An update on probiotics, prebiotics and symbiotics in clinical nutrition

Endocrinol Nutr. 2016 Nov;63(9):482-494. doi: 10.1016/j.endonu.2016.07.006. Epub 2016 Sep 12.
[Article in English, Spanish]


The concept of prebiotics, probiotics, and symbiotics and their use in different situations of daily clinical practice related to clinical nutrition is reviewed, as well as their role in the treatment/prevention of diarrhea (acute, induced by antibiotics, secondary to radiotherapy), inflammatory bowel disease (ulcerative colitis and pouchitis), in colonic health (constipation, irritable bowel), in liver disease (steatosis and minimum encephalopathy), and in intensive care, surgical, and liver transplantation. While their effectiveness for preventing antibiotic-induced diarrhea and pouchitis in ulcerative colitis appears to be shown, additional studies are needed to establish recommendations in most clinical settings. The risk of infection associated to use of probiotics is relatively low; however, there are selected groups of patients in whom they should be used with caution (as jejunum infusion).

Keywords: Clinical nutrition; Nutrición clínica; Prebiotics; Prebióticos; Probiotics; Probióticos; Simbióticos; Symbiotics.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Colonic Neoplasms / etiology
  • Colonic Neoplasms / prevention & control
  • Dietary Carbohydrates / metabolism
  • Dietary Fiber / therapeutic use
  • Digestive System Diseases / microbiology
  • Digestive System Diseases / therapy*
  • Fatty Acids / metabolism
  • Fermentation
  • Gastrointestinal Microbiome
  • Humans
  • Meta-Analysis as Topic
  • Metabolic Diseases / microbiology
  • Metabolic Diseases / therapy
  • Prebiotics*
  • Probiotics*
  • Randomized Controlled Trials as Topic


  • Anti-Bacterial Agents
  • Dietary Carbohydrates
  • Dietary Fiber
  • Fatty Acids
  • Prebiotics