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. 2017 Apr-Jun;82(2):156-178.
doi: 10.1016/j.rgmx.2016.08.004. Epub 2017 Jan 16.

The Mexican consensus on probiotics in gastroenterology

[Article in English, Spanish]
M A Valdovinos  1 , E Montijo  2 , A T Abreu  3 , S Heller  4 , A González-Garay  5 , D Bacarreza  6 , M Bielsa-Fernández  7 , M C Bojórquez-Ramos  8 , F Bosques-Padilla  9 , A I Burguete-García  10 , R Carmona-Sánchez  11 , A Consuelo-Sánchez  12 , E Coss-Adame  13 , J A Chávez-Barrera  14 , M de Ariño  15 , J Flores-Calderón  16 , O Gómez-Escudero  17 , M S González-Huezo  18 , M E Icaza-Chávez  19 , A Larrosa-Haro  20 , M Morales-Arámbula  21 , C Murata  5 , J A Ramírez-Mayans  2 , J M Remes-Troche  22 , T Rizo-Robles  23 , M Peláez-Luna  13 , E M Toro-Monjaraz  2 , A Torre  13 , M E Urquidi-Rivera  24 , R Vázquez  12 , J K Yamamoto-Furusho  13 , F Guarner  25
Affiliations
Free article

The Mexican consensus on probiotics in gastroenterology

[Article in English, Spanish]
M A Valdovinos et al. Rev Gastroenterol Mex. 2017 Apr-Jun.
Free article

Abstract

Introduction: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available.

Aim: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology.

Materials and methods: Controlled clinical trials, meta-analyses, and systematic reviews published up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases, humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologists treating adult patients and 14 pediatric gastroenterologists formulated statements that were voted on until agreement>70% was reached. The level of evidence based on the GRADE system was evaluated for each statement.

Results and conclusions: Eleven statements on the general concepts of probiotics and 27 statements on the use of probiotics in gastrointestinal diseases in both adults and children were formulated. The consensus group recommends the use of probiotics under the following clinical conditions: the prevention of diarrhea associated with antibiotics, the treatment of acute infectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enterocolitis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief from irritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis, and the treatment of covert and overt hepatic encephalopathy.

Keywords: Adultos; Adults; Children; Consenso; Consensus; Enfermedades gastrointestinales; Gastrointestinal diseases; Mexico; México; Niños; Probiotics; Probióticos.

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