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Question clinique
Are probiotics effective in improving symptoms in patients with celiac disease?
L’Essentiel
This systematic review demonstrates that the evidence for probiotics in treating patients with celiac disease is limited to a handful of low-quality studies. 1a-
Référence
Plan de l'etude: Meta-analysis (randomized controlled trials)
Financement: Unknown/not stated
Cadre: Various (meta-analysis)
Sommaire
These authors searched multiple databases and a clinical trials registry to identify randomized trials of probiotics for treating patients with celiac disease. Additionally, they hand-searched the bibliographies of the included studies. The authors identified 8 unique publications, 7 of which (N = 5279 participants) could provide data for pooling. All the studies took place in tertiary medical centers outside of North America; 78% of the participants were women. Only 2 studies used the same probiotic strain and dose. So, if there is no class effect of probiotics, then there is a high probability of selective publication. The authors also describe variability in the inclusion and diagnostic criteria of the participants. The overall methodologic quality of the studies was low. The included studies used a variety of different means to assess response. Although, overall, there was no improvement in symptoms, the 2 studies that used the Gastrointestinal Symptoms Rating Scale reported marked symptom reduction. The authors also looked at largely irrelevant outcomes, such as changes in gut flora and tumor necrosis factor-alpha levels. There were insufficient data on quality of life. All of the studies reported on adverse events and only 7 events occurred, so not much can be concluded about that.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Commentaires
probiotics
I believe there is a potential there but we do not understand all the things bacteria do and more studies are needed. When we introduce bacteria into the gut, which ones end up predominating. does the body prefer certain bacteria based on Genetics??
probiotics in celiac
no proven use but also no harm