Language
English
Publication Date
12-31-2026
Journal
Gut Microbes
DOI
10.1080/19490976.2026.2657049
PMID
41986915
PMCID
PMC13085939
PubMedCentral® Posted Date
4-15-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Many professional organizations publish clinical practice guidelines for the use of probiotics in gastrointestinal disorders. Generally, no two guidelines align perfectly, and some differ markedly. These discrepancies occur because clinical practice guidelines are not purely mechanical outputs of data synthesis. They are shaped by structured interpretation, value judgments, and predefined thresholds for uncertainty. These elements become particularly visible when effect sizes are small, heterogeneity is high, and outcomes vary in clinical relevance-as is the case with probiotic research. This article examines why discordance among probiotic guidelines is predictable and provides practical guidance for clinicians who must decide among conflicting recommendations to make the most appropriate management decisions for their patients. Guidance is also provided for investigators who seek to improve the quality of evidence, confidence in recommendations, and accurate communication of probiotic research to clinicians, patients, and the broader scientific ecosystem.
Keywords
Probiotics, Humans, Practice Guidelines as Topic, Gastrointestinal Diseases, Certainty of evidence, necrotizing enterocolitis, network meta-analysis, systematic reviews
Published Open-Access
yes
Recommended Citation
Preidis, Geoffrey A; Szajewska, Hania; Cunningham, Marla; et al., "When Probiotics Guidelines Differ: A Practical Guide for Clinicians and Researchers" (2026). Faculty, Staff and Students Publications. 7574.
https://digitalcommons.library.tmc.edu/baylor_docs/7574