Hi everyone
Thanks for all your help - I've now written my piece on probiotics, which covers the few uses for which there is evidence of benefit.
But the take-home message is there’s little evidence to support most health claims made for probiotics. No surprise!
Read it here: nhs.uk/Conditions/probiotic...
Comments welcome 
Were you aware the words 'probiotic' and 'prebiotic' themselves are now considered health claims and are not authorised under EFSA rules? The ASA (who adjudicate on the EFSA rules) ruled this in February: asa.org.uk/Rulings/Adjudica...
This basically means that these words cannot be used!
The new EU regulation came in at the end of 2012 but I must admit I had forgotten about it. Just out of interest, I looked at the Danone website for Activia.
danone.co.uk/products/activia/
On the actual page, they do not use the word Probiotic. Er, well, not quite. In the meta description that the search engines pick up they say "Learn about Activia: a delicious, creamy, fruity probiotic yogurt..."
There has been a campaign by the food manufacturers to get the word probiotic accepted as a general descriptor (foodmanufacture.co.uk/Regul..., but the last I read it looked like it may well fail - not totatlly sure what the position is at the moment.
Is that so? So I guess they now call themselves "yoghurts containing live bacteria" and just allude to gut health benefits. I bet this is still an effective marketing strategy.
Indeed. All they have to do is get better at advertising, but it still takes it a small step in the right direction!
Hi Cazza, Thanks for sharing. Have you seen there was a study reported on today in the Mail (and Mirror), "Probiotics 'don't ease' baby colic: Study finds drops have no effect on reducing periods of crying among children aged under three months"
dailymail.co.uk/health/arti...
I did see this, thanks, and the news team covered it here: nhs.uk/news/2014/04April/Pa...
It was a helpful study - important in evidence-based medicine to highlight failures as well as successes, to counter potential publication bias
Hmm well, let's be gritty about this. I'll just tell you that following antibiotics for a chest infection last year (first antibiotics for 20 years), I was concerned about all my internal bacteria being knocked out and I got some probiotics from a company called Higher Nature who produce high quality, properly researched and tested supplements. To my surprise, the result was stools of which I suspect an African would have been proud. I see that your approach is always to attack and destroy anything that is not within your description of mainstream so perhaps you'll tell me I imagined it. Now I'm not taking them my poo has reverted to something less bulky.
Were you to be interested, this is what I took - highernature.co.uk/ShowProd...
If you read the article properly, you will see that it is acknowledged that Probiotics can be helpful in dealing with c-difficile (if it occurs) by replacing missing bacteria following a course of antibiotics.
However, it should also be noted that this problem does not affect everyone (I have never had a bad stomach following antibiotics) and your average, supermarket probiotic yoghurt drink will do the job happily. So, unless you are lactose intolerant, you don't need to spend money on anything extra.
The point about the article is that there are a lot of claims that go far beyond these well documented uses that are far less scientific and possibly rubbish.
It isn't about having an upset stomach Joss, it's about getting thrush both vaginal and oral which is very unpleasant for some people and is the reason why in countries like Germany, probiotics will be prescribed at the same time as antibiotics. The NHS recognises the problem: nhs.uk/Conditions/Thrush/Pa...
Clearly much is available regarding research into C. difficile sciencebasedmedicine.org/iv...
I can see it is tempting therefore to write an authoritative sounding piece for the NHS Living Well pages but it seems both wiser and kinder to not stamp on possibilities that some people might benefit from.
Why kinder? Well let's face it, science is not I biased truth, sometimes something can be proven unquestionably and forever, often, as the best scientists will agree, science is progressive and open to revision. With people it is important to take into account the kind of variation I stated in my response but also the effects of placebo which we all know can result in cure or improvement rates of 40-60%. So why kinder? Because it seems to me that someone who writes informative, perhaps platitudinous pieces for the NHS might take care not to destroy hope while laying out their pitch.
Particularly if you work with older people as I do, you are aware of declining NHS services, longer waiting times, the tiredness and anxiety that come with chronic and long term illnesses. ObviouslY one doesn't want to give false hope or give space to completely useless potions or therapies but people and their biology are more subtle than mainstream science likes to admit and being open and humble are more useful attributes than blind faith in double blind trials.
Information, accurate information is always important.
However, it is not just important but vital that it is clear where things have been proved to have worked and where the evidence is unclear or unreliable.
This is not about being kind, but being fair to people in a world where many manufacturers will push the credibility and claims for their product way beyond what they should be able to get away with. I see nothing kind in saying to a person of any age "well there is no proof that it works, but go on, try it anyway."
And I would say that main stream science has probably the BEST understanding of human biology and indeed spends huge amounts of time and research in documenting and trying to understand the tiny differences between people and how those can be better accommodated in treatments and therapies.
I see no problem with the article at all - it allows for all kinds of possibilities, but warns against the lack of evidence in many areas, especially those claims that are often pushed as "definitely works" by hundreds of less than honest websites and publications. Absolutely right it should do so
And that's meant to be science is not unbiased truth in my comment above. Blind faith in computers is also not a useful stance!
I have deleted the comment you are replying to as content should never be abusive.
Okay, I will delete mine as well as otherwise it makes the thread confusing.
Hi
I've just found this site and would like to add some comments. Although it seems unlikely that a healthy individual may get any benefits from probiotics, there is some evidence that it may be helpful in certain medical conditions.
I have an autoimmune disease, coeliac disease, which means that gluten damages the lining of my gut. Allowing this to repair means eliminating all gluten from my diet. In an attempt to help repair the gut, it is often recommended that we take probiotics.
This research cites researchers in Finland who showed that probiotic bacteria appear to be able to reduce damage to epithelial cells and may accelerate healing.
This research was on mice...
It seems worth trying good quality probiotics/fermented foods, for some people.
Probiotics are marketed to provide 'gut flora', a healthy form of bacteria in the colon. The good bacteria provides a wide range of benefits essential to good health, from preventing diseases, to helping the body absorb nutrients, to keeping bad bacteria in check. A sign of poor gut flora is excessive gas and flatulence. Particularly a problem if your diet has a lot of sugar in it which the bad bacteria thrive on and then produce the bloating and gas.
However, there's cheaper and more natural approach to promoting a healthy gut flora and it's called prebiotic food. Prebiotics is like food for the existing gut flora and makes it work better. You can find it in bananas, artichokes, garlic, leeks and onions.
A much cheaper and healthier alternative to these over-priced sugary milk drinks which is really just another health-fad product. Those drinks make millions for the manufacturers but which are totally unnecessary in a healthy diet and have been proven to be inferior many times.
Tip: saurkraut (pickled cabbage) contains far more probiotics (cultured bacteria) than a whole bunch of those sugary drinks, and it only costs about £1 for a big jar which lasts a month (look in your local Polish store!) It's an accquired taste, but quite nice with sausages, mash and brown sauce 
Hi Caroline, I had a look at what you had covered, but you seem to have left out the use of lactulose/duphylac in liver failure caused by overproduction of gut bacteria that produce ammonia and bring about a toxic state. I have seen this used in a hospital setting with a recurrent patient with a very cirrhosed liver. He would be delirious and very ill, close to comatose (end stage) but when he was given lactulose three times a day - enough to give him copious diarrhea - after about a week he was okay. Previously people died of this problem. I was utterly amazed when I saw it work. Most staff around me simply did not appreciate what they were seeing. Often they thought the lactulose was being used as a laxative, and wouldn't give it because of the diarrhoea. If you read on the lactulose bottles and or info sheets you will find out about this amazing use.
Of course this is a different kind of probiotic from the stuff they sell in supermarkets.
How can I access the evidence my NHS CCG uses to make their funding policy decisions?
If sugar is bad for you, Is there any evidence to suggest low fat milk is healthier than full fat?
What evidence supports this proposal?
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