Probiotic use is common in constipation, but only a minority of general and specialist doctors recommend them and consider there to be an evidence base.

OBJECTIVES

This study aimed to assess the use and perceived effectiveness of probiotics by the general population (with or without self-reported constipation), and their recommendation and perceived effectiveness by general practitioners (GPs) and gastroenterology specialists.

METHODS

A cross-sectional, primarily online, survey was undertaken. Responses were compared between groups using χ tests, and logistic regression was employed to identify predictors of probiotic use.

RESULTS

A total of 2557 members of the general population (1623 self-reported constipation, 934 without), 411 GPs, and 365 gastroenterology specialists completed the survey. A total of 37% of the general population with self-reported constipation had tried probiotics, compared with 11% of those without (P < 0.001), with the strongest predictors of use being the belief that probiotics have been tested in appropriate studies (odds ratio [OR] 1.9; P < 0.001), receiving a formal constipation diagnosis by a doctor (OR 1.6; P < 0.001), and a self-diagnosis of constipation (OR 1.6; P < 0.001). Only 26% of GPs and 34% of gastroenterology specialists recommended probiotics for constipation (P = 0.012). Almost two-thirds of the general population (65%) believed that probiotics had been tested in studies for constipation, whereas only 35% GPs and 43% gastroenterology specialists believed this (P < 0.001).

CONCLUSIONS

There is high usage and perceived evidence for probiotics among people with constipation. However, most GPs and gastroenterology specialists do not recommend them for constipation, suggesting a need for further research and education of health care professionals on existing evidence.