Comparison Table
Organization | Country | Year | Statement Summary | Recommendation Level | Evidence Quality Rating | Conclusion |
|---|---|---|---|---|---|---|
American College of Gastroenterology (ACG) Clinical Guideline: Management of IBS<span class="ref">1</span> | USA | 2021 | “We suggest against probiotics for the treatment of global IBS symptoms.” | Conditional | Very low | Recommends against probiotic use in IBS |
American Gastroenterological Association (AGA)<span class="ref">2</span> | USA | 2020 | “In symptomatic children and adults with irritable bowel syndrome, we recommend the use of probiotics only in the context of a clinical trial.” | No recommendation | N/A | No recommendation or does not advise routine probiotic use in IBS |
Experts of Yale Workshop on Probiotics<span class="ref">3</span> | USA | 2015 | Recommended 4 probiotics, but no summary statement was provided. The recommended strains included: -Bifidobacterium infantis 35624 -VSL #3 -B. animalis -L. plantarum 299v | N/A | Each recommended strain was given an effectiveness letter ranking of either a B or C, though the meaning of these rankings was not explicitly stated | Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations |
The Asian Neurogastroenterology and Motility Association (ANMA) – Second Asian Consensus <span class="ref">4</span> | Asia | 2019 | “The effectiveness of probiotics has not been fully validated in IBS.” | No recommendations | moderate | No recommendation or does not advise routine probiotic use in IBS |
British Society of Gastroenterology<span class="ref">5</span> | UK | 2021 | “Probiotics, as a group, may be an effective treatment for global symptoms and abdominal pain in IBS, but it is not possible to recommend a specific species or strain. It is reasonable to advise patients wishing to try probiotics to take them for up to 12 weeks, and to discontinue them if there is no improvement in symptoms.” | Weak | Very Low | Probiotic use may be considered in IBS. Probiotic response and trials should be assessed within a certain time frame or aimed at specified symptoms |
British Dietetic Association (BDA)<span class="ref">6</span> | UK | 2016 | “Probiotics are unlikely to provide substantial benefit to IBS symptoms. However, individuals choosing to try probiotics are advised to select one product at a time and monitor the effects. They should try it for a minimum of 4 weeks at the dose recommended by the manufacturer. Taking a probiotic product is considered safe in IBS.” | Grade B (The meaning of grade rankings was not explained) | N/A | Probiotic use may be considered in IBS. Probiotic response and trials should be assessed within a certain time frame or aimed at specified symptoms |
Canadian Association of Gastroenterology<span class="ref">7</span> | Canada | 2019 | “We suggest offering IBS patients probiotics to improve IBS symptoms.” | Conditional | Low-quality | Advises probiotic use in IBS but with no strain-specific recommendations |
German Society for Digestive and Metabolic Diseases<span class="ref">8</span> | Germany | 2011 | Probiotics recommended in most/some IBS patients with pain and diarrhea, constipation and bloating/abdominal distension/meteorism/flatulence: Bifidobacterium infantis 35624 Bifidobacterium animalis ssp . lactis DN-173 010 Lactobacillus casei Shirota Lactobacillus plantarum 299v Lactobacillus rhamnosus GG (only in children) E. coli Nissle 1917 | Level A Meaning for physicians: Different decisions are appropriate for different patients, depending on the patient’s situation but also on personal opinions and preferences. Meaning for patients: The majority of patients (> 50%) would decide in favor of the intervention, but many would not. | Strong consensus | Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations |
Japanese Society of Gastroenterology (JSGE)<span class="ref">9</span> | Japan | 2021 | “Probiotics are effective in treating IBS. Probiotics are recommended for IBS.” | Strong recommendation | Level A (High) | Advises probiotic use in IBS but with no strain-specific recommendations |
Korean Society of Neurogastroenterology and Motility (KSNM)<span class="ref">10</span> | Korea | 2018 | “Probiotics may be considered to relieve global symptoms, bloating, and flatulence in irritable bowel syndrome patients.” | Weak (2) | Low Quality (C) | Probiotic use may be considered in IBS. Probiotic response and trials should be assessed within a certain time frame or aimed at specified symptoms |
Polish Society of Gastroenterology<span class="ref">11</span> | Poland | 2018 | “We suggest using certain strains or combinations of probiotic strains tested for their efficacy in IBS, rather than probiotics as a group to reduce overall symptoms of IBS as well as bloating and diarrhea in patients with IBS… It is not possible to determine the efficacy of individual strains included in combined preparations or the efficacy of other configurations (blends) of the aforementioned strains” Monostrains: – Bifidobacterium bifidum MIMBb75 – Bifidobacterium infantis 35624 – Bifidobacterium lactis – Escherichia coli DSM17252 – Lactobacillus acidophilus SDC 2012, 2013 – Lactobacillus plantarum 299v Strains tested in selected populations, or an effect covering only a part of symptoms: – Bacillus coagulans GBI-30, 6086 – Bifidobacterium animalis – Saccharomyces boulardii CNCM I-745 Blends: – Combined preparation: Lactobacillus rhamnosus NCIMB 30174, L. plantarum NCIMB 30173, L. acidophilus NCIMB and Enterococcus faecium NCIMB 30176 – Combined preparation: Lactobacillus animalis subsp. lactis BB-12, L. acidophilus LA-5, L. delbrueckii subsp. bulgaricus LBY-27 and Streptococcus thermophilus STY-31; Bifidobacterium animalis DN-173 010 in fermented milk (together with Streptococcus thermophilus and Lactobacillus bulgaricus) – Combined preparation: Lactobacillus rhamnosus GG, L. rhamnosus LC705, Propionibacterium freudenreichii subsp. shermanii JS DSM 7067 and Bifidobacterium animalis subsp. lactis Bb12 DSM 15954 – Combined preparation Pediococcus acidilactici CECT 7483, Lactobacillus plantarum CECT 7484 and L. plantarum CECT 7485 – Combined preparation: Streptococcus thermophilus DSM24731, Bifidobacterium longum DSM24736, Bifidobacterium breve DSM24732, Bifidobacterium infantis DSM24737, Lactobacillus acidophilus DSM24735, Lactobacillus plantarum DSM24730, Lactobacillus paracasei DSM24733 and Lactobacillus delbrueckii ssp. bulgaricus DSM24734 | Weak quality of evidence | Very Low | Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations |
Romanian Society of Neurogastroenterology<span class="ref">12</span> | Romania | 2021 | “In patients with IBS, we recommend the use of probiotics as an alternative therapy in trials of limited duration.” | Weak | B (Several studies available, at least one of high quality, others with limitations; trustworthy) | Advises probiotic use in IBS but with no strain-specific recommendations |
World Gastroenterology Organisation (WGO)<span class="ref">13</span> | Global | 2017 | “A reduction in abdominal bloating and flatulence as a result of probiotic treatments is a consistent finding in published studies; some strains may ameliorate pain and provide global relief. The literature suggests that certain probiotics may alleviate symptoms and improve the quality of life in patients with functional abdominal pain.” Recommended strains and Blends: -Bifidobacterium bifidum MIMBb75 (3) -Lactobacillus plantarum 299v (DSM 9843) (2) -Escherichia coli DSM17252 (2) -Lactobacillus rhamnosus NCIMB 30174, L. plantarum NCIMB 30173, L. acidophilus NCIMB 30175, and Enterococcus faecium NCIMB 30176. (2) -Lactobacillus animalis subsp. lactis BB-12®, L. acidophilus LA5®, L. delbrueckii subsp. bulgaricus LBY-27, Streptococcus thermophilus STY-31 (3) -Saccharomyces boulardii CNCM I-745 (2) -Bifidobacterium infantis 35624 (2) -Bifidobacterium animalis DN-173 010 in fermented milk (with Streptococcus thermophilus and Lactobacillus bulgaricus) (2) - Lactobacillus acidophilus SDC 2012, 2013 (3) -Lactobacillus rhamnosus GG, L. rhamnosus LC705, Propionibacterium freudenreichii subsp. shermanii JS DSM 7067, Bifidobacterium animalis subsp. lactis Bb12 DSM 15954 (2) -Bacillus coagulans GBI-30, 6086 (3) -Pediococcus acidilactici CECT 7483, Lactobacillus plantarum CECT 7484, L. plantarum CECT 7485 (3) | N/A | Numerical evidence quality rankings were ascribed to each strain. All rankings for IBS probiotics were either a 2 or a 3 (see parenthesis next to strains in statement summary section). Evidence level of 2: Randomized trial or observational study with dramatic effect Evidence level of 3: Nonrandomized controlled cohort / follow-up study | Advises strain-specific probiotic use in IBS and/or provides specific strain/strain blend recommendations |
