Can probiotics or prebiotics treat gastrointestinal (GI) disorders?

Lawrence S. Friedman, MD
Gastrointestinal disorders, including IBS, are prime targets for the many popular yogurts, supplements, fruit juices, and other products marketed as having probiotic or prebiotic ingredients. But in general, the quality of the scientific studies is too poor to provide meaningful evidence, concluded researchers at Massachusetts General Hospital and Tufts Medical Center in a 2010 review article. Although more than 500 studies have been conducted on probiotics and prebiotics, the researchers found that most of the studies were too small and poorly designed to provide good evidence for the use of probiotics or prebiotics in medical treatment. Safety is another issue. Probiotics are live microorganisms that, while safe for most healthy people, pose safety concerns for people with certain medical conditions, including people at risk of invasive infection, people with an abnormal gastrointestinal mucosa barrier, people with central venous catheters, immunocompromised patients, children with short gut syndrome, and critically ill patients in an intensive care unit.

Lastly, the researchers pointed out that test results show that many of the products purported to contain probiotic microbes actually contain none of the stated microbe. Although these products are widely available and are generally considered safe, their effectiveness in treating IBS or other disorders has yet to be established.

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