Nav: Home

AGA does not recommend the use of probiotics for most digestive conditions

June 09, 2020

Bethesda, MD (June 9, 2020) -- It is estimated that more than 3.9 million American adults have taken some form of probiotics, with many patients looking to probiotics to improve their gastrointestinal health. However, after a detailed review of available literature, the American Gastroenterological Association (AGA) has released new clinical guidelines finding that for most digestive conditions there is not enough evidence to support the use of probiotics. This is the first clinical guideline to focus on probiotics across multiple GI diseases while also considering the effect of each single-strain or multi-strain formulation of probiotics independently instead of grouping them all under the single umbrella of "probiotics." These guidelines are published in Gastroenterology, AGA's official journal.

The guideline supports use of certain probiotic formulations in three settings: for the prevention of Clostridioides difficile (C. difficile) infection in adults and children taking antibiotics, for the prevention of necrotizing enterocolitis in preterm, low birthweight infants, and for the management of pouchitis, a complication of inflammatory bowel disease. There was insufficient evidence to recommend probiotics for treatment of Crohn's disease, ulcerative colitis, irritable bowel syndrome (IBS) and C. difficile infection. For acute infectious gastroenteritis in children, AGA recommends against the use of probiotics.

"Patients taking probiotics for Crohn's, ulcerative colitis or IBS should consider stopping," says guideline panel chair Grace L. Su from University of Michigan, Ann Arbor. "The supplements can be costly and there isn't enough evidence to prove a benefit or confirm lack of harm. Talk with your doctor."

Given widespread use and often biased sources of information, it is essential that the public have objective guidance about the appropriate use of and indications for probiotics. AGA employed the gold-standard for guideline development, GRADE methodology, to evaluate the available evidence on clinical efficacy of probiotics.

"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, and that there is also a major variation in results based on the formulation of the probiotic product," says Dr. Su.

Key guideline recommendations:
  • For preterm (born before 37 weeks), low birthweight (< 2500 g) infants, specific probiotics can prevent mortality and necrotizing enterocolitis, reduce the number of days required to reach full feeds, and decrease the duration of hospitalization.
  • Certain probiotics should be considered for the prevention of C. difficile infection in adults and children who take antibiotics and for the management of pouchitis, a complication of ulcerative colitis that has been treated surgically.
  • Probiotics do not appear to be beneficial for children in North America who have acute gastroenteritis - they should not be given routinely to children who present to the emergency room due to diarrhea.
  • There was insufficient evidence for AGA to make recommendations regarding the use of probiotics to treat C. difficile infection, Crohn's disease, ulcerative colitis or IBS. For these conditions, AGA suggests that patients consider stopping probiotics, as there are associated costs and not enough evidence to suggest lack of harm.
  • Well-designed clinical trials will be needed to refine these AGA recommendations on probiotics and to investigate other clinical conditions relevant to gastroenterology.?

Gastroenterologists should suggest the use of probiotics to their patients only if there is clear benefit and should recognize that the effects of probiotics are not species-specific, but strain- and combination-specific.?

Read the AGA Institute guidelines and technical review on the role of probiotics in the management of gastrointestinal diseases to review the complete recommendations.
-end-
WHAT ARE PROBIOTICS?

Probiotics have been around for many years but have lately become more popular. Probiotics are living, microscopic (very small) organisms, including certain bacteria and yeasts, that are usually found in foods or dietary supplements. Some experts believe that probiotics may supplement treatments, but do not often replace them. Since there are many kinds of probiotics with different strains and combinations, it's important for patients to talk to their doctor before starting a probiotic. Learn more about probiotics in the AGA GI Patient Centerhttps://gastro.org/practice-guidance/gi-patient-center/topic/probiotics/.

GUT MICROBIOME EXPERTS

AGA has recruited leading experts in the gut microbiome and digestive health to serve as the scientific advisory board for the AGA Center for Gut Microbiome Research & Educationhttps://gastro.org/aga-leadership/centers/aga-center-for-gut-microbiome-research-and-education.

Email media@gastro.org to speak with our experts about probiotics or other microbiome topics.

Resources

Reporter cheat sheet on probiotics https://aga-cms-assets.s3.amazonaws.com/202052916035---Probiotics%20Guideline_Media%20Brief_Final.pdf

Patient information on probiotics https://www.gastro.org/practice-guidance/gi-patient-center/topic/probiotics

Guidelines https://www.gastrojournal.org/article/S0016-5085(20)34729-6/fulltext

Technical review https://www.gastrojournal.org/article/S0016-5085(20)34732-6/fulltext

American Gastroenterological Association

Related Probiotics Articles:

Probiotics may help manage childhood obesity
Probiotics may help children and adolescents with obesity lose weight when taken alongside a calorie-controlled diet, according to a study being presented at e-ECE 2020.
Which bacteria truly qualify as probiotics?
Today, the word probiotic is used to describe all kinds of 'good' microorganisms in foods and supplements.
AGA does not recommend the use of probiotics for most digestive conditions
After a detailed review of available literature, the American Gastroenterological Association (AGA) has released new clinical guidelines finding that for most digestive conditions there is not enough evidence to support the use of probiotics.
Probiotics may help treat acne
Acne is caused by chronic inflammation and is often treated with antibiotics.
Beware probiotics in ICU patients
A collaborative study published in Nature Medicine sounds a note of caution in using probiotics in the ICU.
Using probiotics to protect honey bees against fatal disease
A group of researchers at Western and Lawson combined their expertise in probiotics and bee biology to supplement honey bee food with probiotics, in the form a BioPatty, in their experimental apiaries.
Scientists revealed how probiotics influence human gut bacteria
A group of researchers from ITMO University and Knomics company studied how gut microbiota of 150 volunteers changed after a month of regular consumption of yogurt fortified with probiotics.
Breastmilk sugars differ in pregnant women on probiotics
The complex sugars found in human breastmilk, long believed to be fixed in their composition, may change in women who are taking probiotics, according to new research from the University of Rochester Medical Center (URMC).
Probiotics could help millions of patients suffering from bipolar disorder
About 3 million people in the US are diagnosed every year with bipolar disorder, a psychiatric condition characterized by dramatic shifts in mood from depression to mania.
Probiotics no help to young kids with stomach virus
A major US study led by Washington University School of Medicine in St.
More Probiotics News and Probiotics Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Warped Reality
False information on the internet makes it harder and harder to know what's true, and the consequences have been devastating. This hour, TED speakers explore ideas around technology and deception. Guests include law professor Danielle Citron, journalist Andrew Marantz, and computer scientist Joy Buolamwini.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.