FOR INFLAMMATORY BOWEL DISEASE, PROBIOTICS ARE UNLIKELY TO HELP
Current therapies for Crohn disease and ulcerative colitis, such as corticosteroids and other immunosuppressive agents, are effective but have significant adverse events.18 Researchers explored whether probiotics might help treat these diseases by improving immune response, the balance of microbes in the GI tract, and the intestinal barrier.18
Crohn disease. In a meta-analysis that was able to identify only one small RCT (N = 11), 80% of patients receiving probiotic treatment went into remission, compared to 83% in the placebo group (OR, 0.80).16 Researchers concluded there was insufficient evidence for the use of probiotics for inducing remission in Crohn disease.
Another meta-analysis of seven small studies (N = 160) found no significant evidence supporting probiotic use for maintaining remission in Crohn disease compared with aminosalicylates or azathioprine.17 One small study in this review found there was a benefit to combining S boulardii with a reduced level of standard maintenance therapy when compared to standard therapy alone, but this difference was not statistically significant.17
Ulcerative colitis. A systematic review of four RCTs (N = 244) that compared conventional treatment alone to conventional treatment plus probiotics for remission or clinical improvement in patients with active ulcerative colitis found no significant differences between groups.18 Another meta-analysis of four studies (N = 587) found that compared to placebo or treatment with mesalazine, probiotics had no benefit for maintaining remission in ulcerative colitis.19 The rate of relapse was 40.1% in the probiotics group, compared to 34.1% in the mesalazine group. The number of adverse effects was similar in both groups.
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