Probiotics for Crohn’s Disease

Please note that each Crohn’s disease probiotic trial is not described in detail. In some trials, drugs, prebiotics and/or additional nutrients were provided that may help the beneficial bacteria be more effective. Also the setting, procedure, and dose for each trial are rarely similar. For more details, search for the reference in Google to find the original publication. The simplest way is to copy and paste the title.

Of the two major forms of inflammatory bowel disease (Crohn’s disease and Ulcerative colitis), Crohn’s disease is the least responsive to probiotic treatment. Still, effective Crohn’s disease probiotics may come in the future. Patients are usually given a daily dose of probiotics along with a standard medication to induce remission (symptom-free period). Time until relapse (reappearance of the disease) or the percentage of patients relapsing is noted and compared to groups receiving a placebo.

Probiotic SupplementsImprovements Seen in TrialReferences
Synbiotic 2000No improvement1
VSL#3Reduced arthralgia2
Probiotic yoghurtImprovement in immune parameters3
Bifidobacteria
Lactobacilli
Improvement of symptoms4
L. johnsonii LA-1No improvement5, 6
L. rhamnosus GGNo improvement7-9
S. boulardiiReduced relapses10

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.

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References

1.         Chermesh, I. T., A.; Reshef, R.; Chowers, Y.; Suissa, A.; Katz, D.; Gelber, M.; Halpern, Z.; Bengmark, S.; Eliakim, R. 2007. Failure of Synbiotic 2000 to prevent postoperative recurrence of Crohn’s disease. Dig Dis Sci 52:385-389.

2.         Karimi, O. P., A. S.; van Bodegraven, A. A. 2005. Probiotics (VSL#3) in arthralgia in patients with ulcerative colitis and Crohn’s disease: a pilot study. Drugs Today (Barc) 41:453-459.

3.         Lorea Baroja, M. K., P. V.; Hekmat, S.; Reid, G. 2007. Anti-inflammatory effects of probiotic yogurt in inflammatory bowel disease patients. Clin Exp Immunol 149:470-479.

4.         Fujimori, S. T., A.; Gudis, K.; Kishida, T.; Mitsui, K.; Ehara, A.; Kobayashi, T.; Sekita, Y.; Seo, T.; Sakamoto, C. 2007. High dose probiotic and prebiotic cotherapy for remission induction of active Crohn’s disease. J Gastroenterol Hepatol 22:1199-1204.

5.         Marteau, P. L., M.; Seksik, P.; Laharie, D.; Colombel, J. F.; Bouhnik, Y.; Cadiot, G.; Soule, J. C.; Bourreille, A.; Metman, E.; Lerebours, E.; Carbonnel, F.; Dupas, J. L.; Veyrac, M.; Coffin, B.; Moreau, J.; Abitbol, V.; Blum-Sperisen, S.; Mary, J. Y. 2006. Ineffectiveness of Lactobacillus johnsonii LA1 for prophylaxis of postoperative recurrence in Crohn’s disease: a randomised, double blind, placebo controlled GETAID trial. Gut 55:842-847.

6.         Van Gossum, A. D., O.; Louis, E.; de Hertogh, G.; Baert, F.; Fontaine, F.; DeVos, M.; Enslen, M.; Paintin, M.; Franchimont, D. 2007. Multicenter randomized-controlled clinical trial of probiotics (Lactobacillus johnsonii, LA1) on early endoscopic recurrence of Crohn’s disease after lleo-caecal resection. Inflamm Bowel Dis 13:135-142.

7.         Prantera, C. S., M. L. 2002. Probiotics and Crohn’s disease. Dig Liver Dis 34 Suppl 2:S66-67.

8.         Schultz, M. T., A.; Herfarth, H. H.; Sartor, R. B.; Vanderhoof, J. A.; Rath, H. C. 2004. Lactobacillus GG in inducing and maintaining remission of Crohn’s disease. BMC Gastroenterol 4:5.

9.         Bousvaros, A. G., S.; Baldassano, R. N.; Botelho, C.; Evans, J.; Ferry, G. D.; Goldin, B.; Hartigan, L.; Kugathasan, S.; Levy, J.; Murray, K. F.; Oliva-Hemker, M.; Rosh, J. R.; Tolia, V.; Zholudev, A.; Vanderhoof, J. A.; Hibberd, P. L. 2005. A randomized, double-blind trial of Lactobacillus GG versus placebo in addition to standard maintenance therapy for children with Crohn’s disease. Inflamm Bowel Dis 11:833-839.

10.       Guslandi, M. M., G.; Sorghi, M.; Testoni, P. A. 2000. Saccharomyces boulardii in maintenance treatment of Crohn’s disease. Dig Dis Sci 45:1462-1464.