Lactobacillus rhamnosus GG (LGG)
Most-studied single probiotic strain, Cochrane support for paediatric acute infectious diarrhoea and AAD prevention.
Why
Lactobacillus rhamnosus GG (LGG, strain ATCC 53103) is the single most-studied probiotic strain in the world, with over 1,000 RCTs across multiple indications. The strongest evidence is for acute paediatric infectious diarrhoea (where Cochrane found ~1 day shortening of duration) and for antibiotic-associated diarrhoea prevention. Smaller bodies support use in atopic eczema prevention in high-risk infants and in C. difficile-positive diarrhoea.
How it works
Surface SpaCBA pili mediate adherence to intestinal mucus, displacing pathogens by competitive exclusion. Bacteriocin secretion inhibits Gram-negative pathogens. Stimulates IgA secretion and modulates Treg/Th17 balance, basis of the atopic prevention signal.
Expected onset · Acute diarrhoea: 1–2 days. AAD prevention: requires concurrent dosing.
How to take
Dosage
Acute diarrhoea: 10¹⁰ CFU twice daily for 5–7 days. AAD prevention: 10⁹–10¹⁰ CFU/day during antibiotic course and 1 week after. Capsules and sachets dose by CFU not weight.
Timing
Daily; with or without food; separate from antibiotic by 2 hours where possible
On the label
Stated 'L. rhamnosus GG' or 'LGG' or 'ATCC 53103', strain identity matters (different L. rhamnosus strains are not equivalent). CFU dose stated at end of shelf life, not at manufacture.
Ideal for
Children with acute infectious diarrhoea (alongside oral rehydration); children and adults starting antibiotic courses; high-risk infants for eczema prevention (with paediatric guidance).
Safety
Evidence
Szajewska 2019 Aliment Pharmacol Ther meta-analysis (15 RCTs, n=2,963): LGG reduced acute paediatric diarrhoea duration by ~1 day and stool frequency on day 2 vs placebo. Cochrane 2017 SR confirmed reduction in AAD risk. ESPGHAN paediatric guideline lists LGG as one of two probiotics with sufficient evidence to recommend for acute gastroenteritis adjunctive use.
- Szajewska et al., Aliment Pharmacol Ther 2019, L. rhamnosus GG for treating acute paediatric gastroenteritis: updated meta-analysis
- Goldenberg et al., Cochrane Database Syst Rev 2017, probiotics for prevention of pediatric AAD
- Hojsak et al., J Pediatr Gastroenterol Nutr 2018, guidance on use of probiotics in clinical practice in children with selected clinical conditions and for prevention of disease
Where to get it
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