Effects of probiotics supplementation on gastrointestinal symptoms in athletes : A systematic review of randomized controlled trials

This study examines the effectiveness of probiotic supplementation on gastrointestinal (GI) symptoms, the gut barrier function, and inflammatory markers in athletes based on data from randomised controlled trials. Searches were conducted in PubMed, the Cochrane Library, and the Web of Science up to October 2021. The protocol for this review was registered with PROSPERO (CRD42021284938). Two reviewers independently screened the titles, abstracts, and full texts to identify articles on the influence of probiotics or symbiotics on GI symptoms, gut barrier function, and cytokines, and the quality of the studies was assessed using RoB2. Ten articles involving 822 athletes were included in this review. A single strain Lactobacillus bacteria was used in three studies, seven studies used a Lactobacillus and Bifidobacterium multi-strain cocktail, and one study used this cocktail with a prebiotic. Only slight evidence was found for a positive effect of probiotics on GI symptoms in athletes during training, exercise, and competition, so it was not possible to identify the best product for managing GI symptoms in athletes. Due to the small number of studies, it was also difficult to find a direct association between the reduced exercise-induced perturbations in cytokines, gut barrier function, and GI symptoms after probiotic supplementation.