Our positions

Probiotics are live bacteria incorporated into certain dairy drinks and yoghurt. You can also buy capsules and powders containing probiotics. These products have a positive effect on the composition of the microbiome when eaten or drunk in sufficient quantities (WHO). There is also evidence that probiotics have a beneficial effect in certain conditions and complaints.

A healthy microbiome is very important for good health. A healthy diet high in fibre contributes to a healthy microbiome. So does sufficient exercise and drinking. Sometimes the microbiome is out of balance, which can lead to complaints. Diseases and external factors such as antibiotics can also hurt the balance of the microbiome. In that case, probiotics sometimes offer a solution.

There is evidence that probiotics help with certain conditions and complaints. For instance, they seem to have a beneficial effect on constipation and diarrhoea. Research shows that they are effective in treating diarrhoea caused by antibiotics. This is also known as antibiotic-related diarrhoea (AGD). Probiotics sometimes also seem to have a beneficial effect in other conditions, such as chronic inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or possibly even depression and anxiety disorders. 

There is still insufficient scientific evidence on the efficacy of probiotics. This is due to several factors. 

• Research on probiotics is often conducted in different ways. This makes it difficult to compare outcomes. Due to differences in research designs, it is not clear which bacterial strains, what dose and what duration of therapy lead to effects.
• In addition, each person’s microbiome is unique. As a result, there is also wide variation in the effectiveness of probiotics on study participants.

These factors mean that there is still insufficient scientific evidence to recommend probiotics. Such as which probiotics, what dose and how long they should be used to achieve a health effect on specific symptoms or conditions. Only in the case of antibiotic-related diarrhoea has this been sufficiently demonstrated. Dutch Digestive Health Fund believes in the importance of a healthy microbiome for everyone. That is why we are committed to better alignment of scientific research on the microbiome and probiotics. Working with the same research design can allow conclusions to be drawn from research in the future.

Important to know

There are different types of probiotics. Each bacterium has its own unique properties. The effects of a bacterial strain and product (particular type of bacterium) are specific. In addition, when using probiotics, it is important that there are enough live bacteria present in the capsule, powder or drink. If this is not the case, insufficient live bacteria will reach the gut, and the product will have no effect.

Are you thinking about taking probiotics? Your GP or specialised doctor will be happy to give you personal advice on the right probiotics. This is especially important if you have a chronic illness or if you want to give probiotics to children. In that situation, we always recommend consulting your GP or doctor first.

Research shows that there are risks associated with taking proton pump inhibitors (PPIs), especially when taken long-term. There may be a link between long-term use of proton pump inhibitors and an increased risk of intestinal infections, an imbalance in the microbiome and a vitamin and mineral deficiency. Dutch Digestive Health Fund therefore believes it is important to be critical of the use of antacids. So that they are not used unnecessarily and/or prescribed by doctors. In addition, it is important that people are well informed before using a product.

If someone suffers from heartburn, for example, Dutch Digestive Health Fund advises first looking at lifestyle and diet. The next step is to consider taking antacids. Antacids are the mildest option. They bind and neutralise the stomach acid. If the symptoms persist and antacids do not work, acid-reducing drugs can help. The acid-blocking drugs we are discussing here are proton pump inhibitors (PPIs). These acid-blocking drugs ensure that less stomach acid is produced. 2.8 million people regularly take these strong acid-blocking drugs.

Do you suffer from heartburn and want to know which treatment is right for you? Or do you take antacids? Discuss with your doctor which treatment is necessary and how you can also reduce the dosage. The treatment for the use of antacids is also called the step-up and reduction method. The guideline of the Dutch general practitioners’ society (NGH) actively promotes this treatment and specifically refers to the reduction of PPIs. The advice is to use PPIs for two to four weeks. Sometimes it is necessary to use antacids for longer. Even then, it is always a good idea to first consult a doctor and to follow the instructions on the package leaflet carefully.

Dutch Digestive Health Fund has noticed that there is growing attention in healthcare for the use of PPIs and possible side effects. This is attention that we applaud.

There are various types of self-tests available in shops or online. A self-test is used to test yourself at home for various conditions. A pregnancy test is also a self-test. Various bodily substances are used for self-testing, such as blood, saliva or even faeces. We advise people to only use the Covid-19 or pregnancy self-test at home. These are reliable and easy to understand. For all other tests, it is advisable to go to the doctor. The outcome of a self-test is not always easy to explain or understand.

The result of a self-test can also be a false positive. This means you think you have a condition when in fact you do not. Or the self-test can be a false negative. This means you think you do not have a condition when in fact you do. A GP or other healthcare provider can include other complaints, symptoms or characteristics in a diagnosis. A self-test also lacks a follow-up process in the form of expert advice or a possible referral to an expert, such as a doctor. Also, self-tests at home do not always undergo quality control. Would you still like to do a self-test? Then discuss it with your doctor.

Dutch Digestive Health Fund advises caution when purchasing medicines (and nutritional supplements) through the internet, especially when the reliability of the provider is not clear. Always consult a doctor or physician about the use of these medicines.

In recent years, the internet has increasingly been used to offer medication. Websites recommend the use of certain medicines (and/or dietary supplements). With products offered on the internet, it is often impossible to check the safety and quality of the medication and the reliability of the supplier. These medicines could be made anywhere, even in countries where monitoring and registration are less strict than in the Netherlands.

We believe that the family doctor, pharmacist or chemist is an important link in the distribution of medicines. The family doctor, pharmacist and chemist can give you advice about the medicine in combination with other medication or about your health. They can answer questions about the medicines and their use directly. It is also important that you have a good overview of the medication you are taking for your doctor or pharmacist. This works better if you go to one or a few regular healthcare providers.

Alternative therapies have not (or sometimes not yet) succeeded in demonstrating through proper scientific research that they work. Yet patients sometimes claim to benefit from them. We advise patients who want to use them to do so cautiously and always in consultation with their GP, specialised doctor, or dietician.

The expression ‘if it doesn’t help, it won’t hurt’ does not always apply. For example, some herbal remedies have been shown to contain large amounts of unhealthy substances. The composition of alternative medicines is often not checked. Furthermore, some manufacturers seem to only want to make money from patients’ complaints. They ask a lot of money for treatments with empty promises. And in this way, they take advantage of patients, who are sometimes desperately looking for a solution to their complaints.

When there is insufficient evidence for an alternative treatment, we do not recommend it. Because it can be harmful. And because it can prevent you from receiving the treatment that would benefit you. Because it can cost unnecessary time and money.

If you want to use alternative remedies or follow a therapy, always do so in consultation with your GP. And be aware that if others say something works, or manufacturers claim something works, it may not work for you.

One of the objectives of Dutch Digestive Health Fund is to encourage good scientific research. With results from thorough scientific research, reliable statements can be made about treatments or diagnostics, for example. Not all research is reliable.

Sometimes, for example, there is no control group. This is a requirement for an approved study. This is important because a placebo effect is almost always found in studies. This means that if people participating in a study are given a fake medicine, they still feel better, or their symptoms could decrease. Even if the fake medicine contains no active ingredients. This is because believing in something and/or receiving attention for the symptoms can have a positive influence on the symptoms. In research into medicines, a placebo effect is almost always found, on average as much as 35%. This means that research into a treatment must always be compared with a control group; a group that does participate in the research but does not receive the treatment or medicine in question.

Furthermore, the study may have been carried out on too small a group of people to be able to make reliable statements. Or the study may have been carried out incorrectly, making the results unreliable. For these and other reasons, studies can sometimes contradict each other. In that case, it is important that a review is carried out. This means that people who are knowledgeable about reliable research first assess the reliability of all studies on a subject. Only then should they make a judgement about the results of the various studies.

Treatment may also be new, which means that there has not yet been enough research done to prove its effectiveness. The treatment could work, but it is also possible that it does not work any better than a placebo or even has harmful effects.

We know many hospitals and specialists through our work. However, we are unable to judge which of them are better than others. That is why we do not provide the names of individual specialists or hospitals.

Doctors specialising in the digestive system are usually called gastroenterologists or sometimes also hepatologists. Gastroenterologists work in almost all hospitals. For a number of examinations and treatments you can also consult an internist. We advise you to consult your GP or treating physician to determine which specialist is best for you. The hospital website often also states which specialism a particular doctor has. You can also contact a patient association that deals with the specific complaint or condition. A patient association can provide information about doctors and hospitals based on their own experiences. More and more patient associations have a monitor on their website where they present the quality of care per hospital. You can find links to the various patient associations here.

There are various sites you can visit to help you make a choice in the area of care, health insurance and health. For example, Kies Beter from the Dutch National Health Care Institute, where you can learn more about the quality of care in the Netherlands. Zorginzicht is for professionals, but also contains links to patient versions of guidelines and reliable patient sites. The information on this website is reliable and answers questions in the field of healthcare.

There are also various decision aids that can help you find a hospital or doctor. For example, there are a number of decision aids (not for all digestive disorders) and Zorgkaart Nederland helps you choose the most suitable healthcare provider. In addition, there are national agreements, whereby some hospitals are only allowed to perform certain operations. A hospital can inform you about this. It is also possible to call various hospitals in the region to ask how much experience they have in performing certain treatments, so you can compare.

We want to fund as little research into animal testing as possible and are working towards the goal of them no longer being necessary. In a small portion of the research (≈3%) that Dutch Digestive Health Fund finances, animal testing is used out of necessity. At the start of 2020, this applied to 3 of the 95 ongoing studies.

Scientific research is necessary to prevent or detect digestive diseases at an early stage. In some cases, laboratory animal research is required by law. Together with other parties, we are actively looking for alternatives.

That is why, within the Dutch Collaborating Health Foundations (Vereniging Samenwerkende Gezondheidsfondsen, SGF), we are investing in new research methods that are as animal friendly as possible. We also encourage alternatives to animal testing.

Joint position

The position on animal testing of the Collaborating Health Foundations in brief: 

• We only fund the best and most important research.
• We support the government’s policy on ‘3R alternatives’ to animal testing (Replacement, Reduction and Refinement).
• We strive for the use of alternative measurement and testing methods based on human cells or ‘organs-on-a-chip’. We also invest in the development of these techniques.
• We are actively committed to animal-free innovations and support the government’s ambition for the Netherlands to be a world leader in this field by 2025.

Because we consider this to be of great importance, we have also included in our general subsidy conditions that we are against the unnecessary use of laboratory animals and that we support the policy regarding the 3Rs. In addition, all research proposals that want to use laboratory animals are assessed by an advisor with expertise in the field of laboratory animal use. 

The equity of Dutch Digestive Health Fund is subdivided into reserves and funds. By doing this, we follow the Responsible Financial Management Guide of the Dutch Charity Association and, as a recognised charity, the quality requirements of the Dutch Fundraising Regulator (CBF).

With regard to the equity of Dutch Digestive Health Fund, a distinction is made between:

1. designated reserves (determined by Dutch Digestive Health Fund)
2. allocated funds (determined by third parties).

Designated reserves

Continuity reserve 

Our risk analysis was reassessed in 2023. Based on this, the continuity reserve was increased to €3.3 million. The purpose of the continuity reserve is to safeguard the continuation of the work of Dutch Digestive Health Fund. The continuity reserve has been confirmed by the managing director and the Supervisory Board and is based on the estimation of potential financial consequences of the identified risks. This reserve enables our organisation to continue the long-term subsidy programmes.

Designated reserve for projects 

The project reserve can be used strategically if a special opportunity arises in which Dutch Digestive Health Fund wants to invest. This reserve was €786k at the end of 2023. The 2024 budget takes additional investments into account in our existing impact themes.

Reserve for unrealised gains on securities 

A reserve is formed for positive unrealised gains on securities at the end of the financial year. Negative unrealised gains are charged to this reserve to the extent that there is a balance. The level of this reserve is €457k at the end of 2023.

INZET reserve 

The designated reserve INZET was created to absorb future decreases in the value of the Participation Cooperative INZET I U.A. The size of the reserve is based on the valuation of the participation at the end of the financial year and the agreed capital injection.

Usufruct reserve 

The income from usufruct is added to the usufruct reserve. This as it is unclear when the income will actually benefit the Dutch Digestive Health Fund. This reserve is released upon termination of the usufruct.

Allocated funds

At the end of 2023, no allocated funds were determined by third parties.