Minoretti Piercarlo
Occupational Health, Studio Minoretti, Oggiono, ITA.
Cureus. 2024 Aug 8;16(8):e66426. doi: 10.7759/cureus.66426. eCollection 2024 Aug.
Probiotics are widely consumed for their potential health benefits, particularly in promoting gastrointestinal health and treating functional gastrointestinal disorders (FGIDs). However, recent studies have raised concerns about the potential association between probiotic use and brain fog, a cognitive dysfunction characterized by confusion, impaired judgment, and lack of focus. A 47-year-old male commercial airline captain with over 10000 flight hours presented with a two-month history of bloating, abdominal distension, and irregular bowel habits following a period of occupational stress and irregular dietary habits. The pilot's previous medical history was largely uneventful, with the exception of a long-standing gastritis diagnosis. To manage this condition, he had been on a daily regimen of 20 mg of pantoprazole for approximately eight years. After a telemedicine consultation, he began taking an over-the-counter probiotic supplement containing 16 strains. Within five days, he experienced a significant exacerbation of abdominal symptoms, accompanied by somnolence, difficulty concentrating, and mental fatigue, raising safety concerns given his profession. Functional gastrointestinal examination revealed a distended abdomen with increased bowel sounds. Probiotic-associated brain fogginess was suspected, and the patient was advised to discontinue the supplements. Rifaximin therapy was initiated, resulting in rapid resolution of both gastrointestinal and cognitive symptoms. The clear temporal association between probiotic intake and symptom onset, followed by resolution after antibiotic treatment, suggests a causal relationship. This case highlights the potential risks of unsupervised probiotic use, particularly in safety-sensitive professions such as commercial aviation. Occupational health physicians and aeromedical examiners should be aware of the potential for probiotic-induced brain fog in airline pilots (APs). Prompt recognition and appropriate antibiotic treatment can result in complete symptom resolution and prevent occupational hazards.
益生菌因其潜在的健康益处而被广泛食用，尤其是在促进胃肠道健康和治疗功能性胃肠疾病（FGIDs）方面。然而，最近的研究引发了人们对益生菌使用与脑雾之间潜在关联的担忧，脑雾是一种以困惑、判断力受损和注意力不集中为特征的认知功能障碍。一名47岁、飞行时长超过10000小时的男性商业航空公司机长，在经历一段时间的职业压力和不规律饮食习惯后，出现了两个月的腹胀、腹部膨隆和排便习惯不规律的症状。该飞行员既往病史基本无异常，仅有长期胃炎诊断。为控制病情，他服用20毫克泮托拉唑的日常方案约八年。经过远程医疗咨询后，他开始服用一种含有16种菌株的非处方益生菌补充剂。五天内，他的腹部症状显著加重，伴有嗜睡、注意力难以集中和精神疲劳，鉴于他的职业，这引发了安全担忧。功能性胃肠道检查显示腹部膨隆，肠鸣音增强。怀疑是益生菌相关的脑雾，建议患者停用补充剂。开始使用利福昔明治疗，胃肠道和认知症状迅速缓解。益生菌摄入与症状发作之间明显的时间关联，以及抗生素治疗后症状缓解，表明存在因果关系。该病例突出了无监督使用益生菌的潜在风险，尤其是在商业航空等对安全敏感的职业中。职业健康医生和航空医学检查人员应意识到航空公司飞行员（APs）中益生菌诱发脑雾的可能性。及时识别和适当的抗生素治疗可使症状完全缓解，并预防职业危害。
