Article Text

Who uses probiotics and why? A survey study conducted among general gastroenterology patients
  1. Elissa Lynch,
  2. Jordan Troob,
  3. Benjamin Lebwohl,
  4. Daniel E Freedberg
  1. Division of Digestive and Liver Diseases, Columbia University, New York, NY, USA
  1. Correspondence to Dr Daniel E Freedberg; def2004{at}


Background The rapid growth of the probiotic industry suggests patients will continue to seek advice from gastroenterologists about probiotics. To best address patient questions and concerns, we must first understand who uses probiotics and why.

Methods This was a cross-sectional study conducted in the endoscopy suite of an academic hospital from June to October of 2019. Surveys were anonymous and contained a combination of multiple choice, free text and Likert scale questions. Participants privately completed a paper survey in English or Spanish and the results were reviewed with them by study personnel to clarify responses. Descriptive statistics were generated and multivariable logistic regression modelling was used to compare characteristics of probiotic users versus non-users.

Results During the 5-month study period, 600 patients were approached and 537 (90%) agreed to participate. Among participants, 89% completed at least 24 survey items and were included in the analysis. Overall, 27% of patients reported probiotic use. Bloating, rather than diarrhoea, was the main gastrointestinal symptom associated with use of probiotics (aOR 2.59, 95% CI 1.52 to 4.44 for bloating; aOR 1.03, 95% CI 0.55 to 1.94 for diarrhoea). Frequent reasons cited for taking probiotics were the beliefs that they improved overall health and longevity (54%) and that they improved gastrointestinal symptoms (45%).

Conclusions Probiotic use is common among general gastroenterology patients, many of whom believe that probiotics confer general rather than specific gastrointestinal health benefits. Symptoms—especially bloating—and not sociodemographic factors seem to motivate probiotic use. By understanding patient expectations for probiotics, clinicians can better advise them.

  • probiotics
  • diarrhoea
  • irritable bowel syndrome

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Raw data variables correspond to the items on the questionnaire.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Raw data variables correspond to the items on the questionnaire.

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  • Contributors EL and JT gathered data and performed initial analyses; EL wrote the manuscript first draft. BL assisted in study design, analyses and manuscript revision. DEF conceived and planned the study, performed the final analyses and critically revised the manuscript. All authors have seen and approved the final manuscript.

  • Funding DEF was supported in part by a Department of Defense Peer Reviewed Medical Research Program Clinical Trial Award (PR181960) and by the Columbia University Irving Medical Center Irving Scholar Award.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.