Probiotics are not recommended for most digestive conditions, according to a clinical practice guideline issued by the American Gastroenterological Association and published online June 9 in Gastroenterology.
Grace L. Su, M.D., from the University of Michigan in Ann Arbor, and colleagues developed guidelines on the role of probiotics in the management of gastrointestinal disorders. The guidelines were accompanied by a technical review, which provided evidence-based information to guide clinicians.
The authors recommend use of probiotics only in the context of a clinical trial for patients with Clostridioides difficile infection. Use of Saccharomyces boulardii or specific combinations of probiotics is suggested over no or other probiotics for prevention of C. difficile infection for adults and children on antibiotic treatment. Probiotics are only recommended in the context of a clinical trial for adults and children with Crohn disease and in adults and children with ulcerative colitis. An eight-strain probiotic combination is suggested in adults and children with pouchitis. Probiotics are recommended only in the context of a clinical trial for symptomatic children and adults with irritable bowel syndrome. The use of probiotics is not suggested for children with acute infectious gastroenteritis. A combination probiotic is recommended in preterm low birth-weight infants.
"While our guideline does highlight a few use cases for probiotics, it more importantly underscores that the public's assumptions about the benefits of probiotics are not well-founded," Su said in a statement.
Two authors of the guideline and two authors from the technical review disclosed financial ties to the pharmaceutical and nutrition industries.