Probiotics

peer reviewedThe interest in the knowledge of the importance of the microbiome present in the gastrointestinal tract is exploding. While a balanced microbiome is related to health, an imbalanced microbiome or dysbiosis is related to many health problems both within the gastrointestinal tract, such as diarrhea and inflammatory bowel disease, and outside the gastrointestinal tract such as obesity, allergy, and development and functioning of the immune system. We are just starting to understand how manipulation of the microbiome can results in harmful and beneficial effects. Strict regulation of the commercialized products is one of the most urgent things to do because the vast majority of these products are commercialized as food (supplements) claiming health benefits which are often not substantiated with clinical relevant evidence. The major indications of probiotics are in the area of the prevention and treatment of gastrointestinal related disorders, but more data become available on extraintestinal indications such as vaginitis, atopic dermatitis, respiratory tract infections, obesity. At least two published randomized controlled trials with the commercialized probiotic product in the claimed indication are a minimal condition before a claim can be sustained. Today, Lactobacillus caseii GG and Saccharaomyces boulardii are the best-studied strains. Although adverse effects have been reported, probiotics are considered as safe