Probiotics Linked to Ulcerative Colitis Remission

Probiotics, or so called “good bacteria”, are tiny organisms introduced into the body for health benefits. They are found in certain foods, such as yogurt, and they also come in supplements, available in the form of tablets and capsules. Probiotics help with digestion and offer protection against harmful intestinal bacteria. It is believed that unbalanced intestinal bacteria are brought about by a number of different reasons such as stress, unhealthy diet, overuse of antibiotics, and chronic illnesses. Recent evidence has surfaced stating that probiotic treatment can also be used to treat ulcerative colitis and restore bacterial balance in the intestine.

Typical medical treatment typically includes the administration of corticosteroids, although recent studies have shown that the use of probiotics for UC seems to shorten and alleviate symptoms of flare-up episodes.

In 2004, a German study observed a group of 327 patients with a personal history of UC. Half were given mesalazine, while the other half were given probiotics (Escherichia coli Nissle 1917). One year after treatment, the average time to remission and the quality of the remission itself was seen as the same for both groups. Another study of 90 volunteers found that patients with ulcerative colitis that were given probiotics had higher remission rates. The higher the dose that they were given, the longer their remission lasted.

Saccharomyces boulardii has also been observed in a small study involving 25 patients with ulcerative colitis. During flare-up episodes, normally each patient would be given steroid treatment. However, all 25 UC patients had had negative reactions to steroids in the past. In this particular study, they were all given 250mg S.boulardii three times a day for approximately four weeks, together with their regular treatment. It was estimated that 17 out of 25 UC patients achieved clinical remission. While the results looked promising, this study was limited in number and lacked a control group. In any case, enough evidence was gathered to encourage the conduction of further studies.

Most recently, a new research study suggests that probiotics may provide a few health benefits to patients with ulcerative colitis. Particularly, probiotics appeared effective as 5-aminosalicylates for preventing relapse in inactive colitis and foods rich in probiotics appeared useful for prompting remission in active colitis. Alex Ford, MD, of the Leeds Gastroenterology Institute at St. James’s University Hospital and his colleagues observed 22 controlled trials. These trials each compared probiotics with either 5-ASAs or placebo in adults with inflammatory bowel disease. The researchers found that probiotics were not superior to placebo in prompting remission in patients with active colitis. They also found that 5-ASAs and probiotics were both equally effective in preventing relapse of inactive colitis. However, the study had its limitations in that the role of probiotics could not be fully determined in individuals with persistent gastrointestinal symptoms and in the absence of inflammation.

A growing number of individuals with ulcerative colitis are turning to probiotics to treat their conditions. In theory, the connection between probiotics and ulcerative colitis makes sense. Ulcerative colitis occurs when harmful bacteria exceeds beneficial bacteria in the body. Recent research suggests that this may be the exact cause of the disease; however, there is not enough evidence to support this theory. Rather, researchers have uncovered mixed results that suggest probiotic bacteria can influence the activity of the cells that line the intestines and the immune cells by eliminating the immune system’s response to harmful bacteria. More specifically, it appears that the “good bacteria” act as a barrier in blocking “bad bacteria” from sticking to the lining of the intestines and triggering inflammation.

Weighing the pros and cons of probiotics

Pros:

• May help alleviate symptoms during flare-up episodes
• May help prevent flare-up episodes
• May help increase time between flare-up episodes
• May help protect against other bowel diseases, such as C. difficile infection or travelers’ diarrhea
• May be safer for prolonged use as opposed to other medications for UC
• Less expensive than other medications for UC
• No severe side effects have been linked with prolonged use of probiotics for UC

Cons:

• Cannot stop flare-up episodes once they have occurred
• Do not cause a faster remission during a flare-up episode
• May increase the risk of infection in individuals with weakened immune systems

Not all probiotics are the same or for that matter, offer the same benefits. For instance, only E.coli Nissle and VSL#3 have proven to be effective in the management of UC. On the other hand, Lactobacillus agents have yet to show competence in treating UC. Each probiotic needs to be studied in randomized controlled trials before researchers can provide substantial evidence to support its benefit in the maintenance of remission in UC. The evidence available to date shows that probiotics work through well-defined anti-inflammatory mechanisms. One approach to ensure whether a probiotic will have a positive impact on your condition is to ask your doctor and health care team questions and do a little research on the probiotic itself and the company that is offering it.

Furthermore, there are many foods that are considered probiotics foods and can be consumed to take in “good bacteria”. Such foods include:

• Yogurt
• Kefir
• Some types of cheeses
• Sourdough bread
• Pickles
• Kimchi
• Sauerkraut
• Miso

If you are suffering from ulcerative colitis, you cannot simply go to a pharmacy and buy a probiotic, assuming that it will treat your condition. If you are thinking of taking probiotics, you should consult with your doctor about high-quality supplements that are right for you. Keep in mind that unlike prescription drugs, probiotics supplements are not regulated by the U.S. Food and Drug Administration (FDA) before they go on the market. For this reason, you need to be aware of the manner appropriate to their use.

Probiotics are considered safe to take as an added food source or supplement, although you should not simply rely on probiotics alone. Consider their use together with other approaches, such as a healthy diet, medications, and lifestyle modifications. Start a journal and keep track of how you feel before and after starting probiotics. After several weeks, discontinue their use. If you begin to notice an increase in your UC symptoms, the probiotics may have been helping your condition after all. Some individuals have reported feeling bloated and gassy at the beginning of their intake. For this reason, doctors typically recommend taking a smaller dosage and building up to the full dosage once your body has adjusted to the change. On the other hand, if you have a weakened immune system, you could do more damage to your health by taking probiotics. Moreover, do not use probiotics as a replacement for any UC medications unless you receive confirmation from your doctor first.

While probiotics are showing promising results in the management of UC, there isn’t one probiotic that works for all. Every individual’s organism is different and reacts differently to various probiotics. As to whether probiotics will make a difference to your health is individual but whatever the case, it is important to speak with your doctor before adding them to your treatment plan.