Probiotics

Inflammatory bowel disease (IBD) is a condition of chronic inflammation on the digestive tract, which can cause symptoms such as abdominal pain, diarrhea, nausea and fatigue. There are various forms of complementary and alternative therapies that some people with IBD choose to try. These forms of therapy are intended for use under the supervision of a healthcare provider to supplement prescribed medications for IBD such as aminosalicylates, immunomodulators, corticosteroids, antibiotics, and biologic therapies. They should never be used to replace medications for IBD, which are the only therapies that have been proven to help treat the inflammation. One form of complementary therapy is the use of probiotics. Patients should consult with their healthcare providers before starting to take any kind of alternative therapy or supplement.

What are probiotics?

Probiotics are supplements that contain certain types of beneficial bacteria that live in human bodies.1,2,4 Unlike harmful bacteria that can cause infections, the bacteria in probiotics have a symbiotic relationship with the human body, meaning they work with it to create an overall healthy environment. They do this by keeping the bad bacteria in check.

How might probiotics affect IBD symptoms?

Many patients with IBD disease experience the symptom of chronic diarrhea.1,3,4 Controlling diarrhea is an important part of treatment of IBD. In many cases, chronic diarrhea is caused by the inflammation from IBD, but it can also result from antibiotic treatment. Chronic diarrhea can lead to serious health issues such as malnutrition and dehydration. Some studies have shown probiotics to be beneficial in helping to prevent chronic diarrhea for some people. Some research has suggested that probiotics may also contribute to maintaining remission, along with the treatment plan set forth by the patient and his/her healthcare provider, in some patients with IBD.

In some cases probiotics may also been used to help supplement treatment for pouchitis. Pouchitis is a condition that can develop as a result of surgery to remove the colon.

It is important to note that only preliminary research on probiotics has been carried out to date. As of now, the U.S. Food and Drug Administration (FDA) has not approved any probiotics for preventing or treating any health-related problems.

What are some forms of probiotic supplementation?

There are many different strains, or types, of probiotic bacteria.1 Many of the different types are sold to be taken orally, either individually or as a complex. Oral probiotic supplements can be found at health food stores and some drug stores. Dosage will be indicated on the package, but patients should seek advice from their healthcare providers about how much to take. There are also some types of foods that contain probiotics. In most foods containing probiotics, the bacteria develop as part of a fermentation process.
These foods include:

  • Yogurt
  • Kefir
  • Sauerkraut
  • Kimchi
  • Miso
  • Tempeh (fermented soy beans)

Some researchers have suggested that the effect of probiotics can be increased when they are taken alongside prebiotics. Prebiotics are foods that help stimulate growth and activity of the beneficial bacteria in the digestive tract.

What are the contraindications associated with probiotics?

Probiotics are generally considered safe for supplementation.1,3 The most common side effect is mild gas related cramping or bloating in the digestive tract.

As with any medication or supplementation, it is important to speak with your healthcare provider before taking anything. There are few scientific research studies that have been completed on probiotics in people with IBD, so all side effects and contraindications may not be known. Make sure your healthcare provider knows about all medications and supplements you are taking before starting probiotics to help ensure there will be no adverse drug interactions.

Written by: Anna Nicholson and Emily Downward | Last Reviewed: January 2018.
View References
  1. Probiotics, National Center for Complementary and Integrative Health. Available at https://nccih.nih.gov/health/probiotics/introduction.htm. Accessed 1/10/18.
  2. O′Bryan CA, Pak D, Crandall PG, Lee SO, Ricke SC. The Role of Prebiotics and Probiotics in Human Health. J Prob Health. 2013 May;1:108. doi:10.4172/2329-8901.1000108
  3. Complementary and Alternative Medicine, Crohn’s and Colitis Foundation of America. Available at http://www.ccfa.org/resources/complementary-alternative.html. Accessed 1/10/18.
  4. Sartor RB. Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics. Gastroenterology. 2004;126:1620–1633.