ISAPP Conference Session

Evidence on probiotics and prebiotics by indication

No fully comprehensive guidelines exist on the evidence for various probiotics and prebiotics by indication. Some useful resources have been created, however, which are listed below.


Throughout hundreds of randomized, controlled trials for different indications, probiotics have an excellent safety record. Yet caution should be used when recommending products to those with certain conditions. See here for a current overview.

Continuing education opportunities

ISAPP periodically shares new continuing medical education opportunities on topics related to probiotics, prebiotics, and the microbiome. See here for a list of archived educational materials for clinicians (including gastroenterologists, general practitioners, and dietitians) to learn about probiotics and prebiotics in clinical practice.

Patient education resources

ISAPP has developed a series of scientifically-based, patient-friendly resources to use in your practice: videos and infographics that explain key concepts related to probiotics, prebiotics, and fermented foods.


Journal of Family Practice Online

Targeting gut flora to treat and prevent disease

This article provides evidence-based recommendations for use of probiotics or prebiotics for IBS, IBD, antibiotic-associated diarrhea, acute infectious diarrhea, traveler’s diarrhea, eczema, and diabetes.

Alliance for Education on Probiotics (AEProbio)

Clinical Guide to Probiotic Supplements Available in the United States

Clinical Guide to Probiotic Supplements Available in Canada

These guides, which list the level of evidence for various probiotic products by indication, are independent tools for healthcare professionals. They are made possible through industry-funded educational grants. Also available as a free mobile downloadUS version:  Google Play and the App Store; Canada version: App Store and Google Play.

World Gastroenterology Organisation

WGO Global Guidelines on Probiotics and Prebiotics

This guideline offers evidence for the use of probiotics for various indications. Note especially Tables 8 and 9, which list strains associated with graded evidence for gastrointestinal benefits.

WGO Handbook on Gut Microbes 

Including 15 chapters by global experts on gut microbiota and its role in health and disease, as well as probiotics and prebiotics.

Irritable Bowel Syndrome (IBS): What is it, what causes it and can I do anything about it?

An educational program on IBS for the general public, developed by the WGO.


Probiotics for gastrointestinal diseases

This is an evidence-based clinical decision support resource, authored by R. Balfour Sartor, MD, for clinicians, healthcare providers, and patients. Accessing this article requires a subscription.


Scientific Opinion on the substantiation of health claims related to live yoghurt cultures and improved lactose digestion

This is an opinion document on the use of yogurt cultures to manage symptoms of lactose intolerance.

Continuing Education Opportunities

Navigating the world of probiotics: Helping patients make good choices

On April 17, 2018, Dan Merenstein, MD, and Mary Ellen Sanders, PhD, served as faculty for a CME-eligible webinar sponsored by Medscape on “Navigating the World of Probiotics. Helping Patients Make Good Choices”. Accessing this webinar requires a login.

The expanding health benefits of prebiotics and probiotics

In February 2018, Dan Merenstein, MD, published a CE activity with the Pharmacy Times, called “The Expanding Health Benefits of Prebiotics and Probiotics”.

Probiotics for GI health in 2012: issues and updates

A CME course that includes assessment of probiotics for GI benefits. The course is no longer available for CME credit, but the content is available to view. Note especially Table 1, which provides a list of probiotics associated with graded evidence of GI benefits.