A Gastroenterologist’s Guide to Probiotics (2024)

1. Williams MD, Ha CY, Ciorba MA. Probiotics as therapy in gastroenterology: a study of physician opinions and recommendations. J Clin Gastroenterol. 2010;44:631–636. [PMC free article] [PubMed] [Google Scholar]

2. Kau AL, Ahern PP, Griffin NW, et al. Human nutrition, the gut microbiome and the immune system. Nature. 2011;474:327–336. [PMC free article] [PubMed] [Google Scholar]

3. Macpherson AJ, Harris NL. Interactions between commensal intestinal bacteria and the immune system. Nat Rev Immunol. 2004;4:478–485. [PubMed] [Google Scholar]

4. Sekirov I, Russell SL, Antunes LC, et al. Gut microbiota in health and disease. Physiol Rev. 2010;90:859–904. [PubMed] [Google Scholar]

5. Ng SC, Hart AL, Kamm MA, et al. Mechanisms of action of probiotics: recent advances. Inflamm Bowel Dis. 2009;15:300–310. [PubMed] [Google Scholar]

6. Madsen KL. Interactions between microbes and the gut epithelium. J Clin Gastroenterol. 2011;45(Suppl):S111–114. [PubMed] [Google Scholar]

7. Rousseaux C, Thuru X, Gelot A, et al. Lactobacillus acidophilus modulates intestinal pain and induces opioid and cannabinoid receptors. Nat Med. 2007;13:35–37. [PubMed] [Google Scholar]

8. Ciorba MA, Riehl TE, Rao MS, et al. Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner. Gut. 2011 Epub ahead of print. [PMC free article] [PubMed] [Google Scholar]

9. Yan F, Cao H, Cover TL, et al. Colon-specific delivery of a probiotic-derived soluble protein ameliorates intestinal inflammation in mice through an EGFR-dependent mechanism. J Clin Invest. 2011;121:2242–2253. [PMC free article] [PubMed] [Google Scholar]

10. Shanahan F. Probiotics in perspective. Gastroenterology. 2010;139:1808–1812. [PubMed] [Google Scholar]

11. Mileti E, Matteoli G, Iliev ID, et al. Comparison of the immunomodulatory properties of three probiotic strains of Lactobacilli using complex culture systems: prediction for in vivo efficacy. PLoS ONE. 2009;4:e7056. [PMC free article] [PubMed] [Google Scholar]

12. Berman S, Spicer D. Safety and Reliability of Lactobacillus Supplements in Seattle, Washington. The Internet Journal of Alternative Medicine. 2003:1. [Google Scholar]

13. Sanders ME. Impact of probiotics on colonizing microbiota of the gut. J Clin Gastroenterol. 2011;45(Suppl):S115–119. [PubMed] [Google Scholar]

14. McNulty NP, Yatsunenko T, Hsiao A, et al. The impact of a consortium of fermented milk strains on the gut microbiome of gnotobiotic mice and monozygotic twins. Sci Transl Med. 2011;3:106ra106. [PMC free article] [PubMed] [Google Scholar]

15. Floch MH, Walker WA, Madsen K, et al. Recommendations for probiotic use-2011 update. J Clin Gastroenterol. 2011;45(Suppl):S168–171. [PubMed] [Google Scholar]

16. Ringel Y, Ringel-Kulka T. The rationale and clinical effectiveness of probiotics in irritable bowel syndrome. J Clin Gastroenterol. 2011;45(Suppl):S145–148. [PubMed] [Google Scholar]

17. Guarner F, Khan AG, Garisch J, et al. Probiotics and prebiotics: World Gastroenterology Organisation Global Guidelines. 2011 Available at: http://www.worldgastroenterology.org/probiotics-prebiotics.html. [PubMed]

18. Thomas DW, Greer FR. Probiotics and prebiotics in pediatrics. Pediatrics. 2010;126:1217–1231. [PubMed] [Google Scholar]

19. Mowat C, Cole A, Windsor A, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011;60:571–607. [PubMed] [Google Scholar]

20. Centre for Evidence Based Medicine Levels of Evidence. 2009 www.cebm.net. Available at: www.cebm.net.

21. Guandalini S. Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol. 2011;45(Suppl):S149–153. [PubMed] [Google Scholar]

22. Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics. 2005;115:5–9. [PubMed] [Google Scholar]

23. Pedone CA, Arnaud CC, Postaire ER, et al. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract. 2000;54:568–571. [PubMed] [Google Scholar]

24. Szajewska H, Kotowska M, Mrukowicz JZ, et al. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr. 2001;138:361–365. [PubMed] [Google Scholar]

25. Szymanski H, Pejcz J, Jawien M, et al. Treatment of acute infectious diarrhoea in infants and children with a mixture of three Lactobacillus rhamnosus strains--a randomized, double-blind, placebo-controlled trial. Aliment Pharmacol Ther. 2006;23:247–253. [PubMed] [Google Scholar]

26. Allen SJ, Martinez EG, Gregorio GV, et al. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010:CD003048. [PMC free article] [PubMed] [Google Scholar]

27. Johnston BC, Goldenberg JZ, Vandvik PO, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2011;11:CD004827. [PubMed] [Google Scholar]

28. Szajewska H, Ruszczynski M, Radzikowski A. Probiotics in the prevention of antibiotic-associated diarrhea in children: a meta-analysis of randomized controlled trials. J Pediatr. 2006;149:367–372. [PubMed] [Google Scholar]

29. McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006;101:812–822. [PubMed] [Google Scholar]

30. Hickson M, D’Souza AL, Muthu N, et al. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ. 2007;335:80. [PMC free article] [PubMed] [Google Scholar]

31. Gao XW, Mubasher M, Fang CY, et al. Dose-response efficacy of a proprietary probiotic formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea prophylaxis in adult patients. Am J Gastroenterol. 2010;105:1636–1641. [PubMed] [Google Scholar]

32. Kelly CP, LaMont JT. Clostridium difficile--more difficult than ever. N Engl J Med. 2008;359:1932–1940. [PubMed] [Google Scholar]

33. Lo Vecchio A, Zacur GM. Clostridium difficile infection: an update on epidemiology, risk factors, and therapeutic options. Curr Opin Gastroenterol. 2012;28:1–9. [PubMed] [Google Scholar]

34. McFarland LV, Surawicz CM, Greenberg RN, et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA. 1994;271:1913–1918. [PubMed] [Google Scholar]

35. Surawicz CM, McFarland LV, Greenberg RN, et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis. 2000;31:1012–1017. [PubMed] [Google Scholar]

36. Na X, Kelly C. Probiotics in clostridium difficile Infection. J Clin Gastroenterol. 2011;45(Suppl):S154–158. [PMC free article] [PubMed] [Google Scholar]

37. Cohen SH, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA) Infect Control Hosp Epidemiol. 2010;31:431–455. [PubMed] [Google Scholar]

38. Brandt LJ, Chey WD, Foxx-Orenstein AE, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol. 2009;104(Suppl 1):S1–35. [PubMed] [Google Scholar]

39. Carroll IM, Ringel-Kulka T, Keku TO, et al. Molecular analysis of the luminal- and mucosal-associated intestinal microbiota in diarrhea-predominant irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol. 2011;301:G799–807. [PMC free article] [PubMed] [Google Scholar]

40. Kassinen A, Krogius-Kurikka L, Makivuokko H, et al. The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects. Gastroenterology. 2007;133:24–33. [PubMed] [Google Scholar]

41. Marshall JK, Thabane M, Garg AX, et al. Incidence and epidemiology of irritable bowel syndrome after a large waterborne outbreak of bacterial dysentery. Gastroenterology. 2006;131:445–450. quiz 660. [PubMed] [Google Scholar]

42. Spiller R, Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009;136:1979–1988. [PubMed] [Google Scholar]

43. Ford AC, Spiegel BM, Talley NJ, et al. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2009;7:1279–1286. [PubMed] [Google Scholar]

44. Pimentel M, Lembo A, Chey WD, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011;364:22–32. [PubMed] [Google Scholar]

45. Spiegel BM. Questioning the bacterial overgrowth hypothesis of irritable bowel syndrome: an epidemiologic and evolutionary perspective. Clin Gastroenterol Hepatol. 2011;9:461–469. quiz e459. [PubMed] [Google Scholar]

46. Moayyedi P, Ford AC, Talley NJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59:325–332. [PubMed] [Google Scholar]

47. Brenner DM, Moeller MJ, Chey WD, et al. The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review. Am J Gastroenterol. 2009;104:1033–1049. quiz 1050. [PubMed] [Google Scholar]

48. Horvath A, Dziechciarz P, Szajewska H. Meta-analysis: Lactobacillus rhamnosus GG for abdominal pain-related functional gastrointestinal disorders in childhood. Aliment Pharmacol Ther. 2011;33:1302–1310. [PubMed] [Google Scholar]

49. O’Mahony L, McCarthy J, Kelly P, et al. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology. 2005;128:541–551. [PubMed] [Google Scholar]

50. Whorwell PJ, Altringer L, Morel J, et al. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol. 2006;101:1581–1590. [PubMed] [Google Scholar]

51. Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med. 2009;361:2066–2078. [PMC free article] [PubMed] [Google Scholar]

52. Sartor RB. Genetics and environmental interactions shape the intestinal microbiome to promote inflammatory bowel disease versus mucosal homeostasis. Gastroenterology. 2010;139:1816–1819. [PubMed] [Google Scholar]

53. Khor B, Gardet A, Xavier RJ. Genetics and pathogenesis of inflammatory bowel disease. Nature. 2011;474:307–317. [PMC free article] [PubMed] [Google Scholar]

54. Sartor RB. Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics. Gastroenterology. 2004;126:1620–1633. [PubMed] [Google Scholar]

55. Danese S, Fiocchi C. Ulcerative colitis. N Engl J Med. 2011;365:1713–1725. [PubMed] [Google Scholar]

56. Schultz M, Timmer A, Herfarth HH, et al. Lactobacillus GG in inducing and maintaining remission of Crohn’s disease. BMC Gastroenterol. 2004;4:5. [PMC free article] [PubMed] [Google Scholar]

57. Bousvaros A, Guandalini S, Baldassano RN, et al. A randomized, double-blind trial of Lactobacillus GG versus placebo in addition to standard maintenance therapy for children with Crohn’s disease. Inflamm Bowel Dis. 2005;11:833–839. [PubMed] [Google Scholar]

58. Prantera C, Scribano ML, Falasco G, et al. Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn’s disease: a randomised controlled trial with Lactobacillus GG. Gut. 2002;51:405–409. [PMC free article] [PubMed] [Google Scholar]

59. Meijer BJ, Dieleman LA. Probiotics in the treatment of human inflammatory bowel diseases: update 2011. J Clin Gastroenterol. 2011;45(Suppl):S139–144. [PubMed] [Google Scholar]

60. Kruis W, Fric P, Pokrotnieks J, et al. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut. 2004;53:1617–1623. [PMC free article] [PubMed] [Google Scholar]

61. Tursi A, Brandimarte G, Papa A, et al. Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment: a double-blind, randomized, placebo-controlled study. Am J Gastroenterol. 2010;105:2218–2227. [PMC free article] [PubMed] [Google Scholar]

62. Sood A, Midha V, Makharia GK, et al. The probiotic preparation, VSL#3 induces remission in patients with mild-to-moderately active ulcerative colitis. Clin Gastroenterol Hepatol. 2009;7:1202–1209. 1209, e1201. [PubMed] [Google Scholar]

63. Miele E, Pascarella F, Giannetti E, et al. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol. 2009;104:437–443. [PubMed] [Google Scholar]

64. Naidoo K, Gordon M, fa*gbemi AO, et al. Probiotics for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2011;12:CD007443. [PubMed] [Google Scholar]

65. Fujimori S, Gudis K, Mitsui K, et al. A randomized controlled trial on the efficacy of synbiotic versus probiotic or prebiotic treatment to improve the quality of life in patients with ulcerative colitis. Nutrition. 2009;25:520–525. [PubMed] [Google Scholar]

66. Shanahan F, Guaraner F, von Wright A, et al. A one year, double-blind, placebo controlled trial of a Lactobacillus or a Bidfidobacterium probiotic for maintenance of steroid-induced remission of ulcerative colitis. Gastroenterology. 2006;130:A-44, 249. [Google Scholar]

67. Gionchetti P, Rizzello F, Helwig U, et al. Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology. 2003;124:1202–1209. [PubMed] [Google Scholar]

68. Mimura T, Rizzello F, Helwig U, et al. Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut. 2004;53:108–114. [PMC free article] [PubMed] [Google Scholar]

69. Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology. 2000;119:305–309. [PubMed] [Google Scholar]

70. Shen B, Brzezinski A, Fazio VW, et al. Maintenance therapy with a probiotic in antibiotic-dependent pouchitis: experience in clinical practice. Aliment Pharmacol Ther. 2005;22:721–728. [PubMed] [Google Scholar]

71. Gosselink MP, Schouten WR, van Lieshout LM, et al. Delay of the first onset of pouchitis by oral intake of the probiotic strain Lactobacillus rhamnosus GG. Dis Colon Rectum. 2004;47:876–884. [PubMed] [Google Scholar]

72. Pardi DS, D’Haens G, Shen B, et al. Clinical guidelines for the management of pouchitis. Inflamm Bowel Dis. 2009;15:1424–1431. [PubMed] [Google Scholar]

73. Holubar SD, Cima RR, Sandborn WJ, et al. Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis. Cochrane Database Syst Rev. :CD001176. [PubMed] [Google Scholar]

74. Lata J, Jurankova J, Kopacova M, et al. Probiotics in hepatology. World J Gastroenterol. 17:2890–2896. [PMC free article] [PubMed] [Google Scholar]

75. Macbeth WA, Kass EH, McDermott WV., Jr Treatment of Hepatic Encephalopathy by Alteration of Intestinal Flora with Lactobacillus Acidophilus. Lancet. 1965;1:399–403. [PubMed] [Google Scholar]

76. Liu Q, Duan ZP, Ha DK, et al. Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology. 2004;39:1441–1449. [PubMed] [Google Scholar]

77. Bajaj JS, Saeian K, Christensen KM, et al. Probiotic yogurt for the treatment of minimal hepatic encephalopathy. Am J Gastroenterol. 2008;103:1707–1715. [PubMed] [Google Scholar]

78. Bajaj JS. [Accessed 12/11/2011];2011 clinicaltrials.gov/ct2/show/NCT00992290. Available.

79. Snydman DR. The safety of probiotics. Clin Infect Dis. 2008;46(Suppl 2):S104–111. discussion S144–151. [PubMed] [Google Scholar]

80. Hempel S, Newberry S, Ruelaz A, et al. Services USDoHaH. Safety of Probiotics to Reduce Risk and Prevent or Treat Disease. 2011. [PMC free article] [PubMed] [Google Scholar]

81. Besselink MG, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;371:651–659. [PubMed] [Google Scholar]

82. Boyle RJ, Robins-Browne RM, Tang ML. Probiotic use in clinical practice: what are the risks? Am J Clin Nutr. 2006;83:1256–1264. quiz 1446–1257. [PubMed] [Google Scholar]

83. Ciorba MA, Stenson WF. Probiotic therapy in radiation-induced intestinal injury and repair. Ann N Y Acad Sci. 2009;1165:190–194. [PMC free article] [PubMed] [Google Scholar]

84. Packey CD, Ciorba MA. Microbial influences on the small intestinal response to radiation injury. Curr Opin Gastroenterol. 2010;26:88–94. [PMC free article] [PubMed] [Google Scholar]

85. Shanahan F, Collins SM. Pharmabiotic manipulation of the microbiota in gastrointestinal disorders, from rationale to reality. Gastroenterol Clin North Am. 2010;39:721–726. [PubMed] [Google Scholar]

A Gastroenterologist’s Guide to Probiotics (2024)
Top Articles
Latest Posts
Article information

Author: Duane Harber

Last Updated:

Views: 5909

Rating: 4 / 5 (71 voted)

Reviews: 86% of readers found this page helpful

Author information

Name: Duane Harber

Birthday: 1999-10-17

Address: Apt. 404 9899 Magnolia Roads, Port Royceville, ID 78186

Phone: +186911129794335

Job: Human Hospitality Planner

Hobby: Listening to music, Orienteering, Knapping, Dance, Mountain biking, Fishing, Pottery

Introduction: My name is Duane Harber, I am a modern, clever, handsome, fair, agreeable, inexpensive, beautiful person who loves writing and wants to share my knowledge and understanding with you.