Probiotics and UC
The human gastrointestinal tract is a unique environment home to millions of bacteria. There is a great deal of interest in understanding the role these bacteria play in the GI tract and how they can be modulated to treat disease.
Probiotics are living organisms in food and dietary supplements which when ingested, improve the health of the host beyond their inherent, basic nutrition. Similar to the living bacterial cultures in yogurt, probiotics are ingestible cultures of organisms believed to have health benefits. Examples of probiotics include: Lactobacillus GG (LGG), Lactobacillus acidophilus, Saccharomyces boulardii, Bifidobacterium, and E. coli Nissle 1917. Studies in ulcerative colitis have shown that probiotics do not differ significantly from 5-ASA medications for remission of UC with regard to efficacy or safety. Whether they add an additional health benefit when used in conjunction with conventional therapy is an area of active investigation
Probiotics have been shown to have a definitive benefit in the treatment of chronic pouchitis for UC patients who have undergone colectomy with creation of an ileal pouch. A study of the probiotic VSL#3 showed that 90% of patients taking the probiotic had remission of symptoms after a year, compared to only 60% of patients who took a placebo. Other studies suggest that VSL#3 may be useful in preventing pouchitis in patient who undergo colectomy. Studies of Lactobacillus GG in pouchitis, however, did not active the demonstrate the beneficial results as VSL#3.
It should be noted that because probiotics are not a "drug" type therapy, their manufacturing and use is not overseen by governmental body such as the FDA. As such, there is diversity among probiotics in terms of the number of active organisms contained in each and their potential efficacy. Patients considering the use of probiotics are advised to speak with their doctors regarding the efficacy and choice of a probiotic for their condition.