Purpose of review: This review summarizes recent developments in our understanding of what gastrointestinal disorders probiotics can be of benefit for, focussing on conditions associated with infection or disruption of the normal gut flora. New insights into the effects administered strains can have in the gut, their safety, and potential for future development, will also be discussed.
Recent findings: Recent clinical studies have shown that probiotics can protect young children from diarrhoeal illness, including antibiotic-associated diarrhoea. They may also protect neonates from necrotizing enterocolitis. In adults, they can help prevent or reduce the severity of diarrhoeal illness, and ameliorate side-effects for those undergoing antibiotic therapy for infection. Researchers are looking at combining probiotics with prebiotics to enhance anti-inflammatory effects and restore colonization resistance of the commensal flora. New technologies are elucidating complex effects on gene expression in the gut, the probiotic, and bacterial pathogens. Recombinant strains capable of binding bacterial toxins are being developed as novel therapeutics against gastrointestinal infection.
Summary: Considering the clinical trial evidence of therapeutic benefit, probiotics are an underused treatment modality for prevention and amelioration of diarrhoeal illness. Better understanding of strain-specific effects, dosing regimens and any contraindications should help resolve this.