2879 Evaluating the Pattern of Probiotic Use by Patients and Gastroenterology Providers

Abstract

INTRODUCTION: Probiotic use for management of GI conditions is becoming more popular, as it is perceived to be a natural and low-risk therapeutic option. Despite their increasing use, how patients choose to use probiotics or how GI providers make recommendations has not been well-studied. This survey aims to characterize the pattern of probiotic use by patients and GI providers. METHODS: Surveys were distributed to patients seen at a GI clinic at a single tertiary medical center. Surveys were also distributed to GI providers who attended a regional postgraduate course. Survey questions included basic demographics, indication for probiotic use, subjective clinical response to probiotics, side effects, brand of probiotics, and factors that influenced choice of probiotics. RESULTS: 76 patient surveys and 58 provider responses were collected. Patients used probiotics for general digestive health (22%), IBS (17%), and GERD (16%), while providers recommended probiotics for IBS (81%), Clostridioides difficile infection (64%), and IBD (45%). For symptoms, patients used probiotics to treat abdominal pain (38%) and bloating (26%), while providers recommended it for bloating (76%) and diarrhea (71%). 45% of patients reported improvement of GI symptoms, whereas 21% reported no improvement. Side effects were uncommon, but bloating and diarrhea were most frequently reported. Providers recommended specific brands and bacterial strains, while patients took a wide variety of brands without knowing specific strains. Most patients (82%) chose to take probiotics without their provider’s recommendations. Patients’ selection of probiotics was driven by cost, variety of strain, and number of colonies forming units. 91% of providers felt the need for more specific guidelines on probiotic use. CONCLUSION: This study shows that patients and their gastroenterologists have vastly different probiotic “prescribing” patterns. Despite a relative lack of evidence for many conditions, probiotics were frequently utilized. Patients use probiotics for different symptoms and conditions than physicians and have remarkably different factors that influence selection of a probiotic. Providers should proactively discuss current evidence on probiotic use and help patients identify key features and differences between probiotic products.