What Are Probiotics And Why Would You Need Them
Among the estimated 100 trillion microbes living in your gut, there are some really helpful bacteria. They break down stuff like fiber into nutrients that your body then uses for energy and as a weapon against everything from cardiovascular disease to cancer.
Bottom line
The pro in probiotics refers to good bacteria that you can ingest as food or in tablet form, among other methods. If the good bacteria survive the journey through your digestive system into your gut, they will settle in and colonize it, eventually driving out the bad guys.
Effect Of Probiotics For Inducing Remission/response In Active Ulcerative Colitis And Crohn’s Disease
Effect for Inducing Remission/Response in Active Ulcerative Colitis and Crohn’s Disease
Twelve trials reported on the remission or improvement of IBD.,,,,,,, Data were available for 723 patients, of who 368 received probiotics as supplement treatment and 355 received conventional treatment including salazosulphapyridine, 5-ASA, corticosteroids, and immunosuppressants with or without placebo. The pooled risk ratio for the remission/response rates of probiotics supplementation versus control group was 1.28, with 95% confidence interval, 1.00 to 1.64. Although meta-analysis showed better effect on probiotics supplementation for IBD , remission/response rates from these 12 trials still showed some heterogeneity . Because of the heterogeneity within the pooled trials, subanalyses according to different diseases are needed. Nine trials included patients with UC,,,,,, and 3 included patients with CD.,, Subgroup analyses suggested a significant benefit in favor of probiotics supplement in UC subgroup , but not in CD subgroup . However, we could not ignore that there was significant heterogeneity in UC subgroup .
The forest plot of the remission/response rates for probiotics compared with control groups in inducing remission of IBD.
Sensitivity Analyses for Inducing Remission/Response in Active Ulcerative Colitis and Crohn’s Disease
The subgroup analysis for the remission/response rates of probiotics compared with placebo in inducing remission of UC and CD.
Inflammatory Bowel Disease And The Gastrointestinal Microbiota
The causes of IBD have not been fully elucidated, but are thought to involve both genetic and environmental factors. More recently, a number of observations have suggested that the intestinal microbiota may drive intestinal inflammation. First, experimental animal models of IBD remain healthy when reared in a germ-free environment and develop inflammation only after colonisation with commensal bacteria . Second, higher concentrations of bacteroides and enterobacteria are found in regions of inflamed mucosa in CD . Third, in both CD and pouchitis disease activity deteriorates when the faecal stream is surgically restored to previously-defunctioned intestine, implying that the lumen contents are necessary for the development of inflammation. Finally, the association between ileal CD and mutations in the bacterial-sensing caspase-activating recruitment domain 15 gene implicate bacterial recognition as a central pathogenic process .
The present review aims to assess the evidence that these observations from in vitro experiments and animal models can be put into clinical practice. The evidence presented relates to trials that have assessed these therapies in terms of clinical outcomes in IBD, and the data extracted and presented are the clinical end points in each study.
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A Look At The Research So Far: Clinical Trials For Probiotics And Crohns Disease
A non-pathogenic strain of E.coli has been one of the most clinically trialled probiotics with regard to Crohns disease. In a 1997 double-blind study by Malchow5 E.Coli Nissle 1917 or placebo was taken daily for twelve months by 32 patients with active Crohn’s disease. Both groups also received standard steroid treatment at the same time. The results showed that whilst remission rates were similar for both groups the subsequent relapse rates were lower in the E.coli treated group . This means that once remission had been achieved less of the probiotic group re-developed symptoms. Whilst this particular strain of E. coli has shown probiotic potential, we would suggest practitioners wait for more research before seeking out any E. coli supplements, as of course other strains of this bacteria are well documented and widely known for their pathogenic effect on the human body. E. coli does not appear on the European Food Safety Authority’s Qualified Presumption of Safety list.
Saccharomyces boulardii
The fact that the relapse rate was significantly lower in patients treated with the drug in combination with S. boulardii, suggests a protective effect from the probiotic.
What Are The Precautions Of Probiotics For Ulcerative Colitis
You are probably thinking of buying the best probiotic for ulcerative colitis now, so you can help remedy your digestive issue. However, there are certain precautions that you need to consider before you start buying all the probiotics that you come across because you should keep in mind that probiotics cannot be used in place of medications when it comes to ulcerative colitis.
Also, if your immune system has been compromised or weakened, you might want to consider other alternatives to soothing the inflammation in your digestive tract. There might be some effects on your overall health if you consume too many probiotics.
The best probiotic for ulcerative colitis can help reduce the symptoms and flare-ups, but they cannot stop it altogether. Therefore you still need to follow the medication that your doctor has prescribed to help you with your digestive problem. Think of probiotics as simply a supplement for your treatment.
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Will Probiotics Cure My Ibd
No. Unfortunately there is currently no cure for IBD.
However, some people have found that some probiotics assist in alleviating some symptoms of their IBD. If you choose to take a probiotic it is recommended you do so alongside any other treatment you are undergoing and that you discuss taking it with your doctor before starting.
People who report success with probiotics have found a reduction in symptoms such as bloating, diarrhoea, fatigue, skin conditions and constipation. Probiotics are increasingly being recognised to help people who have irritable bowel syndrome. Many people with IBD suffer from IBS too.
The success rate varies from person to person and a probiotic that may produce results for one person may not do the same for another.
What Is The Difference Between Collagenous Colitis And Lymphocytic Colitis
While collagenous colitis also involves the formation of excess collagen in the colon, both forms may actually just be different phases of the same condition.
For this reason, symptoms, risk factors and treatment for both CC and lymphocytic colitis are the same.
However, rates of LC are slightly higher than that of CC, and women have a greater risk of developing CC than men .
Summary: Microscopic colitis is an inflammation of the large intestine that causes chronic watery diarrhea. Lymphocytic colitis and collagenous colitis experience an abundance of inflammatory cells, but the latter also shows a thickened layer of collagen in the colons tissue. Both forms share the same symptoms, risk factors and treatment protocols.
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Can Probiotics Make Uc Worse
Probiotics may help by providing good bacteria that help restore the bacterial balance in the intestine, eliminating the problem to which the immune system is responding. With the perceived danger gone, the immune system may soften or stop its attack.
As we stated previously, probiotics may help increase the time between flare-ups and may make the symptoms of a flare-up less severe. Also, probiotics are likely less expensive than typical UC medications, and they may be safer over long periods.
Probiotics may also protect against other bowel problems such as Clostridium difficile colitis and travelers diarrhea.
There are a lot of benefits, but there are a few cons when using probiotics with UC. The main one is that theyre probably not useful in causing a faster remission during a flare-up of UC.
Another con is that certain people should use them cautiously. Probiotics contain living bacteria, so they may increase infection risk in people with compromised immune systems . This is because a weakened immune system might not be able to keep the live bacteria in check, and an infection may result.
The Relationship Between Gut Bacteria And Uc
Our intestines are home to 100 trillion microorganisms including bacteria, fungi, and other microbes known collectively as your gut microbiome. Some forms of bacteria are considered positive and helpful, while others can have negative health effects if they become too prevalent.
While the role of gut bacteria in UC isnt fully understood, its clear that people with inflammatory bowel disease tend to have a different profile of bacteria in their intestines, and certain differences and changes in the composition of gut bacteria can help predict the course of the disease.
In a review published in the Journal of Experimental Medicine, researchers found that different strains of gut bacteria may combat different chronic inflammatory conditions like UC.
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Can Probiotics Treat Other Gi Issues
Studies show that probiotics help with symptoms of inflammatory bowel disease. But more research to form a standard treatment goes on.
Research into whether probiotics may help people with Crohnâs disease is less clear. The studies have been small, and we need more research into what types of probiotics might work. Because of this, doctors aren’t likely to recommend probiotics to people with Crohnâs disease.
Efficacy Of Probiotics In Inducing Remission In Patients With Ibd
In five studies, containing 667 patients, effects of probiotics were compared with 5-ASA compounds on the remission of types of IBD. The diagnosis of IBD in these studies was made according to the DAI and the Western Ontario, and McMaster Universities Arthritis index. One of these studies used EcN on 48 healthy volunteers and showed that the combination of EcN and mesalamine has no considerable effects on the survival of EcN, and the difference between the two groups was not statistically significant . Only one serious adverse event was reported in a volunteer in the mesalamine group, who developed diarrhoea, fever and haematochezia on the day 7 of the investigational phase, when the administration of EcN plus mesalamine was ended. Tomasello et al. investigated the effects of a combination of Lactobacillus spp., Enterococcus faecium and S. boulardii in IBD patients with extra-intestinal involvement and they found that probiotics improved the clinical response to standard therapy and reduce the need for corticosteroids .
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How They Compare To Other Uc Treatments
The most common prescription medication for UC is mesalamine. This is a nonsteroidal anti-inflammatory drug . Several large studies looked at how well E. coli Nissle worked compared to mesalamine. They found that the treatments were equally effective against UC.
No studies have compared VSL#3 to mesalamine head-to-head, but experts think the probioticâs effects on UC are similar.
Can Probiotics Help Prevent Flare
The use of probiotics for this purpose shows more promise.
Several studies have shown that probiotics may be as effective as traditional UC medications, including the gold-standard treatment mesalazine.
A 2004 German study followed a group of 327 patients with a history of UC, giving half of them mesalazine and the other half probiotics . After one year of treatment, the average time to remission and the quality of remission was the same for both groups.
Similar results have been seen in other studies. And another probiotic,
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Side Effects And Safety Of Probiotics
Probiotics generally dont have severe side effects. You might experience an upset stomach, diarrhea, bloating, and gas when you begin taking them. However, some people have allergic reactions to probiotics, and theyre not recommended for people who might have weakened immune systems, such as people who have just had surgery or who are undergoing chemotherapy.
Some MyCrohnsAndColitisTeam members find that adjusting their diet to eat more probiotic-containing foods is easier than taking supplements. I cant take the capsules. It gives me gas and upsets my stomach. But I do eat the yogurt. I really don’t know if it helps, but it doesn’t hurt, one member said.
Other team members say that taking probiotic supplements at a certain time or with a certain sort of food or drink can reduce side effects. One member said, I take all of my probiotics before bedtime because otherwise I get nauseous. Another member said, I have a probiotic and lemon water next to my bed and take it at least an hour before I eat anything in the morning. It gives the gut a chance to get going before I eat. Seems to help.
Just as with any supplement, talk to your health care provider before beginning to use probiotics. Remember that the use of probiotics is not a replacement for any prescription medication you are taking for your ulcerative colitis.
Sparse Current Evidence Points To Some Benefit In Managing Pouchitis And Keeping Uc Quiescent
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Expert Critique
In the early 1900s, the Russian biologist Élie Metchnikoff of the Pasteur Institute described a correlation between probiotic lactobacillus-containing foods and immunity, intestinal health, and longevity. Since then, researchers have steadily homed in on probiotic therapy as being potentially beneficial in medical conditions ranging from acne and bipolar disorder to Crohns disease and ulcerative colitis .
And consumers have been boarding the probiotics bandwagon, with almost four million Americans reporting the use of prebiotics and probiotics in 2012 according to a National Center for Complementary and Integrative Health , a number that has likely increased even more since the market research firm Nilesen recently reported that 20% of Americans say that probiotics are important to them.
While evidence suggests that probiotics can be effective against various types of diarrhea and functional bowel disease, the potential in inflammatory bowel disease remains unclear. One recent literature found a positive effect of the yeast Saccharomyces boulardii in two CD studies and one UC study.
No benefit of probiotics emerged in inducing remission of active CD, in preventing relapse of quiescent CD, or in preventing endoscopic or clinical relapse of CD after surgically induced remission.
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The Evidence For Probiotics In Ulcerative Colitis
How good are probiotics at easing the symptoms of ulcerative colitis and maintaining remission? Studies differ. According to a 2017 review of clinical trials, probiotic therapy may induce remission during some ulcerative colitis flare-ups and be equally as effective as the anti-inflammatory aminosalicylate drug mesalamine in preventing flare-ups.
A 2019 systematic review of studies found no clear evidence that probiotics are as effective as mesalamine in preventing ulcerative colitis from relapsing. The same review found that when probiotics were compared with a placebo , it was unclear whether using probiotics was better than the placebo at keeping flare-ups from occurring. Researchers in the 2019 review concluded there just isnt enough information on probiotics yet to know how well they work to manage ulcerative colitis. There have been no large-scale studies of ulcerative colitis treatment with probiotics. However, these same reviews found no significant side effects or withdrawal effects from the use of probiotics.
What To Consider Before Purchasing The Best Strains For Ulcerative Colitis
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Probiotics Boost Intestinal Immunity
Probiotics offer your body many benefits, the main one being enhancing the immune defenses of your intestines. The largest organ in the immune system is your digestive tract. Probiotics increase the intestinal mucus thickness, and this acts to keep bad bacteria from entering the colon.
Probiotics also discourage the pathogenic bacteria from the digestive tract, discouraging their harmful effects. Good bacteria stick to the lining of the colon, crowding out bad bacteria so that they cant take over any part of the intestinal lining.
Probiotic Fact #: Probiotics Are Strain Dose & Duration Specific
When we evaluate the research on a probiotic in our practice, we always consider the strain name of a probiotic.
When identifying a probiotic, there are three parts to a name:
- The first part is the genus.
- The second part is the species.
- The third part is the strain.
The letters and numbers after that specify the STRAIN of probiotic which is the most important identifying factor when it comes to probiotics. In research on probiotics- the strain name is what differentiates it from the sometimes hundreds of others in its category.
However, many probiotics do not even list the strain name which makes it hard to even evaluate its effectiveness. Not understanding which strain is being used is one major reason why people disagree on the use of probiotics and why its so hard to find consistent information on probiotics for IBD.
The bottom line is: If the strain isnt listed, avoid it.
Beyond strains, the specific dose and how long you take a probiotic can also play a role in its effectiveness. For example, if the evidence shows that it takes 6 weeks to reduce symptoms while taking 10 billion CFUs, we cant expect that taking 1 billion of the same strain for 2 weeks will yield the same results.
Yet oftentimes people will assume probiotics work at every level and any time duration. Like most things- the quality and duration of use can really make a difference. Avoid experimenting on yourself and go with what we know works in research.
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