New advice from the American Gastroenterological Association (AGA) that people suffering common digestive conditions should consider stopping using probiotics “ignores scientific evidence”, a leading US trade body says. 

In June, the AGA released new clinical guidelines stating that for most digestive conditions there is not enough evidence to support the use of probiotics. AGA claims this the first clinical guideline to focus on probiotics across multiple GI diseases while also considering the effect of each single-strain or multi-strain formulation of probiotics independently instead of grouping them all under the single umbrella of ‘probiotics’.

The guidelines do support use of certain probiotic formulations in three settings – prevention of Clostridioides difficile (C. difficile) infection in adults and children taking antibiotics, prevention of necrotizing enterocolitis in preterm, low birthweight infants, and management of pouchitis, a complication of inflammatory bowel disease. 

Insufficient evidence
But AGA says there was insufficient evidence to recommend probiotics for treatment of Crohn’s disease, ulcerative colitis, irritable bowel syndrome (IBS) and C. difficile infection. For acute infectious gastroenteritis in children, AGA recommends against the use of probiotics.

“Patients taking probiotics for Crohn’s, ulcerative colitis or IBS should consider stopping,” says guideline panel chair Grace L. Su from University of Michigan, Ann Arbor. “The supplements can be costly and there isn’t enough evidence to prove a benefit or confirm lack of harm. Talk with your doctor.”

This week, the Natural Products Association hit back at the AGA’s stance on probiotics, warning that the guidelines “ignore the bulk of scientific evidence related to the health benefits of probiotics” 

“Consumers should always consult with their doctors or medical professionals before using probiotics, but these guidelines will only lead to more confusion for consumers”

Consumer confusion
“These guidelines are at odds with the overwhelming number of studies supporting the safety and efficacy of probiotics in modern medicine.  Consumers should always consult with their doctors or medical professionals before using probiotics, but these guidelines will only lead to more confusion for consumers,” said Sibyl Swift, NPA Senior vice president for scientific and regulatory affairs.  “Probiotics are among the most popular supplement products, primarily because consumers trust their safety and the important role they play in supporting their health.”

NPA says that thousands of studies have supported the safe use and efficacy of probiotics for a range of treatments and patient populations, including treating acute bowl infections, preventing antibiotic-associated diarrhea in children, managing irritable bowel syndrome and reducing the likelihood of infection during antibiotic treatments.