New ISAPP publication sheds light on the translation of probiotic research into clinical guidelines
In an expert panel at the ISAPP 2025 annual meeting in Banff, clinicians and other experts addressed the issue of clinical translation of biotic science. One primary challenge raised by the medical professionals on the panel was how to navigate guidelines from trusted professional societies when they produce differing conclusions about the use of probiotics for gastrointestinal disorders.
Sharing key outcomes of this discussion, several panel members have led the publication of an Editorial in Gut Microbes on this topic: “When probiotics guidelines differ: a practical guide for clinicians and researchers” (1). The article directly addresses this recognised issue in the probiotic field, discussing why it arises and providing suggestions for interpreting recommendations that differ in either subtle or significant ways. The authors also outline a case study, comparing the recommendations published by AGA in 2020 with the ones published by ESPGHAN in 2023.
The authors state, “Disagreement among probiotic guidelines is not a failure of evidence-based medicine”, but they say these discrepancies arise because of multiple, complex factors: disparate data collection and endpoints, strain-specific effects and other intricacies of probiotic research, different criteria for evaluating evidence, as well as human judgment.
Many guideline recommendations for probiotics are conditional, guiding clinicians to work with individual patients to weigh potential benefits, risks, and individual preferences to make a decision consistent with their values. Accordingly, the authors shared the view that guidelines are tools to support decision making, rather than providing a definitive answer for all patients.
Ultimately to continue strengthening confidence in probiotic recommendations, the Editorial argues, more high-quality and transparent research is needed – and this research must be communicated clearly and effectively. The authors also provide tips for researchers to increase the clinical impact of future research, moving toward a future where probiotic evidence leads to clear and consistent recommendations.
(1) Preidis GA, Szajewska H, Cunningham M, Bauchner H, Merenstein DJ. When probiotics guidelines differ: a practical guide for clinicians and researchers. Gut Microbes. 2026;18(1):2657049.
