The recently published Clinical Practice Guidelines on the role of probiotics in the management of gastrointestinal disorders by the American Gastroenterological Association (AGA) contains some interesting points on the role of probiotics, but also requires some clarifications. Probiotics should not be seen as the magic solution, just as drugs are not solving all the medical problems in the world.
IPA Europe welcomes the approach of analysing probiotic interventions individually, and not grouping different probiotic strains and combinations of strains into one meta-analysis. All studies indicate that the probiotic family is not a single uniform block: if several different probiotics have shown similar effects in different studies, their action depends on the strain, or the combination of strains used.
Much evidence for probiotics substantiates their use to support health and in preventing and mitigating disease and in a wider scope of conditions.
A large majority of trials are conducted in Europe (420 in Europe compared to 270 in North America in 2018). Excluding studies solely because they were not conducted in North America, as AGA states, could therefore reduce the relevance of AGA’s recommendations.
To find out more download the “IPA Europe Q&A on the publication of the American Gastroenterological Association (AGA) – 2020 Clinical Practice Guidelines of Probiotics in the Management of Gastrointestinal Disorders”.
In the letter published in December 2020 by Maurizio Koch, MD and Lucio Capurso, MD, the Authors comment on two clinical recommendations of the AGA. They bring additional arguments for the use of probiotics in the prevention of Clostridioides difficile infection, and on acute gastroenteritis in children, which are based on recent systematic review.