Efficacy Of Probiotic Supplementation Research Articles

Efficacy of probiotic supplementation in preventing infections in pediatric populations

Efficacy of probiotic supplementation in preventing infections in pediatric populations

Efficacy of probiotic supplementation in the treatment of psoriasis-A systematic review and meta-analysis.

Many studies have emphasized the possible role of probiotics in psoriasis, probiotic supplementation might be helpful to treat psoriasis. This study systematically evaluated the efficacy of probiotic supplementation for the treatment of psoriasis. We searched some databases with keywords until November 10, 2023, including PubMed, Cochrane Library, Embase, and Web of Science. These keywords included probiotics, psoriasis RCT, and so on. After rigorous literature screening by two authors, five studies were identified. Eventually, the required data were independently extracted by another author. A total of five studies with 286 patients were included. The pooled results showed that the efficacy of probiotic supplementation was superior to placebo in the treatment of psoriasis. The Psoriasis Area and Severity Index (SMD = -1.40, 95% Cl = -2.63 to -0.17, p < 0.00001) and Dermatology Life Quality Index (SMD = -0.92, 95% Cl = -1.86 to 0.01, p < 0.00001). Score decreased after probiotic supplementation. The meta-analysis showed that probiotic supplementation could be a new treatment option for psoriasis.

Randomized controlled trial to study the safety and efficacy of probiotics supplementation in addition to the standard treatment in novel coronavirus (SARS‑CoV‑2) positive patients

Background: The severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) infection spread at a catastrophic rate, rapidly becoming a pandemic. Apart from the symptoms related to viral infection, a few patients with Coronavirus Disease 2019 (COVID-19) also experienced gastrointestinal symptoms. There was initial evidence of intestinal microbial dysbiosis in COVID-19 cases, and a few international studies showed the benefits of probiotics in reducing gastrointestinal (GI) symptoms and favorably altering the course of COVID-19 disease. Aims and Objectives: This study was planned to investigate if probiotics show any beneficial effects on COVID-19 disease in Indian patients. Materials and Methods: A prospective, randomized, open-label study was conducted to evaluate the effect of probiotic supplements added to the existing standard treatment in patients with the novel coronavirus SARS-CoV2 and compared them with the control group. Ninety patients were included in this study and were observed on day 1, day 3, day 5, day 10, day 14, and day of discharge for progression or recovery. Patients were monitored for symptom progression, the need for oxygen therapy, ventilation needs, etc. Results: There was no significant difference in the parameters at baseline in either of the groups. Cough was significantly less in group A (the standard control group) compared to group B (the probiotic group) only on day 5. No significant difference in the number of patients with coughs was seen on the other days. Other important parameters were not significantly different on any day of observation. Conclusion: The study results do not support the use of probiotics for the treatment of GI symptoms related to COVID19 and do not alter the course of COVID-19 disease or symptoms so as to be used as adjunct therapy for COVID-19 patients.

Efficacy of probiotics supplementation in amelioration of celiac disease symptoms and enhancement of immune system

Patients with celiac disease (CD) have a mucosal layer that is unable to regulate the gut microbiota, leaving the host vulnerable to dangerous infections and antigens. When compared to healthy people, this dysbiosis is marked by a decrease in intra- and intergeneric biodiversity, which demonstrates an imbalance between helpful bacteria and possibly harmful or proinflammatory species. The early gut microbiota is influenced by the genotype of newborns with the HLA-DQ2 haplotypes, and this may modify how gluten is handled in the intestinal lumen, polarize innate or adaptive immune responses, and result in glutensensitive enteropathy. The outcome of gluten digestion can vary depending on the composition of the intestinal gut bacteria and the partial conversion of gluten into peptides larger than ten amino acids in the small intestines, which can be immunogenic. In the small intestine, 114 different bacterial strains belonging to 32 different species have 27 of them exhibiting peptidolytic activity. Thus, the individual risk of developing a gluten-related illness is further influenced by microbial composition and gluten degrading capacity. The conclusion that lactobacilli and Bifidobacterium spp. may be used as a probiotic supplement in CD patients is based on their shared possession of the most extensive peptidolytic and proteolytic activity thought to be engaged in the breakdown of gluten among all potential bacterial genera present in the gut microbiota. In children with CD autoimmunity, daily oral dose of Lactobacillus. plantarum HEAL9 and Lactobacillus. paracasei 8700:2 was found to modify the peripheral immune response. Bifidobacterium. breve strains have demonstrated a beneficial effect on reducing pro-inflammatory cytokine TNF- production in CD children on gluten-free diets.

Safety and efficacy of probiotic supplementation in 8 types of inflammatory arthritis: A systematic review and meta-analysis of 34 randomized controlled trials.

ObjectiveTo evaluate Safety and efficacy of probiotic supplementation in inflammatory arthritis.MethodsThe literature on the treatment of inflammatory arthritis with probiotics has been collected in databases such as CNKI, Pubmed, Cochrane library, Embase, etc. The search time is for them to build the database until May 2022. The included literatures are randomized controlled trials (RCTs) of probiotics in the treatment of hyperuricemia and gout. The Cochrane risk assessment tool was used for quality evaluation, and the Rev Man5.3 software was used for meta-analysis.ResultsA total of 37 records were finally included, involving 34 RCTs and 8 types of autoimmune disease (Hyperuricemia and gout, Inflammatory bowel disease arthritis, juvenile idiopathic arthritis [JIA], Osteoarthritis [OA], Osteoporosis and Osteopenia, Psoriasis, rheumatoid arthritis (RA), Spondyloarthritis). RA involved 10 RCTs (632 participants) whose results showed that probiotic intervention reduced CRP. Psoriasis involved 4 RCTs (214 participants) whose results showed that probiotic intervention could reduce PASI scores. Spondyloarthritis involved 2 RCTs (197 participants) whose results showed that probiotic intervention improved symptoms in patients. Osteoporosis and Ostepenia involving 10 RCTs (1156 participants) showed that probiotic intervention improved bone mineral density in patients. Hyperuricemia and gout involving 4 RCTs (294 participants) showed that probiotic intervention improved serum uric acid in patients. OA involving 1 RCTs (433 participants) showed that probiotic intervention improved symptoms in patients. JIA involving 2 RCTs (72 participants) showed that probiotic intervention improved symptoms in patients. Inflammatory bowel disease arthritis involving 1 RCTs (120 participants) showed that probiotic intervention improved symptoms in patients. All of the above RCTs showed that probiotics did not increase the incidence of adverse events.ConclusionProbiotic supplements may improve Hyperuricemia and gout, Inflammatory bowel disease arthritis, JIA, OA, Osteoporosis and Osteopenia, Psoriasis, RA, Spondyloarthritis. However, more randomized controlled trials are needed in the future to determine the efficacy and optimal dosing design of probiotics.Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021286425, identifier CRD42021286425.

Efficacy of Probiotics Supplementation on the Prognosis of Patients After Liver Transplantation: a Systematic Review and Meta-analysis

Efficacy of Probiotics Supplementation on the Prognosis of Patients After Liver Transplantation: a Systematic Review and Meta-analysis

Efficacy of Probiotic Supplementation for the Treatment of Pediatric Atopic Dermatitis. A Systematic Review and Meta-analysis: Assessment of SCORAD Index, Serum Immunoglobulin-E, and Interleukin-4 Parameters

Efficacy of Probiotic Supplementation for the Treatment of Pediatric Atopic Dermatitis. A Systematic Review and Meta-analysis: Assessment of SCORAD Index, Serum Immunoglobulin-E, and Interleukin-4 Parameters

Targeting the Gut Microbiome in Prader-Willi Syndrome.

Overwhelming evidence demonstrates an important role of the gut microbiome in the development of a wide range of diseases, including obesity, metabolic disorders, and mental health symptoms. Indeed, interventions targeting the gut microbiome are being actively investigated as a therapeutic strategy to tackle these diseases. Given that obesity and mental health symptoms are both hallmarks of Prader-Willi syndrome, targeting the gut microbiome may be a promising therapeutical strategy. Only a few studies have investigated the gut microbiome in the context of Prader-Willi syndrome and assessed the efficacy of probiotic supplementation as a therapeutic strategy for this disease. Here, we review the knowledge obtained to this date regarding the gut microbiome in individuals with Prader-Willi syndrome. The limited evidence available indicate that probiotic supplementation improves some metabolic and mental health aspects, however further studies are warranted to determine whether targeting the gut microbiome may constitute a safe and efficient strategy to treat individuals with Prader-Willi syndrome.

Probiotics in the Management of Atopic Dermatitis for Children: A Case-Based Review

Background Atopic dermatitis or eczema is one of the most common dermatologic problems, especially in children. Several studies have hypothesized that alteration of gut-colonizing microbes might have induced and conditioned the development of the disease. Thus, modulation of microbial diversity and abundance might help alleviate symptoms and conditions for patients. Given the ability of commensal and symbiotic microorganisms in modulating the immune system, probiotics administration has been studied in previous research in the management of eczema. However, until today, there are conflicting results between studies making inconclusive recommendations towards probiotics supplementation in the management of atopic dermatitis. This case-based review was done to assess and evaluate the therapeutic efficacy of probiotics supplementation in the management of eczema in children. Method An electronic database search was conducted in PubMed-NCBI, Cochrane, EBSCO, ProQuest, and SCOPUS in March 2020. Individual studies and reviews were then gathered for screening using predetermined inclusion and exclusion criteria. The included studies were then critically appraised for their validity and importance. Result A total of 5 studies, all of which were RCTs, were included in this review. Out of all the studies included, 4 showed no clinically significant improvements in using probiotics in the management of eczema in children as they did not pass the minimal clinically important difference (MCID) of eczema severity as determined by SCORAD (SCORing Atopic Dermatitis). Conclusion Supplementation of probiotics in the management of eczema in children does not show a clinically relevant difference vs. standard treatment in reducing eczema severity.

Microbiota profile and efficacy of probiotic supplementation on laxation in adults affected by Prader-Willi Syndrome: A randomized, double-blind, crossover trial.

BackgroundProbiotics may provide a benefit for adults with Prader‐Willi syndrome (PWS) experiencing constipation. The primary aim was to determine if Bifidobacterium animalis ssp. lactis B94 (B. lactis B94) improves stool frequency, with secondary aims of stool form and gastrointestinal symptoms. Exploratory aims included diet quality and fecal microbiota composition.MethodsFollowing a 4‐week baseline, 25 adults with PWS were randomized to consume B. lactis B94 by capsule (15 billion) or placebo for 4 weeks, followed by 4‐week washout in a double‐blind, crossover design. Stool frequency and Bristol Stool Form (BSF) were assessed daily, and Gastrointestinal Symptom Rating Scale (GSRS) and dietary intake (7‐days food records), per period. Fecal microbiota per period was analyzed using 16S rRNA gene amplicon sequencing and taxa of interest by qPCR (n = 24).ResultsNo adverse events were reported. Stool frequency at baseline (n = 25; 2.0 ± 0.1 stools/day), GSRS syndromes, and microbiota composition did not differ with the probiotic intervention overall; however, a delayed, carry‐over effect on BSF types 6 and 7 was seen. Diet quality by HEI‐2015 was 65.4 ± 8.5.ConclusionIn adults with PWS, B. lactis B94 exhibited little effect on laxation over 4 weeks; however, further research is needed.

Impact of a short-term synbiotic supplementation on metabolic syndrome and systemic inflammation in elderly patients: a randomized placebo-controlled clinical trial.

The connection between gut microbiota imbalance, inflammation and its role in the pathogenesis of metabolic syndrome (MetS) clustering factors has been increasingly recognized. However, data on the efficacy of probiotics supplementation on MetS components are few and almost lacking in the elderly. To address this issue, we conducted a randomized, double-blind, placebo-controlled, parallel-group, clinical study on a large sample of MetS elderly patients. After 14days of diet and physical activity standardization, 60 elderly patients were randomized to treatment with a synbiotic formula of Lactobacillus plantarum PBS067, Lactobacillus acidophilus PBS066 and Lactobacillus reuteri PBS072 with active prebiotics or placebo. Patients were evaluated anamnestically and by the execution of a physical examination and laboratory and haemodynamic analyses at the baseline and after 60days of treatment. At enrollment and at the end of the trial, all enrolled patients complete the EuroQol-5 Dimension (EQ-5D) questionnaire. Through the 2-month period of treatment, patients who received active treatment experienced a statistically significant improvement in waist circumference and in fasting plasma insulin, total cholesterol, high-density lipoprotein cholesterol, non-HDL-C, triglycerides (TG), low-density lipoprotein cholesterol, high-sensitivity C-reactive protein and tumor necrosis factor alpha serum levels, compared both to the baseline and the control group. Visceral adiposity index improvement in the synbiotic treatment group was significantly greater than in placebo group. Compared to baseline, treatment with synbiotics also significantly reduced mean arterial pressure and fasting plasma glucose. All treatment groups demonstrated a significant decrease in TG. TG reduction in the synbiotic group was significantly greater than in the control group. The EQ-5D VAS questionnaire significantly improved only in probiotics-treated subjects. Treatment with a synbiotic formula of L. plantarum PBS067, L. acidophilus PBS066 and L. reuteri PBS072 with active prebiotics decreased MetS syndrome prevalence, several cardiovascular risk factors and markers of insulin resistance in elderly patients.

The gut microbiome and the potentials of probiotics: an interview with Simon Gaisford.

In this exclusive interview, Simon Gaisford discusses his current research into gut dysbiosis and its possible relevance to disease states, as well as the efficacy of probiotic supplementation and its possible use as treatment. This interview was conducted by Ellen Colvin,Commissioning Editor of Future Microbiology. Professor Simon Gaisford is the Head of Department at UCL School of Pharmacy, University College London. He uses isothermal microcalorimetry to monitor the growth and interactions of bacteria, with his research-interest focus on the use of probiotic supplements to improve general health and well-being, ameliorate symptoms of disease and eradicate gut pathogens. He has published 120 papers, four books and eight book chapters.

Does probiotics reduce crying time in infantile colic in exclusively breastfed babies? A comprehensive meta-analysis

Background : Infantile colic is one of the common pediatric problems that Pediatricians encounter in practice. This condition is associated with excessive crying in healthy thriving infants over a regular period during the day and is sustained for the first few months of life. It has been historically described as irritable or compulsive crying or paroxysmal fussing with multifactorial etiology. Although it affects 5-19% of young infants, it remains a frustrating problem for parents and caregivers, because it is difficult to treat and may result in significant psychosocial consequences. Different treatment options are available with no definitive and conclusive benefit. In this metaanalysis, we pooled relevant data regarding the use of probiotics in infantile colic and tried to find out any beneficial effect thereof.Objective : To evaluate the efficacy of probiotics supplementation in the reduction of the duration of crying time in infantile colic.Method : It is a comprehensive meta-analytic study where literature searches were conducted in the Pubmed using end note package and Google scholar. Randomized controlled trials those enrolled healthy, term breastfed infants with infantile colic were included for analysis. After meticulous scrutiny for methods and study population, five studies with a total of 384 breastfed infants were selected for final analysis. All these studies used Lactobacillus reuteri DSM 17938 as probiotics in the therapeutic intervention and supplementation of this was compared to placebo.Result : Analysis of pooled data showed that at Initiation of therapy mean difference of crying time 0.29 minutes; 95% CI-6.61, 7.20, p=0.89, after 3weeks of probiotics therapy mean difference of crying time -30.64, 95% CI- 34.48, -26.81, p=0.0001.Conclusions : Probiotics use for 3 weeks significantly reduced the duration of crying time in exclusively breastfed infants suffering from infantile colic.Northern International Medical College Journal Vol.9(1) July 2017: 245-247

The efficacy of probiotic supplementation in rheumatoid arthritis: a meta-analysis of randomized, controlled trials.

Probiotics are considered as -immunomodulatory agents; their efficacy as an adjunct therapy option for rheumatoid arthritis (RA), however, remains controversial. The main aim of the present meta-analysis, therefore, was to compare available data from the published randomized, controlled trials (RCTs) recruiting adults with RA which compared probiotics with placebo. The English literature search was performed using Ovid version of Medline, EmBase, Web of Science, and the Central Cochrane library through October 2016 and supplemented by hand searching reference lists. Among 240 citations identified, 4 RCTs (153 participants; 89% female) were included. All data were pooled using a standardized mean difference (SMD) with a 95% CI. Compared to the placebo, probiotics did not change the inflammatory parameters (erythrocyte sedimentation rate, tumor necrosis factor [TNF]-α, interleukin [IL]-1β, IL-6, IL-10, and IL-12) and oxidative stress indices (total antioxidant capacity and malondialdehyde) significantly. The borderline significant reduction as a result of probiotic administration was only determined in C-reactive protein [SDM -0.32 (95% CI -0.65 to 0.00)]. Among disease activity indices (disease activity score [DAS], tender joint count, and swollen joint count), DAS showed a significant improvement following probiotic treatment with a SMD (95% CI) of -0.58 (-0.97 to -0.19). The number of trials was too small to determine if a strain-, dose-, or duration-response effect was present. Probiotics seem to be less effective in RA; however, to reach a firm conclusion, we need further evidence.

Efficacy of Probiotics Supplementation On Chronic Kidney Disease: a Systematic Review and Meta-Analysis

Background/Aims: Dysbiosis of the intestinal microbiota may accelerate the progression of chronic kidney disease (CKD) by increasing the levels of urea toxins. In recent years, probiotics have been recognized to maintain the physiological balance of the intestinal microbiota. In this study, we aim to assess the therapeutic effects of probiotics on CKD patients with and without dialysis via meta-analysis. Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) by searching the databases of Pubmed, EMBASE and Cochrane Library (No. CRD42018093080). Studies on probiotics for treatment of CKD adults lasting for at least 4 weeks were selected. The primary outcomes were the levels of urea toxins, and the second outcomes were the levels of interleukin (IL)-6, C-reactive protein (CRP) and hemoglobin (Hb). The risk of bias was assessed by Cochrane Collaboration’ tool, and the quality of evidence was appraised with the Grading of Recommendation Assessment. Means and standard deviations were analyzed by random effects analysis. Stratified analysis was done and sensitivity analysis was performed when appropriate. Results: Totally, eight studies with 261 patients at CKD stage 3 to 5 with and without dialysis were included. We found a decrease of p-cresyl sulfate (PCS) of 3 studies with 125 subjects (P = 0.01, SMD -0.57, 95% CI, -0.99 to -0.14, I² = 25%) and an increase of IL-6 in 3 studies with 134 subjects (P = 0.03, 95% CI, SMD 0.37, 0.03 to 0.72, I² = 0%) in the probiotics groups. Analysis of serum creatinine (P = 0.47), blood urine nitrogen (P = 0.73), CRP (P = 0.55) and Hb (P = 0.49) yielded insignificant difference. Conclusion: Limited number of studies and small sample size are limitations of our study. Probiotics supplementation may reduce the levels of PCS and elevate the levels of IL-6 whereby protecting the intestinal epithelial barrier of patients with CKD.

Probiotics for the prevention or treatment of hyperbilirubinaemia in late preterm and term neonates

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the safety and efficacy of probiotics supplementation in preventing hyperbilirubinaemia among late preterm (born at gestational age (GA) 34 weeks to 36 weeks and six days) and term neonates (≥ 37 weeks) To determine the safety and efficacy of probiotics supplementation in treating hyperbilirubinaemia among late preterm (born at 34 weeks to 36 weeks and six days) and term neonates (≥ 37 weeks) Subgroup analyses will include gestational age at birth (term vs late preterm), cause of jaundice (haemolytic vs non-haemolytic jaundice), mode of feeding at the time of enrolment (exclusive breastfeeding vs mixed feeding/formula feeding), and types of probiotics used.

Efficacy of probiotic supplementation on growth performance and carcass traits in Japanese quails

This study aimed to evaluate the effects of probiotics on fattening performance and carcass parameters in 1– to 35–day-old Japanese quails. Day-old male Japanese quail chicks (288) were randomly divided into 4 treatments with 3 replicates of 24 / pen (mean body weight 8.39 g). The dietary treatments were as follows: Group A, basal diet; group B, basal diet supplemented with 0.5 kg/tonne protexin; group C, basal diet supplemented with 1.0 kg/ tonne protexin; and group D, basal diet supplemented with 1.5 kg/tonne protexin. The study lasted for 5 weeks. Results showed that probiotic did not influence body weight gain (BWG), feed intake (FI), feed conversion ratio (FCR), and carcass traits of 35–d-old broilers (P&gt; 0.05). Inclusion of 1.5 kg/tonne probiotic in the diet of quails decreased average weekly body weights, compared with those fed with basal diet and another groups (P&lt; 0.05).

Efficacy of probiotic supplementation on quality of life and pulmonary symptoms due to sulfur mustard exposure: a randomized double-blind placebo-controlled trial

Objective: This study investigated the efficacy and safety of supplementation with probiotics in improving chronic pulmonary symptoms due to sulfur mustard (SM) exposure. Methods: In a randomized double-blind placebo-controlled study, 65 subjects suffering from chronic pulmonary complications of SM were assigned to one probiotic capsule (1 × 109 CFU containing seven strains of lactic acid-producing bacteria) every 12 h or an identical placebo for six weeks. Serum high-sensitivity C-reactive protein (CRP) concentrations, pulmonary function tests (FEV1, FEV1/FVC and MMEF 25–75%) and COPD assessment test (CAT) were assessed at baseline and at the end of trial. Results: The groups were comparable in baseline characteristics. There were significant improvements in FEV1/FVC in the probiotic but not in placebo group. CAT scores were decreased in both study groups. However, between-group comparison of changes in the assessed parameters reached statistical significance only for CAT score (p < 0.001). There was no report of adverse events during the course of trial. Conclusions: Findings of the present trial favor the efficacy of probiotic supplementation in improving the pulmonary symptoms of SM-exposed subjects.

Meta-analysis of randomized controlled trials on the efficacy of probiotics in Helicobacter pylori eradication therapy in children

The efficacy of probiotics supplementation in children undergoing Helicobacter pylori (H. pylori) eradication therapy remains controversial. This study aimed to meta-analyze whether probiotics supplementation in triple therapy could improve H. pylori eradication rates and reduce therapy-related side effects in children. Electronic databases PubMed and Embase were searched to identify all randomized controlled trials in pediatric patients comparing probiotics supplementation with placebo or no extra intervention in H. pylori eradication therapy. Two authors independently extracted the data. Results were expressed as odds ratios (ORs) and accompanying 95 % confidence intervals (CIs). Stata version 12.0 was used to perform all statistical analyses. Seven studies consisting of 508 pediatric patients were included in our study. The pooled ORs (studies n = 7) of eradication rates by intention-to-treat and per-protocol analysis in the probiotics group versus the control group were 1.96 (95 % CI 1.28-3.02) and 2.25 (95 % CI 1.41-3.57), respectively. The pooled OR (studies n = 5) of incidence of total side effects was 0.32 (95 % CI 0.13-0.79), with significant heterogeneity observed (I (2) = 71.9 %). Probiotics supplementation in triple therapy for H. pylori infection may have beneficial effects on eradication and therapy-related side effects, particularly diarrhea, in children.

Role of Probiotics in Short Bowel Syndrome in Infants and Children—A Systematic Review

Short bowel syndrome (SBS) is a cause of significant morbidity and mortality in children. Probiotics, due to their beneficial effects on the gastrointestinal tract (e.g., improving gut barrier function, motility, facilitation of intestinal adaptation and decreasing pathogen load and inflammation) may have a therapeutic role in the management of SBS. To conduct a systematic review of the current evidence for the effects of probiotic supplementation in children with SBS, the standard Cochrane methodology for systematic reviews was used. The databases, Pubmed, Embase, ACTR, CENTRAL, and the international trial registry, and reference lists of articles were searched for randomised (RCT) or quasi-randomised controlled trials reporting on the use of probiotics in SBS. Our search revealed no RCTs on the use of probiotics in children with SBS. We found one small cross-over RCT (placebo controlled crossover clinical trial), one case control study and nine case reports on the use of probiotics in children with SBS. In the crossover RCT, there was no consistent effect on intestinal permeability (primary outcome) after supplementation with Lactobacillus rhamnosus (LGG) in nine children with SBS. The case control study (four cases: four controls) reported a trend for increase in height and weight velocity and improvement in non-clinical outcomes, such as gut flora, lymphocyte count and serum prealbumin. Five of the nine case reports showed that children (n = 12) with SBS were benefited (e.g., cessation of diarrhoea, improved faecal flora, weight gain and weaning from parenteral nutrition) by probiotic supplementation. The remaining four reported on the adverse effects, such as Lactobacillus sepsis (n = 3) and D-lactic acidosis (n = 2). There is insufficient evidence on the effects of probiotics in children with SBS. The safety and efficacy of probiotic supplementation in this high-risk cohort needs to be evaluated in large definitive trials.