A Meta-Analysis of Probiotic Efficacy for Gastrointestinal Diseases
Open accessAbstract
BACKGROUND: Meta-analyses on the effects of probiotics on specific gastrointestinal diseases have generally shown positive effects on disease prevention and treatment; however, the relative efficacy of probiotic use for treatment and prevention across different gastrointestinal diseases, with differing etiology and mechanisms of action, has not been addressed. METHODS/PRINCIPAL FINDINGS: We included randomized controlled trials in humans that used a specified probiotic in the treatment or prevention of Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, Antibiotic Associated Diarrhea, Traveler's Diarrhea, or Necrotizing Enterocolitis. Random effects models were used to evaluate efficacy as pooled relative risks across the eight diseases as well as across probiotic species, single vs. multiple species, patient ages, dosages, and length of treatment. Probiotics had a positive significant effect across all eight gastrointestinal diseases with a relative risk of 0.58 (95% (CI) 0.51-0.65). Six of the eight diseases: Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, and Antibiotic Associated Diarrhea, showed positive significant effects. Traveler's Diarrhea and Necrotizing Enterocolitis did not show significant effects of probiotcs. Of the 11 species and species mixtures, all showed positive significant effects except for Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium infantis. Across all diseases and probiotic species, positive significant effects of probiotics were observed for all age groups, single vs. multiple species, and treatment lengths. CONCLUSIONS/SIGNIFICANCE: Probiotics are generally beneficial in treatment and prevention of gastrointestinal diseases. Efficacy was not observed for Traveler's Diarrhea or Necrotizing Enterocolitis or for the probiotic species L. acidophilus, L. plantarum, and B. infantis. When choosing to use probiotics in the treatment or prevention of gastrointestinal disease, the type of disease and probiotic species (strain) are the most important factors to take into consideration.
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Probiotic efficacy is well established to be strain-, dose-, and formulation-specific, with clinical benefit demonstrated only for selected organisms and indications rather than for probiotics as a class.
“Probiotic efficacy is well established to be strain-, dose-, and formulation-specific, with clinical benefit demonstrated only for selected organisms and indications rather than for probiotics as a class.52-54”
From Safety and efficacy concerns in Indian probiotics: Insights from whole-genome sequencing and <i>in vitro</i> assessment (2026) · cites this paper as [54]
The Discussion says probiotic species or strain and the GI disease being treated are important to efficacy; the Results also find significant effects for eight of eleven species examined. But the Discussion says dosage has relatively minor effects and reports no efficacy difference between single- and multiple-species preparations. It also concludes that probiotics are generally beneficial for GI diseases, so this paper does not support the claim's full dose- and formulation-specific framing or its rejection of a class-level benefit. (LLM, conf=0.88)
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- Authors
- Ritchie, M. L., & Romanuk, T. N.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Ritchie, Marina L.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2012-04-18
- Volume
- 7
- Issue
- 4
- Pages
- e34938
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3329544
- OpenAlex
- W2010508425
- Cited by
- 474
- References
- 88
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 24 · 2023: 33 · 2022: 31 · 2021: 43 · 2020: 37 · 2019: 34 · 2018: 34 · 2017: 36 · 2016: 41 · 2015: 44 · 2014: 28 · 2013: 35 · 2012: 14
- FWCI
- 5.09
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DalSpace (Dalhousie University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Natural Sciences and Engineering Research Council of Canada
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- probiotics, gastrointestinal diseases, probiotic efficacy, pouchitis, infectious diarrhea, irritable bowel syndrome, Helicobacter pylori, antibiotic-associated diarrhea, traveler's diarrhea, necrotizing enterocolitis, Lactobacillus acidophilus, Lactobacillus plantarum, Bifidobacterium infantis, disease prevention
- MeSH terms
- Age Factors, Gastrointestinal Diseases, Humans, Randomized Controlled Trials as Topic, Treatment Outcome, Publication Bias, Probiotics
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