A Look At The Intestinal Flora Of Ibd Patients
It has been hypothesised for many years that alterations to the intestinal bacterial flora may contribute to the onset and progression of IBD. This is a theory that is now supported by clinical evidence, as several different research studies have found the composition of gut flora to be very different in IBD patients to healthy control patients. Three separate trials1,2,3all found greater numbers of anaerobic bacteria in faecal samples taken from Crohns disease patients than in healthy controls, with particularly elevated levels of Bacteroides .
Contrary to these studies, Giaffer et al4 found no difference in total anaerobes between active CD patients, inactive CD patients and healthy controls, but they did find more aerobes and Enterobacteria in active CD, and fewer Lactobacilli in CD patients than healthy controls.
Other research groups have focused their studies into the presence of possible pathogens in IBD, such as bacteria from the Mycobacteria and Listeria genus.
To date, the results from many of these studies are difficult to interpret and often contradictory. Imbalances in gut flora are generally found, supporting the theory that intestinal flora contributes to the pathogenesis of IBD, but the bacterial species involved often differs.
What Do Probiotics Do
Lets start with the basics. Theres a bunch of bacteria in your intestines, both good and bad. When the good bacteria gets low, the bad bacteria can overgrow and contribute to symptoms like gas, bloating, diarrhea, constipation, or other mostly bathroom related difficulties.
Thats where probiotics come in. Probiotics are the good bacteria and are thought to help rebuild those friendly bacteria levels in the gut, and in turn, provide health benefits.
Consuming probiotics in food or supplements helps contribute to a more beneficial gut microbiome and potentially positive health outcomes, since the good bacteria can crowd out the bad, and prevent the bad from proliferating.
When you have a Crohns flare, it can affect the balance of good and bad bacteria which might make your symptoms of the disease worse. So striking the right balance of good and bad bacteria in the gut is important.
Increasing your probiotic intake can help boost good bacteria and hopefully reduce Crohns symptoms.
But should you bother with probiotics? Lets look at how they may affect your health.
Benefits Of Taking Probiotics
Not all probiotics are the same. Different strains of the bacteria have different effects. For example, one strain may fight against cavity-causing organisms in our mouths and don’t need to survive a trip through our guts.
Research has been promising for these friendly critters. Potential benefits of probiotics have been seen in the treatment or prevention of
- H. pylori
- vaginal infections
- infection of the digestive tract caused by
- pouchitis
- eczema in children.
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How To Take Probiotics
When you take probiotics for UC, there are two key things to know.
To keep up the benefits, you have to keep taking them. If you stop, the balance of bacteria in your colon will change and a flare-up may occur. Talk to your doctor about a long-term probiotic plan.
Where Can I Get Probiotics
There are countless types of probiotic products available and many strains of microorganisms that may be used in them. Two of the most common types of bacteria used are Lactobacillus and Bifidobacterium.
You can get probiotics from a range of sources. You can find them in foods such as yogurt, kefir , and even sauerkraut.
You can also take them as supplements, in forms such as capsules, tablets, liquids, or gummies. Your local pharmacy likely has several options available.
If youre thinking of using probiotics, you should keep in mind that unlike prescription drugs, probiotic supplements are not regulated by the . This means the FDA doesnt check whether supplements are safe or effective before they go on the market.
If you would like guidance on finding a high-quality probiotic, talk to your doctor.
Prebiotics are carbohydrates that are the food for certain groups of bacteria. Consuming prebiotics can help boost the population of your own gut probiotics for this reason. Some natural sources of prebiotics include:
- garlic
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Can Probiotics Help Prevent Flare
The use of probiotics for this purpose shows more promise.
Several studies have shown that probiotics may be as effective as traditional UC medications, including the gold-standard treatment mesalazine.
A 2004 German study followed a group of 327 patients with a history of UC, giving half of them mesalazine and the other half probiotics . After one year of treatment, the average time to remission and the quality of remission was the same for both groups.
Similar results have been seen in other studies. And another probiotic,
Probiotics For Ulcerative Colitis
The AGA doesnt recommend probiotics for treating ulcerative colitis outside of use in a clinical trial. As with Crohns disease, the limitations in the type of studies that have been done so far are the main factor in this decision.
The AGA found 11 studies done using probiotics for treating ulcerative colitis. They used various different strains of probiotics, which makes comparing these studies difficult.
There were four studies that compared the use of probiotics with the medications mesalamine or balsalazide. A few of the studies allowed co-therapy with steroids and one was done with the use of probiotic enemas in children.
While the evidence was considered low, the AGA does indicate that for some of the studies, the benefit was uncertain. There was one study that showed a potential for benefit. This appears to be in contrast to Crohns disease, where there doesnt seem to be much indication that probiotics might be beneficial.
Theres a call for more research and there are no recommendations for using probiotics for ulcerative colitis.
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Do Probiotics Help Ulcerative Colitis And Crohn’s Disease
Researchers are starting to think that imbalances in our gut microbiome are linked to many diseases, ailments and even our mental health.
There is increasing evidence that suggests intestinal microbiota plays a role in initiating, maintaining and determining the characteristics and development of IBD1, 2. And, some people with IBD do report that taking probiotics can help with easing some of their symptoms.
However, studies into the effectiveness of probiotics on people with IBD are limited. There have been a few studies into specific strains of bacteria and their effect on IBD and even fewer studies specifically testing probiotic products on IBD. Generally, at the moment, the research shows that some specific probiotics may be helpful for people with ulcerative colitis but the evidence in Crohns Disease is less convincing.
Some of these studies include:
Probiotic product specific
VSL#3 and pouchitis. The study concluded that high doses of the probiotic VSL#3 are effective in the treatment of mild pouchitis3.
VSL#3 and ulcerative colitis. The study demonstrated that VSL#3 is effective in achieving clinical responses and remissions in patients with mild-to moderately active UC4.
Some studies have also been carried out into Crohn’s disease and microscopic colitis.
Symprove and ulcerative colitis. The study found that 76% of those with ulcerative colitis taking part in the study had significant reductions in faecal levels of calprotectin5.
Bacteria strain specific
Probiotics And Vaginal Health
Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. The dominant Lactobacilli strains normally make it too acidic for harmful microorganisms to survive. But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.
Many women eat yogurt or insert it into the vagina to treat recurring yeast infections, a “folk” remedy for which medical science offers limited support. Oral and vaginal administration of Lactobacilli may help in the treatment of bacterial vaginosis, although there isn’t enough evidence yet to recommend it over conventional approaches. Probiotic treatment of urinary tract infections is under study.
Probiotics are generally considered safe they’re already present in a normal digestive system although there’s a theoretical risk for people with impaired immune function. Be sure the ingredients are clearly marked on the label and familiar to you or your health provider. There’s no way to judge the safety of unidentified mixtures.
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The Benefits Of Probiotics For Inflammatory Bowel Diseases
The answer is complicated, according to Berkeley Limketkai, MD, PhD, an associate professor of medicine at UCLA and the director of clinical research at the schools Center for Inflammatory Bowel Diseases.
Unfortunately, probiotics have not been shown to be helpful for Crohns disease directly, for either induction of remission or maintenance of remission, he says, partially due to a lack of robust studies. A review co-authored by Dr. Limketkai published in July 2020 in The Cochrane Database of Systematic Reviews turned up only two studies that investigated probiotics for the remission of Crohns, and after six months, the treatment showed no difference compared with placebo. A previous review, published in the journal Clinical and Experimental Gastroenterology, included 14 studies on Crohns and 21 studies on ulcerative colitis it found that while probiotics were a beneficial addition to conventional treatment for ulcerative colitis, no such benefit was found for patients with Crohns compared with a placebo.
For that reason, Limketkai doesnt typically recommend probiotics for his patients with Crohns disease.
That doesnt mean probiotics arent helpful for Crohns just that enough research hasnt been done yet to prove or disprove their efficacy.
Do The Ileum A Colon Differ In Their Way Of Handling Bacteria Both In Health And Inflammation
The small intestine is a complex organ that does not just accomplish the digestion and uptake of nutrients. Its huge surface is constantly exposed to intestinal microflora consisting of more than 400 bacterial species. This requires an important ability of intestinal cell systems in host defence to ensure tolerance to commensal bacteria or efficient recognition and elimination of pathogens. The mechanisms and factors protecting mucosal surface from bacteria are not fully understood, but it is clear that components of both the innate and the adaptive immune systems contribute to this phenomenon. However, while the initiation of the adaptive immune responses requires several days, many infections are eliminated by rapidly acting innate immune functions before they become apparent. Bactericidal effectors of the innate immune system include several peptides or proteins such as defensins, cathelicidins, cryptdin-related sequence peptides, certain chemokines, and bactericidal/permeability-increasing protein as well as the antimicrobial enzymes lysozyme and group IIA phospholipase A2.
The small intestine and the colon differ profoundly not only in their bacterial loads , but also in the components of the epithelial innate immune defence both in health and during inflammation.
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Reason #4 No Additives
The strains, many times called super strains, are carefully selected strains of beneficial bacteria and their products do not contain GMOs, Soy, Gluten, FOS, and there are dairy-free options.
This alone is extremely impressive. To find a brand that guarantees super strains and does not contain at least one of the previous additives is very hard to find. And for those of us who have dairy as their enemy number one, Natren got us covered!
Why Does The Person At The Local Organic Food Store Or Nutrition Supply Shop Tell Me That Herbal Products Will Work For My Ibd
Diet supplements are a multi-billion dollar business in the United States. The Food and Drug Administration is not allowed to regulate their products as long as they do not make specific health claims. The people who work in these stores are sometimes paid extra when they sell supplements. They will often guide people to products that pay the highest rates, to add to their own pay. In contrast, your doctor does not receive money from drug companies for medicines you are prescribed.
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Why You Should Be Taking Probiotics For Crohns Disease
Close to 800,000 people suffer from Crohns Disease in the United States. Each year the number of people diagnosed is increasing.
Though theres no cure for Crohns, there are ways to make it manageable and to tame flare-ups. Many treatment options exist, but one popular alternative is probiotics.
What are probiotics and how do they influence people with Crohns Disease? Are they really as helpful as some people believe?
Lets explore how probiotics for Crohns Disease could provide some relief for people with this painful condition.
Do Probiotics Really Help Crohn’s
People who practice Complimentary and Alternative Medicine have long used probiotics to treat various illnesses. Recently, however, they have been in the limelight, especially by manufacturers touting the health benefits of foods that contain probiotics.
If you have Crohn’s disease, do probiotics help?
What are probiotics?
Our intestinal tract is home to millions of bacterial microflora. Good bacteria help keep us healthy, however, disease or pathogens can disrupt this natural process. We know that in people with Inflammatory Bowel Disease , their immune system has a faulty response to beneficial microflora, reacting as if the organisms were foreign objects. Researchers find that the sections of the gut with the highest bacteria count are the same areas most affected by IBD.
Probiotics are live microorganisms we ingest through food or supplements. They may be effective in preventing or managing Crohn’s disease. You can find probiotics in certain foods, including live-culture yogurt, some milk products and beverages and fermented soy products . You can also purchase probiotic dietary supplements.
Here are just a few of the many reported benefits of probiotics.
- Reduces lacto-intolerance
- Reduces diarrhea, particularly if caused by rotaviruses
- Offsets side effects from antibiotics
- Protects against cancer and pathogens
- Shortens duration of intestinal infections by the Clostridium difficile bacteria, which is of particular concern to IBD patients
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Can Probiotics Actually Help With Crohns Symptoms
Individuals with an IBD, like Crohns, typically have less beneficial and anti-inflammatory bacteria than individuals without IBD, so the theory that probiotics can improve and populate that missing bacteria makes sense.
However, research conducted on the benefits of probiotics in treating Crohns symptoms has not shown consistent results. While there may be some promise when it comes to treating the symptoms of ulcerative colitis, another IBD, with probiotics, studies around Crohns arent as conclusive.
Additionally, because there are many kinds of probiotics, its still a mystery as to which kinds are most beneficial for individuals with IBDs.
If youre considering adding probiotics to your diet to help with your Crohns symptoms, talk with your doctor first.
What Is Crohns Disease
Crohns Disease is an inflammation of the intestinal and digestive tract. Its an autoimmune disease, meaning it affects your immune system as well.
In 1932 Dr. Burrill B. Crohn first characterized Crohns Disease. Crohns falls under the umbrella of a number of other illnesses known as irritable bowel syndrome or IBS. While some parts of Crohns overlap with IBS, Crohns affects different parts of the digestive tract, mainly the beginning of the colon and end of the small intestine.
In a normal intestine, the healthy bacteria in the intestines are responsible for breaking down food and keeping the body balanced. In Crohns disease, the immune system falsely recognizes healthy bacteria as harmful and attacks them, causing pain and inflammation in the bowel that does not cease.
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Is There Harm In Taking A Probiotic
People who live with IBD might wonder what harm there could be in taking a probiotic. For one thing, it might be expensive. For another, it might not help.
While in some cases, probiotics might not have any adverse side effects, for some people it could lead to bloating, gas, or diarrhea. Sometimes these effects will go away over time and with continued use of the probiotic.
Another potential harm is the cost: in some cases probiotics can be quite expensive. If theyre not giving any benefit, that is a problem, especially for people who already have high medical costs.
Whats less well understood is if a probiotic might be used instead of receiving a treatment for IBD that has been proven to work in clinical trials. The harm would be in taking probiotics that might not have an effect and in forgoing other treatment.
Can Probiotics Help Ibd
Most probiotics have not been shown to work for Crohns disease or ulcerative colitis. VSL 3# is the only probiotic that has been shown to be of benefit for some people in order to prevent pouchitis after colectomy. Probiotics have been shown to be harmful in rare cases for people who are very sick. Talk to your doctor before starting a probiotic.
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What Will The Probiotics Of The Future Look Like
Ciorba says researchers are trying to pinpoint exactly how these bugs benefit us humans. All bacteria, including the ones in probiotics, create metabolites, which are small molecules that perform specific purposes inside your gut. Some metabolites help break down certain food products and keep our intestines healthy, for example. If researchers can figure out how to isolate those metabolites, they might be able to create medications that include just the most helpful molecules. But that research is just getting started, and Ciorba suspects scientists might eventually realize that the bacteria themselves are necessary. The bugs are a good delivery mechanism. They get whatever it is the metabolites do to the right location, says Ciorba. Right against the wall of the colon, or within the mucus, or somewhere that taking a metabolite may not be good enough.
For now, Ciorba says, its not necessaryor even prudentto take probiotics if your digestive health is pretty good. But if you are keen on trying them, do it in a rational way, he says. If a month of daily probiotic supplements dont make you feel noticeably better, its probably not worth spending your hard earned cash on these misunderstood bugs.
