Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Lactobacillus species, a type of probiotic bacteria, are used adjunctively during chemotherapy primarily to help reduce gastrointestinal side effects, such as diarrhea and mucositis. There is growing scientific evidence supporting their use, although the strength of the evidence is moderate and varies depending on the specific strain and patient population. Several randomized controlled trials and meta-analyses have indicated that certain strains of Lactobacillus, often in combination with other probiotics, can decrease the incidence and severity of chemotherapy-induced diarrhea, particularly in patients with colorectal or pelvic cancers. The proposed mechanisms include restoration of gut microbiota balance, enhancement of mucosal barrier function, and modulation of local immune responses to reduce inflammation caused by chemotherapeutic agents.

However, not all studies show significant benefit, and the effects are often strain-specific. Most clinical trials use well-characterized strains such as Lactobacillus rhamnosus GG or Lactobacillus casei, and evidence for unspecified or mixed Lactobacillus preparations is less robust. Safety is generally good in immunocompetent patients, but caution is warranted in severely immunocompromised individuals due to rare cases of bacteremia. Overall, while not universally recommended in all guidelines, the use of Lactobacillus probiotics for mitigating chemotherapy-induced GI side effects is supported by a moderate level of scientific evidence.

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