Abstract: Specified probiotics benefitting irritable bowel syndrome（IBS） and antibiotic-associated diarrhea was put forward by the Probiotics in the Management of Lower Gastrointestinal Symptoms in Clinical Practice：an Evidence-Based International Guide by the ESPCG in 2013，and the effects of probiotics on gastrointestinal diseases were studied and verified further by more than 70 randomized controlled trials in the recent 5 years.Based on a systematic review of the results of these studies combined with a consensus reached by using Delphi technique，8 experts updated the Probiotics in the Management of Lower Gastrointestinal Symptoms：an updated Evidence-Based International Consensus，proposed that specified probiotics can reduce the symptoms of IBS，and can prevent antibiotic-associated diarrhea and diarrhea associated with Helicobacter pylori eradication therapy with good safety.We intensively analyzed the updated main essentials with relevant studies and data，with a view to providing a reference for general practitioners using probiotics to treat or prevent lower gastrointestinal symptoms.

Key words: Probiotics, Lower gastrointestinal tract, Guidebooks

摘要： 自2013年欧洲初级保健肠胃病学会（ESPCG）首次发布《益生菌在下消化道症状管理中的应用国际共识》，提出某些益生菌可以使肠易激综合征和其他胃肠疾病患者获益以来，近5年又有70多项随机对照试验公布了研究结果。8位专家通过德尔菲法对研究结果进行了系统评价，发布了2018版《益生菌在下消化道症状管理中的应用国际共识》。该共识认为，特定的益生菌可以减轻肠易激综合征患者的胃肠道症状，预防由抗生素和幽门螺杆菌根除治疗引发的腹泻，并显示了良好的安全性。本文就该指南的主要更新要点结合相关文献及数据进行深入分析，旨在帮助全科医生更精准地采用益生菌来治疗或预防下消化道症状。

关键词: 益生菌, 下胃肠道, 指南