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October 20, 2020
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Probiotics may improve GI symptoms in celiac disease

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Patients with celiac disease who use probiotics may experience improvements in gastrointestinal symptoms, according to results published in the American Journal of Gastroenterology.

"Probiotics may be effective to relief symptoms in people with celiac disease adhering to a GFD, however, we need more good quality and larger randomized controlled trials to increase the confidence in the results and being able to make further recommendations,” Maria Ines Pinto Sanchez, MD, from McMaster University in Hamilton, Ontario, Canada, told Healio Gastroenterology.

Pinto Sanchez and colleagues used EMBASE, Medline, CINAHL, Web of Science, Central, and DARE to identify seven articles that included six randomized controlled trials that compared probiotics with placebo for the treatment of celiac disease. Investigators collected data on GI symptoms, quality of life, adverse events, serum tumor necrosis factor-alpha, intestinal permeability and microbiota composition.

When assessed by the GI symptoms Rating Scale, probiotics improved GI symptoms. No difference was seen in GI symptoms regarding probiotics when investigators pooled different questionnaires. Probiotics increased the levels of bifdobacteria (95% CI, 0.38–1.32 log colony-forming units per gram).

Investigators reported insufficient data on tumor necrosis factor-alpha levels or QOL when comparing probiotics vs. placebo. Adverse events were not different between probiotics and placebo.

“There is a need for additional high-quality large [randomized controlled trials] from different geographical areas, including North America, to assess the effects of specific probiotic bacteria in CD and to investigate the potential mechanisms,” the researchers concluded.