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Health News Archive 832 - Ulcerative Colitis
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Probiotics for Ulcerative Colitis

Twenty-nine children (mean age 9.8 years, range 2-16 years) with newly diagnosed ulcerative colitis were randomly assigned to receive, in double-blind fashion, a probiotic preparation (VSL#3; 1,800 billion bacteria per day) or placebo for one year.  VSL#3 consists of four strains of lactobacilli, three strains of bifidobacteria, and one strain of Streptococcus salivarius subsp. thermophilus.  All patients received glucocorticoids and mesalazine until remission occurred, and then continued to receive mesalazine as maintenance therapy.  The proportion of patients who achieved remission was significantly greater in the probiotic group than in the placebo group (93% vs. 36%; p<0.001).  After one year, the relapse rate was significantly lower in the probiotic group than in the placebo group (21% vs 73%; p=0.014). No adverse effects of VSL#3 were seen.

Comment by Alan Gaby, MD

It has been suggested that chronic infection plays a role in the pathogenesis of ulcerative colitis.  In one study, facultatively enteropathogenic organisms such as Klebsiella spp. or Pseudomonas aeruginosa were found in colonic biopsy samples of nearly one-half of patients with ulcerative colitis.  The possible role of bacterial infection in this disease is supported by a study in which colonic infusion (by retention enema) of fecal flora from healthy donors resulted in an apparent cure in six of six patients, with severe ulcerative colitis.  The beneficial effect of probiotic treatment in the present study is presumably due to changes in the intestinal flora. 

Source: Miele E, et. al. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol. 2009;104:437-443.

Reprinted with exclusive permission by Townsend Letter, July, 2009

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