Experts: The effectiveness of probiotic preparations depends on the microorganisms it contains

Professor Hanna Szajewska, head of the Pediatrics Department of the Medical University of Warsaw reminded that the term "probiotic" refers to living microorganisms - usually bacteria, but also yeasts, which, administered in appropriate amounts, have a beneficial effect on the host organism. But this beneficial effect must be documented in scientific research.

"In the case of probiotics, scientific data are the basis for reliable probiotic therapy. If someone uses a random probiotic, that is not a medical intervention" - emphasised Prof. Szajewska. She pointed out that particular diseases require using specific strains of probiotic microorganisms, the effects of which have been documented.

"All those letters and numbers in the strain names are extremely important, it is like a passport or ID card" - she explained. She advised against buying any probiotic preparations that do not have these markings.

The specialist added that there were not many studies confirming the effectiveness of probiotics in the prevention of various diseases or supporting their treatment. In paediatrics, the benefits of their use in the treatment of acute infectious diarrhoea and prevention of diarrhoea associated with the use of antibiotics have been documented well. The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) recommends two strains in the treatment of these conditions - Lactobacillus GG bacteria or yeasts Saccharomyces boulardii, as their effects have been documented in the studies.

The benefits of using probiotics to prevent or treat allergies, respiratory infections, and necrotizing enterocolitis in premature babies are still less well documented and there are no specific indications.

Professor Grażyna Rydzewska, president of the Gastroenterological Society, noted that the effects of using probiotics were different for children and for adults. In the case of adults, there is still insufficient evidence of the effectiveness of probiotics in the prevention or treatment of antibiotic diarrhoea. "The most common disease in adults, in which probiotic support is used, is the hypersensitive bowel syndrome" - she said. Scientific societies recommend using certain bacterial strains in this case. The second group of diseases of adults, in which gastroenterologists recommend various probiotics, are non-specific inflammatory bowel diseases, including Crohn`s disease and ulcerative colitis.

According to Prof. Szajewska, probiotics are a huge market. About 100 probiotic products are available in Poland, most of them in the form of dietary supplements. Only some are registered as medicines and some are found in food.

The expert pointed to a huge problem with the quality of probiotics. According to Szajewska, information on the labels of these products is often misleading or untrue.

Professor Rydzewska reminded that according to the 2017 report of the Supreme Audit Office, the majority (89 percent) of probiotic preparations in our pharmacies do not meet the requirements. "Many of them did not have the declared content of probiotic strains, and some were contaminated with potentially dangerous and harmful strains" - explained the expert. She added that for a large group of these preparations there were no scientific studies or doctors` recommendations. Meanwhile, patients buy them because they are cheaper and, for example, the manufacturer declares a higher content of strains, which does not translate into effectiveness.

The results of a study conducted in May 2018 for the purposes of the campaign "Probiotic - I choose consciously" show that the social knowledge about probiotics is small. For example, although nearly 57 percent Poles use probiotics, only a quarter of them pays attention to their quality.

Professor Szajewska reminded that the International Scientific Association for Probiotics and Prebiotics had developed special guidelines to facilitate the consumer selection. According to the guidelines, when choosing a probiotic, we should primarily focus the type, species and strain of a given micro-organism the preparation contains, as well as its expiration date, dose, storage conditions and whether the declared action of a given probiotic has been confirmed in scientific research on patients.

According to Prof. Rydzewska, it is a very positive fact that there is more talk about using probiotics and taking care of our microbiome (intestinal microflora), microorganisms that inhabit our body, especially the intestines. "We can expect that probiotics may have a broader effect because our microbiome certainly affects more than just the function of the intestines. However, as of today there is still not enough research and many things remain uncertain" - she concluded. (PAP)

author: Joanna Morga

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