Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice - an evidence-based international guide

Autor: C. Mulligan, B. Pot, J.-m. Philippart De Foy, Christos Lionis, A. P. S. Hungin, Greg Rubin, Christopher C Winchester, Lars Agréus, N.J. de Wit, P. Fracasso, Peter J. Whorwell, Juan M. Mendive
Přispěvatelé: Department of Bio-engineering Sciences, Faculty of Arts and Philosophy
Rok vydání: 2013
Předmět:
Diarrhea
Abdominal pain
medicine.medical_specialty
Evidence-based practice
Systematic Reviews
Gut flora
Medical sciences
Placebo
Gastroenterology
Irritable Bowel Syndrome
Bloating
Quality of life
Delphi technique
Internal medicine
medicine
Humans
Pharmacology (medical)
Bescherming en bevordering van de menselijke gezondheid
Geneeskunde(GENK)
Intensive care medicine
Irritable bowel syndrome
Randomized Controlled Trials as Topic
Econometric and Statistical Methods: General
Irritable Bowel Syndrome/therapy
Hepatology
biology
business.industry
Geneeskunde (GENK)
Probiotics
Probiotics/therapeutic use
Anti-Bacterial Agents/adverse effects
biology.organism_classification
medicine.disease
General [Econometric and Statistical Methods]
Abdominal Pain
Anti-Bacterial Agents
Diarrhea/chemically induced
medicine.symptom
business
Abdominal Pain/therapy
Zdroj: Alimentary Pharmacology & Therapeutics
Alimentary pharmacology and therapeutics, 2013, Vol.38(8), pp.864-886 [Peer Reviewed Journal]
Alimentary Pharmacology & Therapeutics, 38(8), 864. Wiley-Blackwell
ISSN: 0269-2813
DOI: 10.1111/apt.12460
Popis: BackgroundEvidence suggests that the gut microbiota play an important role in gastrointestinal problems. AimTo give clinicians a practical reference guide on the role of specified probiotics in managing particular lower gastrointestinal symptoms/problems by means of a systematic review-based consensus. MethodsSystematic literature searching identified randomised, placebo-controlled trials in adults; evidence for each symptom/problem was graded and statements developed (consensus process; 10-member panel). As results cannot be generalised between different probiotics, individual probiotics were identified for each statement. ResultsThirty seven studies were included; mostly on irritable bowel syndrome [IBS; 19 studies; treatment responder rates: 18–80% (specific probiotics), 5–50% (placebo)] or antibiotic-associated diarrhoea (AAD; 10 studies). Statements with 100% agreement and ‘high’ evidence levels indicated that: (i) specific probiotics help reduce overall symptom burden and abdominal pain in some IBS patients; (ii) in patients receiving antibiotics/Helicobacter pylori eradication therapy, specified probiotics are helpful as adjuvants to prevent/reduce the duration/intensity of AAD; (iii) probiotics have favourable safety in patients in primary care. Items with 70–100% agreement and ‘moderate’ evidence were: (i) specific probiotics help relieve overall symptom burden in some patients with diarrhoea-predominant IBS, and reduce bloating/distension and improve bowel movement frequency/consistency in some IBS patients and (ii) with some probiotics, improved symptoms have led to improvement in quality of life. ConclusionsSpecified probiotics can provide benefit in IBS and antibiotic-associated diarrhoea; relatively few studies in other indications suggested benefits warranting further research. This study provides practical guidance on which probiotic to select for a specific problem.
Databáze: OpenAIRE
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