Who uses probiotics and why? A survey study conducted among general gastroenterology patients

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.