Ulcerative colitis affects an estimated 700,000 Americans, according to the Crohn's and Colitis Foundation of America. Despite its prevalence, little is known about the cause of the disease, and current treatments are not able to manage the symptoms of many patients. Probiotic supplements have recently been used to treat other gastrointestinal conditions and are currently being assessed as a treatment for ulcerative colitis.
Ulcerative Colitis
Ulcerative colitis is a type of inflammatory bowel disease characterized by a chronic inflammation of the large intestine. Symptoms include abdominal cramping and diarrhea. Ulcerative colitis is caused by the body's immune system mistaking harmless substances like food and friendly bacteria as threats. The immune system launches attacks against these perceived threats, resulting in the release of toxic substances from white blood cells. Ulcerative colitis patients experience alternating periods of inflammation and remission. Over time the recurring inflammation causes sores to form along the large intestine lining.
Probiotics
Probiotics are defined by the World Health Organization as living microorganisms that can positively impact the health of humans. Probiotics are bacteria and yeasts originally from the human digestive tract that have been closely studied and can be ingested and survive passage through the stomach and small intestines. These microorganisms must be alive when they reach the large intestine in order to have probiotic effects. Probiotics are present in many fermented dairy and vegetable products and are also available in pill form.
Treatments for Ulcerative Colitis
There is no cure for ulcerative colitis, but several types of therapies are used to improve quality of life for patients. Aminosalicylates, corticosteroids, immune modifiers, antibiotics and biological therapies are all used to manage the symptoms of ulcerative colitis. However, for some patients these therapies are not sufficient to offer relief. Probiotics have shown promise as a treatment for ulcerative colitis symptoms and are currently the focus of many studies to determine their efficacy for preventing and alleviating the symptoms of the disease.
Evidence
The scientific literature on the ability of probiotics to treat ulcerative colitis symptoms is complex. Some studies have reported increased rates of remission in patients taking probiotics compared to patients not receiving treatment. However, an article in the "Netherlands Journal of Medicine" summarizing data from nine clinical trials reported treatment with probiotics resulted in similar remission rates to treatment with anti-inflammatory medications. A study in the Cochrane Database of Systemic Reviews found that probiotics had no impact on remission rates but did modestly improve symptoms in patients experiencing inflammation.
Considerations
Each person affected by ulcerative colitis experiences a different set of symptoms and responds to therapy in a unique way. Probiotics therapies are one of several treatment options and have shown potential to improve quality of live for some ulcerative colitis patients. While they are generally considered safe, probiotics are live microorganisms and therefore may not be suitable for all people, especially those with suppressed immune systems.
References
- Crohn's and Colitis Foundation of America: About Ulcerative Colitis and Proctitis
- World Health Organization: Health and Nutritional Properties of Probiotics in Food including Powder Milk With Live Lactic Acid Bacteria Report
- "American Journal of Gastroenterology"; VSL#3 Probiotic-Mixture Induces Remission in Patients With Active Ulcerative Colitis; Rodrigo Bibiloni, Richard N. Fedorak M, Gerald W Tannock, Karen L Madsen, Paolo Gionchetti, Massimo Campieri, Claudio De Simone and R. Balfour Sartor; July 2005
- "World Journal of Gastroenterology": Effects of Probiotic on Intestinal Mucosa of Patients With Ulcerative Colitis
- "Netherlands Journal of Medicine": Probiotics and Remission of Ulcerative Colitis: a Systematic Review
- Cochrane Library: Probiotics for Induction of Remission in Ulcerative Colitis
