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Rev Gastroenterol Mex. 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]

Author information

1
Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México. Electronic address: miguelvaldovinosd@gmail.com.
2
Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México.
3
Servicio de Gastroendoscopia, Hospital Regional n.(o) 2 con Unidad de Medicina de Atención Ambulatoria, IMSS, Ciudad de México, México.
4
Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México.
5
Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México, México.
6
Hospital Infantil de las Californias, Tijuana, BC, México.
7
Unidad de Pacientes en Estudio, Universidad Autónoma de Guadalajara, Zapopan, Jalisco, México.
8
UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, IMSS, , Guadalajara, Jalisco, México.
9
Departamento de Medicina Interna, División de Gastroenterología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, N.L., México.
10
Departamento de Epidemiología Genética e Infecciones, CISEI, INSP, Cuernavaca, Mor., México.
11
Práctica privada, San Luis Potosí, S.L.P., México.
12
Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
13
Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
14
Departamento de Gastroenterología Pediátrica, UMAE Hospital General Dr. Gaudencio González Garza, Centro Médico Nacional La Raza, IMSS, Ciudad de México, México.
15
Servicio de Gastroenterología, Hospital Español, Ciudad de México, México.
16
Departamento de Gastroenterología y Endoscopia, UMAE Hospital de Pediatría Dr. Silvestre Frenk Freund, Centro Médico Nacional Siglo XXI, Ciudad de México, México.
17
Clínica de Gastroenterología, Endoscopia Digestiva y Motilidad Gastrointestinal, Hospital Ángeles Puebla, Puebla, México.
18
Departamento de Gastroenterología, Centro Médico Issemym, Metepec, Estado de México, México.
19
Hospital Star Médica, Mérida, Yucatán, México.
20
Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México.
21
Práctica privada, Guadalajara, Jalisco, México.
22
Laboratorio de Motilidad y Fisiología Digestiva, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana (UV), Veracruz, México.
23
Servicio de Gastroenterología, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, IMSS, Ciudad de México, México.
24
Servicio de Gastroenterología Pediátrica y Endoscopia, Hospital Regional ISSSTE, Monterrey, N.L., México.
25
Servicio de Aparato Digestivo, Hospital Vall d'Hebrón, Barcelona, España.

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

PMID:
28104319
DOI:
10.1016/j.rgmx.2016.08.004
[Indexed for MEDLINE]
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