Probiotics are a hot topic in medicine. Quigley said research supports their use, but it's not clear which ones are best. "We need more studies comparing doses and preparations, and there hasn't been a lot of that done," he said. Still, probiotics are safe and patients tolerate them well, he noted.
"In regards to specifics, patients have to talk to their doctor," Quigley said.
Dr. William Chey, a gastroenterologist and professor of medicine at the University of Michigan, agreed that it's difficult to decide which probiotic product to recommend. He said one possibility is the product known as Align, which is widely available.
However, the guidelines indicate that there's not enough evidence to support the use of prebiotics (components of food that can't be digested and promote healthy bacteria) and synbiotics (products that combine probiotics and prebiotics).
As for diet, Quigley said there's some evidence that gluten-free diets and so-called "FODMAP" diets can help reduce symptoms of irritable bowel syndrome. FODMAP diets cut out potentially troublesome foods, such as certain added sugars, and then reintroduce them to the diets of patients to help figure out which ones cause symptoms.
Chey said the guidelines slightly understate the value of treatments that involve changing diet since there's evidence that "diet plays a role in the development of the condition and has a role in treatment."
For patients with chronic idiopathic constipation, Quigley said, "there are a lot of relatively simple and relatively inexpensive treatments that work for constipation, and most of them are pretty safe."
Chronic idiopathic constipation is long-term constipation that doesn't have a known cause. Approximately 10 percent to 15 percent of the general population suffers from this condition.
The guidelines for chronic idiopathic constipation strongly recommend the use of
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