Clinical Guidance and Practical Recommendations for Probiotic Use in Patients With Irritable Bowel Syndrome,...

Area of Science:

• Gastroenterology
• Microbiology
• Immunology

Background:

• Probiotics are increasingly considered for lower gastrointestinal disorders.
• Evidence for their efficacy, especially concerning sex-related differences, is limited.
• This review focuses on probiotics for irritable bowel syndrome (IBS), functional constipation (FC), and Clostridioides difficile infection (CDI).

Purpose of the Study:

• To provide evidence-based insights and practical recommendations for probiotic use in IBS, FC, and CDI.
• To consider potential sex-related differences in probiotic efficacy.
• To guide clinicians in selecting appropriate probiotic interventions.

Main Methods:

• Review of evidence from randomized controlled trials and meta-analyses.
• Analysis of clinical studies and experimental animal models for IBS.
• Consideration of immunological differences related to sex and age for CDI.

Main Results:

• Probiotics show modest, strain-specific benefits for IBS symptoms (global, pain, bloating) and FC (bowel frequency, stool consistency).
• Clinical studies show no significant sex differences in IBS, but animal models suggest potential sex-dependent responses.
• Probiotic efficacy for preventing CDI is inconsistent; routine use is not typically recommended.

Conclusions:

• Probiotics may serve as adjunctive therapy for IBS and FC, with responses influenced by microbial, host, and potential sex-related factors.
• Current evidence does not support routine probiotic use for CDI prevention.
• Personalized probiotic strategies, considering strain specificity and patient characteristics (including sex), require further research.