The AGA Center for Gut Microbiome Research and Education responded to two recently published studies in The New England Journal of Medicine on the usage of probiotics in children with acute gastroenteritis — “Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children” and “Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis.” The studies received significant media coverage and stimulated questions about the value of probiotics for children with gastrointestinal symptoms.
The comments of the AGA Center for Gut Microbiome Research and Education about the studies are not an endorsement of these studies or their findings. They are meant to clarify the issues and offer a guide to facilitate conversations with physician colleagues, as well as parents and caregivers to pediatric patients.
TALKING TO YOUR PATIENTS
- These studies show that two particular probiotic supplements containing L. rhamnosus GG or L. rhamnosus R0011/L. helveticus R0052 at the prescribed doses, frequencies, and durations are of no benefit for children with acute gastroenteritis in North America.
- These results are not necessarily generalizable to children in other geographic locations where specific pathogens such as rotavirus are more prevalent, to adults with acute gastroenteritis, or to children and adults with other gastrointestinal disorders.
- These studies examined two specific products sold in the U.S. and Canada in the context of a particular population (children), condition (acute gastroenteritis), and dose (4 x 109 or 1 x 1010 CFU). Until similarly rigorous studies are performed with other probiotic products, we cannot conclude that other probiotic products are beneficial or cause no harm.
- Probiotics are generally thought to be safe for healthy children. However, as with adults, probiotics should be used with caution in children who have a chronic illness, are immunocompromised or are otherwise vulnerable. Probiotics should not be used indiscriminately; potential risks and benefits should be considered as for all therapeutic interventions.
- Probiotics currently on the market are foods or dietary supplements. To date, no probiotic products have been approved by the FDA to treat, mitigate, cure or prevent specific diseases.
AGA has recently developed educational materials for patients on probiotics, which can be accessed at www.gastro.org/probiotics in English and Spanish.