The Mexican consensus on probiotics in gastroenterology

Area of Science:

• Gastroenterology
• Microbiology
• Clinical Therapeutics

Background:

• Probiotics are widely used for gastrointestinal disorders, but their effective prescription is hindered by knowledge gaps and product variability.
• Clinical trials support probiotic efficacy, yet standardized usage guidelines are lacking.

Purpose of the Study:

• To establish a consensus-driven review and evidence-based recommendations for probiotic use in clinical gastroenterology.
• To guide healthcare professionals in the appropriate selection and application of probiotics.

Main Methods:

• A systematic literature search identified controlled trials, meta-analyses, and reviews up to 2015.
• The Delphi method involved 32 gastroenterologists (adult and pediatric) to formulate consensus statements.
• GRADE system assessed the level of evidence for each recommendation.

Main Results:

• Eleven general statements and 27 disease-specific statements on probiotics were formulated.
• High agreement (>70%) was reached on recommendations for various gastrointestinal conditions.

Conclusions:

• Probiotics are recommended for preventing antibiotic-associated diarrhea and Clostridium difficile infection.
• Specific indications include treatment of infectious diarrhea, irritable bowel syndrome, functional constipation, and inflammatory bowel disease.
• Probiotics are also recommended for necrotizing enterocolitis prevention and managing hepatic encephalopathy.