Probiotics: time for a dose of realism.

There is already a long research and retail history of probiotics, but progress in the scientific and medical validation of these products has been extremely slow. Even now, adequate information by which the consumer and health professional can judge the efficacy and safety of retailed probiotics is lacking. Probiotic products have not been subjected to large scale trials of efficacy that are used in the pharmaceutical industry. Without these trials and subsequent approval by fastidious regulatory agencies such as the FDA (USA), probiotics continue to languish in the self-care health market. Optimistically, a new generation of probiotics may be developed that have medical validity with respect to the prevention or treatment of atopic and inflammatory bowel diseases. These new products, however, will need to be targeted at the alleviation of specific medical conditions, and the mechanistic basis of their effectiveness will need to be provided.