Article

A Meta-Analysis of Probiotic Efficacy for Gastrointestinal Diseases

Department of Biology, Dalhousie University, Halifax, Nova Scotia, Canada.
PLoS ONE (Impact Factor: 3.53). 04/2012; 7(4):e34938. DOI: 10.1371/journal.pone.0034938
Source: PubMed

ABSTRACT Meta-analyses on the effects of probiotics on specific gastrointestinal diseases have generally shown positive effects on disease prevention and treatment; however, the relative efficacy of probiotic use for treatment and prevention across different gastrointestinal diseases, with differing etiology and mechanisms of action, has not been addressed.
We included randomized controlled trials in humans that used a specified probiotic in the treatment or prevention of Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, Antibiotic Associated Diarrhea, Traveler's Diarrhea, or Necrotizing Enterocolitis. Random effects models were used to evaluate efficacy as pooled relative risks across the eight diseases as well as across probiotic species, single vs. multiple species, patient ages, dosages, and length of treatment. Probiotics had a positive significant effect across all eight gastrointestinal diseases with a relative risk of 0.58 (95% (CI) 0.51-0.65). Six of the eight diseases: Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, and Antibiotic Associated Diarrhea, showed positive significant effects. Traveler's Diarrhea and Necrotizing Enterocolitis did not show significant effects of probiotcs. Of the 11 species and species mixtures, all showed positive significant effects except for Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium infantis. Across all diseases and probiotic species, positive significant effects of probiotics were observed for all age groups, single vs. multiple species, and treatment lengths.
Probiotics are generally beneficial in treatment and prevention of gastrointestinal diseases. Efficacy was not observed for Traveler's Diarrhea or Necrotizing Enterocolitis or for the probiotic species L. acidophilus, L. plantarum, and B. infantis. When choosing to use probiotics in the treatment or prevention of gastrointestinal disease, the type of disease and probiotic species (strain) are the most important factors to take into consideration.

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    • "However, their efficacy varied between different age groups or length of treatment or for single versus multiple species (Ritchie and Romanuk 2012). Similarly, L. crispatus CCTCC M206119 strain was found to be involved in the exacerbation of intestinal inflammation in DSS-colitis mice (Zhou et al. 2012), suggesting the safety and strain based specificity against specific diseases (Ritchie and Romanuk 2012; Van Neil 2005). In a previous study conducted in our laboratory, Sudhakaran et al. (2013) assessed the anti-inflammatory properties of one of the most potent indigenous L. plantarum strains Lp91 both in vitro in THP- 1 cell lines and in vivo using mouse model under inflammatory conditions, demonstrating significant downregulation of TNF-a and increase in IL-6 expression. "
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    Genes & Nutrition 05/2014; 9(3):398. DOI:10.1007/s12263-014-0398-2 · 3.42 Impact Factor
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    • "The Western human diet contains several thousand times less bacteria than preindustrialized diets, mainly due to improved hygiene and nutrition and the use of processed and sterile foods which contain artificial sweeteners and preservatives, rather than fresh fruits and vegetables [1]. Decreased concentration of the gut microbiome or dysbiosis may be implicated in gastrointestinal disorders including diarrheal diseases, ulcerative colitis, inflammatory bowel diseases, and life style diseases [2]. "
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    01/2014; 2014:208064. DOI:10.1155/2014/208064
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    Annals of Gastroenterology 01/2012; 25(4):371.
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