Fundamental research into the human microbiome has provided a mechanistic basis for what probiotic scientists have known all along: augmentation of the populations and activities of our colonizing microbes can improve health. This idea is catching on with consumers – the market for probiotic ingredients is strong (~$40 billion worldwide in 2015) and projected to continue robust growth globally.
The idea is also catching on with clinicians. As evidence of this trend, the Journal of Family Practice just published a paper providing guidance to family practice physicians about when to recommend probiotics or prebiotics (Schneiderhan et al. 2016). The paper grades available evidence for probiotics or prebiotics in the management of irritable bowel syndrome (grade A), inflammatory bowel disease (grade A), antibiotic associated diarrhea (grade A), acute infectious diarrhea (grade A), traveler’s diarrhea (grade B), eczema (grade B) and diabetes (grade C), and recommends specific products for patients. It also discusses research areas of clinical importance that are on the horizon, pointing to guarded optimism that probiotics may play a role in the future for managing obesity, psychiatric illnesses (including depression and autism spectrum disorder) and some autoimmune conditions.
After stressing the importance of diets rich in fruits and vegetables, they conclude that since currently available probiotics have a strong safety profile, that recommending them for patients to help manage IBS, ulcerative colitis, acute infectious diarrhea, antibiotic-associated diarrhea and traveler’s diarrhea is reasonable. Such practical recommendations are evidence that the medical community is embracing the available evidence for probiotics and points to the importance of continued research to optimize probiotics for human health.
Schneiderhn J, Master-Hunter T, Locke A. 2016. Targeting gut flora to treat and prevent disease. J Family Practice 65(1): 33-38.