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Health News Archive 90 - Ulcerative Colitis
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Probiotics Reduce Ulcerative Colitis Symptoms

Probiotics may be helpful in ulcerative colitis. Taking a mixture of several probiotic bacteria reduces symptoms in patients with ulcerative colitis that do not respond to conventional medications. The probiotic mixture contained four strains of Lactobacillus, three strains of Bifidobacterium and one strain of Streptococcus salivarius -- all well-known species of good bacteria.

Researchers from the University of Alberta in Edmonton, Canada enrolled 34 patients with active ulcerative colitis who were treated with the probiotic mixture twice daily for 6 weeks. A variety of standard treatments had been tried on the patients first, with no help.

Remission occurred in 53 percent of the patients and an additional 24 percent experienced some degree of improvement in symptoms. A few patients experienced no improvement or worsening of their symptoms. The only apparent side effect from the probiotic mixture was increased bloating. Testing of sampled colonic tissue provided direct evidence that the probiotic bacteria had, in fact, reached the diseased sites of the colon.

SOURCE: American Journal of Gastroenterology, July 2005.

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Probiotics Implicated in Ulcerative Colitis Remission

OBJECTIVES: Probiotics can be useful in the treatment of inflammatory bowel disease. In a previous report, the non-pathogenic yeast Saccharomyces boulardii was found to be beneficial in the maintenance treatment of Crohn's disease. The aim of this study was to assess the efficacy of S. boulardii in ulcerative colitis patients.

METHODS: A group of 25 patients with a mild to moderate clinical flare-up of ulcerative colitis received additional treatment with S. boulardii 250 mg three times a day for 4 weeks during maintenance treatment with mesalazine. These patients were unsuitable for steroid therapy. Before and after treatment, Rachmilewitz's clinical activity index was calculated. The probiotic treatment was considered a therapeutic success only when the final score was lower than 6.

RESULTS: Of the 24 patients who completed the study, 17 attained clinical remission; this was confirmed endoscopically.

CONCLUSIONS: Our preliminary results suggest that S. boulardii can be effective in the treatment of ulcerative colitis. Controlled studies with this probiotic agent are warranted.

Guslandi M, Giollo P Raffaele University Hosptial, Milan, Italy. Eur J Gastroenterol Hepatol. 2003 Jun;15(6):697-8.

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Probiotic Reduces Ulcerative Colitis Relapse

BACKGROUND & AIMS: Pouchitis is the major long-term complication after ileal pouch-anal anastomosis for ulcerative colitis. Most patients have relapsing disease, and no maintenance treatment study has been performed. We evaluated the efficacy of a probiotic preparation (VSL#3) containing 5 x 10(11) per gram of viable lyophilized bacteria of 4 strains of lactobacilli, 3 strains of bifidobacteria, and 1 strain of Streptococcus salivarius subsp. thermophilus compared with placebo in maintenance of remission of chronic pouchitis.

METHODS: Forty patients in clinical and endoscopic remission were randomized to receive either VSL#3, 6 g/day, or an identical placebo for 9 months. Patients were assessed clinically every month and endoscopically and histologically every 2 months or in the case of a relapse. Fecal samples were collected for stool culture before and after antibiotic treatment and each month during maintenance treatment.

RESULTS: Three patients (15%) in the VSL#3 group had relapses within the 9-month follow-up period, compared with 20 (100%) in the placebo group (P < 0.001). Fecal concentration of lactobacilli, bifidobacteria, and S. thermophilus increased significantly from baseline levels only in the VSL#3-treated group (P < 0.01).

CONCLUSIONS: These results suggest that oral administration of this probiotic preparation is effective in preventing flare-ups of chronic pouchitis.

Gionchetti P. Gastroenterology 8/2000

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