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