BACKGROUND: In 2013, a systematic review and Delphi consensus reported that specific probiotics can benefit adult patients with irritable bowel syndrome (IBS) and other gastrointestinal (GI) problems. AIM: To update the consensus with new evidence. METHODS: A systematic review identified randomised, placebo-controlled trials published between January 2012 and June 2017. Evidence was graded, previously developed statements were reassessed by an 8-expert panel, and agreement was reached via Delphi consensus. RESULTS: A total of 70 studies were included (IBS, 34; diarrhoea associated with antibiotics, 13; diarrhoea associated with Helicobacter pylori eradication therapy, 7; other conditions, 16). Of 15 studies that examined global IBS symptoms as a primary endpoint, 8 reported significant benefits of probiotics vs placebo. Consensus statements with 100% agreement and "high" evidence level indicated that specific probiotics help reduce overall symptom burden and abdominal pain in some patients with IBS and duration/intensity of diarrhoea in patients prescribed antibiotics or H. pylori eradication therapy, and have favourable safety. Statements with 70%-100% agreement and "moderate" evidence indicated that, in some patients with IBS, specific probiotics help reduce bloating/distension and improve bowel movement frequency/consistency. CONCLUSIONS: This updated review indicates that specific probiotics are beneficial in certain lower GI problems, although many of the new publications did not report benefits of probiotics, possibly due to inclusion of new, less efficacious preparations. Specific probiotics can relieve lower GI symptoms in IBS, prevent diarrhoea associated with antibiotics and H. pylori eradication therapy, and show favourable safety. This study will help clinicians recommend/prescribe probiotics for specific symptoms.

Barcelona Spain

Bergen Norway

Brighton UK

Brussels Belgium

Heraklion Greece

Manchester UK

Newcastle upon Tyne UK

Oxford UK

Prague Czech Republic

Rome Italy

Stockholm Sweden

Utrecht The Netherlands

000      

00000naa a2200000 a 4500

001      

bmc19028565

003      

CZ-PrNML

005      

20190816095537.0

007      

ta

008      

190813s2018 enk f 000 0|eng||

009      

AR

024    7_

$a 10.1111/apt.14539 $2 doi

035    __

$a (PubMed)29460487

040    __

$a ABA008 $b cze $d ABA008 $e AACR2

041    0_

$a eng

044    __

$a enk

100    1_

$a Hungin, A P S $u Newcastle upon Tyne, UK.

245    10

$a Systematic review: probiotics in the management of lower gastrointestinal symptoms - an updated evidence-based international consensus / $c APS. Hungin, CR. Mitchell, P. Whorwell, C. Mulligan, O. Cole, L. Agréus, P. Fracasso, C. Lionis, J. Mendive, JM. Philippart de Foy, B. Seifert, KA. Wensaas, C. Winchester, N. de Wit, European Society for Primary Care Gastroenterology,

520    9_

$a BACKGROUND: In 2013, a systematic review and Delphi consensus reported that specific probiotics can benefit adult patients with irritable bowel syndrome (IBS) and other gastrointestinal (GI) problems. AIM: To update the consensus with new evidence. METHODS: A systematic review identified randomised, placebo-controlled trials published between January 2012 and June 2017. Evidence was graded, previously developed statements were reassessed by an 8-expert panel, and agreement was reached via Delphi consensus. RESULTS: A total of 70 studies were included (IBS, 34; diarrhoea associated with antibiotics, 13; diarrhoea associated with Helicobacter pylori eradication therapy, 7; other conditions, 16). Of 15 studies that examined global IBS symptoms as a primary endpoint, 8 reported significant benefits of probiotics vs placebo. Consensus statements with 100% agreement and "high" evidence level indicated that specific probiotics help reduce overall symptom burden and abdominal pain in some patients with IBS and duration/intensity of diarrhoea in patients prescribed antibiotics or H. pylori eradication therapy, and have favourable safety. Statements with 70%-100% agreement and "moderate" evidence indicated that, in some patients with IBS, specific probiotics help reduce bloating/distension and improve bowel movement frequency/consistency. CONCLUSIONS: This updated review indicates that specific probiotics are beneficial in certain lower GI problems, although many of the new publications did not report benefits of probiotics, possibly due to inclusion of new, less efficacious preparations. Specific probiotics can relieve lower GI symptoms in IBS, prevent diarrhoea associated with antibiotics and H. pylori eradication therapy, and show favourable safety. This study will help clinicians recommend/prescribe probiotics for specific symptoms.

650    _2

$a zvířata $7 D000818

650    _2

$a konsensus $7 D032921

650    _2

$a průjem $x farmakoterapie $7 D003967

650    _2

$a infekce vyvolané Helicobacter pylori $x farmakoterapie $7 D016481

650    12

$a Helicobacter pylori $7 D016480

650    _2

$a lidé $7 D006801

650    _2

$a syndrom dráždivého tračníku $x farmakoterapie $7 D043183

650    _2

$a probiotika $x terapeutické užití $7 D019936

650    _2

$a randomizované kontrolované studie jako téma $7 D016032

655    _2

$a časopisecké články $7 D016428

655    _2

$a práce podpořená grantem $7 D013485

655    _2

$a systematický přehled $7 D000078182

700    1_

$a Mitchell, C R $u Oxford, UK.

700    1_

$a Whorwell, P $u Manchester, UK.

700    1_

$a Mulligan, C $u Brighton, UK.

700    1_

$a Cole, O $u Oxford, UK.

700    1_

$a Agréus, L $u Stockholm, Sweden.

700    1_

$a Fracasso, P $u Rome, Italy.

700    1_

$a Lionis, C $u Heraklion, Greece.

700    1_

$a Mendive, J $u Barcelona, Spain.

700    1_

$a Philippart de Foy, J-M $u Brussels, Belgium.

700    1_

$a Seifert, B $u Prague, Czech Republic.

700    1_

$a Wensaas, K-A $u Bergen, Norway.

700    1_

$a Winchester, C $u Oxford, UK.

700    1_

$a de Wit, N $u Utrecht, The Netherlands.

710    2_

$a European Society for Primary Care Gastroenterology

773    0_

$w MED00009085 $t Alimentary pharmacology & therapeutics $x 1365-2036 $g Roč. 47, č. 8 (2018), s. 1054-1070

856    41

$u https://pubmed.ncbi.nlm.nih.gov/29460487 $y Pubmed

910    __

$a ABA008 $b sig $c sign $y a $z 0

990    __

$a 20190813 $b ABA008

991    __

$a 20190816095807 $b ABA008

999    __

$a ok $b bmc $g 1433714 $s 1067025

BAS    __

$a 3

BAS    __

$a PreBMC

BMC    __

$a 2018 $b 47 $c 8 $d 1054-1070 $e 20180220 $i 1365-2036 $m Alimentary pharmacology & therapeutics $n Aliment Pharmacol Ther $x MED00009085

LZP    __

$a Pubmed-20190813