Probiotics and Prebiotics

Inflammatory bowel disease (IBD) is a condition that causes chronic inflammation in the digestive tract. Some people may want to try complementary and integrative health (CIH) methods to help manage their IBD. CIH methods are approaches that fall outside of traditional medicine. CIH treatment methods that may help manage IBD symptoms include probiotics and prebiotics.^1,2

What are probiotics and prebiotics?

Probiotics are live microorganisms that are consumed. Probiotics include many different types of microorganisms. The most common are bacteria from the groups Lactobacillus and Bifidobacterium. Different types of probiotics have different advantages.^1,2

You might think of microorganisms like bacteria as unhealthy. But many healthy bacteria already live in your gastrointestinal (GI) tract. This is called your gut microbiome. Probiotics may help your body maintain a healthy gut microbiome. A healthy gut microbiome is linked to better digestion.^1-3

Prebiotics are a special type of plant fiber. All prebiotics are fiber, but not all fiber is prebiotic. Prebiotics are special because they feed the healthy bacteria in the GI tract. This can help maintain overall digestive health.^2,3

What are possible sources of probiotics and prebiotics?

Both probiotics and prebiotics occur naturally in many foods and are also sold in supplement form. Foods that contain probiotics include:^1-3

• Yogurt
• Kefir
• Fermented foods like sauerkraut or kimchi

Foods that contain prebiotics include:³

• Almonds
• Certain vegetables like raw leafy greens, cabbage, peas, and eggplants
• Flax
• Whole grains
• Beans

Probiotics versus prebiotics for IBD

Research on probiotics and prebiotics for IBD is mixed. One weakness is the lack of large studies that prove their effectiveness. Some research is promising, but without large, high-quality trials it is hard to be certain. And for people with GI issues, probiotics and prebiotics may cause discomfort. This may include cramping, bloating, or gas.^2-5

Some research shows that a healthy gut microbiome can reduce inflammation. Inflammation is a driving factor in IBD. Probiotics and prebiotics can both help create a healthy gut microbiome.^2-5

Additionally, in some small IBD studies, certain types of probiotics and prebiotics have helped reduce symptoms. However, this research is limited. Other studies have not found any improvements from using probiotics or prebiotics. More large-scale trials are needed to determine any links between probiotics, prebiotics, and IBD.^2-5

Other things to know

Probiotics and prebiotics are generally considered safe. But talk to your healthcare provider before taking any new drug or supplement. Before beginning any new treatment for IBD, tell your doctor about all your health conditions and any other drugs, vitamins, or herbal supplements you are taking. This includes over-the-counter drugs.^1-3

Supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency confirms the purity of the ingredients or suggested dose.^6,7

For example, a fish oil supplement may have more or less fish oil than listed on the label. A supplement may also contain ingredients that are not labeled correctly or at all. This can be dangerous. It can lead to taking too much or taking unwanted ingredients.^6,7

The FDA created good manufacturing practices (GMPs) to help this situation. GMPs are guidelines for companies to follow when making supplements. But the FDA rarely inspects facilities making supplements in the United States. Companies outside the United States do not have these inspections at all.^6,7

Many more supplements are sold than are tested. Your doctor can help you decide whether a supplement is safe.^6,7