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 χ2 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.