A MICROSCOPIC VIEW OF THIS CHAPTER
• The type and number of probiotics in the intestines affects health.
• Negative changes in intestinal microflora is called dysbiosis.
• Dysbiosis may cause many diseases, including inflammatory bowel diseases.
• Probiotics aid intestinal disorders.
• People with irritable bowel syndrome may benefit from probiotics.
• Probiotics promote intestinal health.
• Inflammatory bowel diseases include ulcerative colitis and Crohn’s disease.
• Inflammation causing damage in these diseases can be reduced by probiotics.
• Prebiotics and the use of multiple species of probiotics can rescue the intestines.
The gastrointestinal tract is one of the largest points of contact between the outside world and your internal environment. From your mouth to anus, the gastrointestinal tract forms a 30-foot-long tube. In fact, your gastrointestinal tract is your body’s second-largest surface area, the first being the skin.
The gastrointestinal tract is the body’s second-largest surface area.
Over a normal lifetime, about 60 tons of food will pass through your gastrointestinal tract. Everyone agrees that food is extremely important for well-being; however, its passage through your gastrointestinal tract is actually a threat to your health. Yes, food provides nutrients vital to your health, yet in digesting and absorbing these nutrients, food exposes you to antigens, bad microbes and toxic chemicals. As the second-largest surface area in the body, the gastrointestinal tract is a big area through which harmful things try to gain access into your body.
THE MICROFLORA AND INTESTINAL DISEASES
Probiotic research studies have been published in a wide variety of scientific journals including those focusing on pediatrics, gastrointestinal health, pharmaceuticals and nutrition. Probiotic research involves an unusually wide range of disciplines: pediatrics, gastroenterology, nutrition, immunology and microbiology. This is what makes this new area of health so fascinating—it affects your entire body at every stage of life! Some of the most promising areas of research on probiotics relates to inflammatory intestinal disorders. These diseases affect many and no cure has yet been found.
Why are probiotics so promising in the field of intestinal health? Consider the following. Intestinal microbes outnumber cells in the human body 10-fold. The microflora of your body has a metabolic activity that is the same as your organs. The microflora is kind of a virtual organ, sometimes called the “neglected organ.” Thus, the type and number of intestinal microbes have a great impact on our intestinal tract’s health, immune response and may be involved in many intestinal disease conditions.
The intestinal tract is lined with a mucus layer that is produced by the intestinal cells. The normal flora in the intestinal tract has an important influence on the structure, function and development of the mucus layer. Probiotics and bad microbes interact with these cells affecting the mucus layer and the body’s response to things that stimulate inflammation, e.g., bad microbes and allergens. Probiotics and bad microbes also exchange signals with the immune system that lies below the intestinal lining. Since probiotics can talk with your immune system, they are able to help reduce inflammation-related illnesses such as irritable bowel disease.
Diseases of the intestinal tract commonly involve inflammation. Irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), Crohn’s disease, ulcerative colitis, intestinal dysbiosis and pouchitis all involve the immune system. Because probiotics can talk with the immune system in the intestinal tract, scientists think that probiotics can help rescue you from these disease conditions.
There are more bacteria in the gut than cells in the body.
INTESTINAL DYSBIOSIS
Repeatedly we see the importance of a balanced, healthy microflora in the intestinal tract. When this balance is altered, intestinal dysbiosis (a negative change in the intestinal microflora) occurs and numerous diseases can result. An imbalance in the intestinal flora can be caused by a number of factors associated with modern Western living. Factors such as antibiotics, psychological and physical stress, chronic diarrhea or constipation and certain foods have been found to contribute to intestinal dysbiosis. Intestinal dysbiosis has symptoms that include bloating, flatulence, abdominal pain, diarrhea and/ or constipation. This imbalance in intestinal flora can lead to fungal overgrowth, e.g., Candida. Yeast infections can cause itchiness, redness, heat and pain.
Dysbiosis
The term dysbiosis was originally coined by Metchnikoff to describe a change in bad microbes in the gut. Today, dysbiosis is described as a state in which the microflora produces harmful effects via: (1) changes in the number and type of intestinal flora; (2) changes in their metabolic activities; and (3) changes in their local distribution.
Our modern diet and lifestyle, and use of antibiotics can lead to a disruption of our normal intestinal microflora. These factors cause unfavorable changes in the growth of probiotics and bad microbes and can increase the amount of toxic products in your gut, all of which play a role in many chronic and degenerative diseases, including irritable bowel syndrome, inflammatory bowel disease (e.g., colitis and Crohn’s disease) and systemic conditions such as rheumatoid arthritis. This is called the dysbiosis hypothesis.
The intestinal mucosa is the mucus coating in the gastrointestinal tract. It plays a dual role: absorbing nutrients and stopping bad substances from getting into the body (through the bloodstream). The health and strength of the intestinal mucosa are very important to immunity and health. The food we consume exposes the gastrointestinal tract to bad microbes that can produce ammonia, endotoxins, hydrogen sulphide, phenols and indoles. These toxic products can have detrimental effects on both the mucus lining of your intestines and the health of your body. The amount of these toxins present in your intestinal tract is dependent on the nutrients you eat and the type of microbes in your intestinal tract. To explain, diets that are high in protein and sulfates (a food additive) have been shown to promote the production of these toxins by bad microbes in your intestinal tract. In other words, avoiding these foods and keeping your probiotics healthy are great ways to reduce these toxins in your gut.
Prebiotics are another food you can eat that will affect the health of your intestinal mucus lining and your intestinal cells. Prebiotics selectively promote probiotics, helping them grow in your intestines. Since probiotics can fight bad microbes and promote the health of your intestinal cells and mucus lining, prebiotics are an important food to add to your diet.
The theory that intestinal dysbiosis causes so many diseases of the intestinal tract has created a deep appreciation for the effect your microflora has on your health. You need to maintain a healthy balance of microflora in your intestinal tract to enjoy health. Probiotics, prebiotics and a proper diet can help.
Changes in the natural intestinal microflora can lead to chronic and degenerative diseases.
Alterations in intestinal flora are thought to play a role in many gastrointestinal disease conditions including irritable bowel syndrome, inflammatory bowel disease (e.g., colitis and Crohn’s disease) and systemic conditions such as rheumatoid arthritis. Research has found probiotics play a protective and beneficial role in these disease conditions. Let’s discover what we know to date about these diseases and probiotics.
IRRITABLE BOWEL SYNDROME
About 20 percent of adults have irritable bowel syndrome (IBS). It is one of the most common syndromes diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50% of people. By definition, irritable bowel syndrome is “a functional gastrointestinal disorder that includes a combination of chronic or recurrent gastrointestinal symptoms that cannot be explained by structural or biochemical abnormalities.”
Irritable bowel syndrome is characterized by abdominal pain, excessive gas, bloating and changes in intestinal movement and transit. There is no evidence of detectable organic disease. The main symptom criterion is abdominal pain that is relieved by going to the bathroom (defecation) or that is associated with changes in frequency or consistency of stools.
Gastroenteritis and antibiotic use are currently thought to be environmental risk factors for developing irritable bowel syndrome. Researchers have noted a link between the onset of irritable bowel syndrome and a recent episode of gastroenteritis where the person used antibiotics. Inflammation disturbs the natural reflexes or movements of the intestinal tract, according to human and animal studies. Also, inflammation activates the visceral sensory system even if the inflammatory response is minimal. Research suggests that a change in your intestinal microflora may be an underlying cause (etiology factor) of irritable bowel syndrome.
Irritable bowel syndrome is reported as the leading cause of work absenteeism, second only to the common cold.
Naturally, researchers have wondered if probiotic therapy could be a preventative or potential treatment for irritable bowel syndrome. From the first research study investigating probiotics in patients with irritable bowel syndrome there has been excitement about the potential for this therapy. Some probiotics exhibit antibacterial, anti-viral and anti-inflammatory properties and can restore the intestinal microflora balance, suggesting that they may become a treatment for irritable bowel syndrome.
The earliest reported use of probiotics to treat gastrointestinal concerns was in 1955, when Winkelstein compiled a series of case studies from his private practice. He reported resolving constipation or diarrhea problems in 26 patients with daily administration of an unidentified strain of Lactobacillus acidophilus. Unfortunately, it was not until the 1980s that controlled trials were reported.
Lactobacillus acidophilus LB was used in the first controlled trial and was found to significantly reduce symptoms of irritable bowel syndrome. Many other species of probiotics have been used in controlled trials to treat irritable bowel syndrome. Here is a summary of the findings of the effects of various probiotic species on irritable bowel syndrome.
L. acidophilus and L. rhamnosus
Clinical studies have found modest improvements in irritable bowel syndrome symptoms with Lactobacillus acidophilus supplementation. A combination of L. acidophilus and L. rhamnosus has beneficial effects on irritable bowel symptoms.
L. paracasei
Research suggests that Lactobacillus paracasei NCC2461 appears to help reduce inflammation and improves movement in the bowels of those suffering from irritable bowel syndrome.
L. plantarum
L. plantarum has consistently produced improvement in patients with irritable bowel syndrome in clinical studies. For example, a European study in 2001 found L. plantarum reduced all irritable bowel syndrome symptoms in 95% of patients after four weeks of supplementation. Another study gave L. plantarum for four weeks to 60 people with irritable bowel syndrome. This double-blind, placebo-controlled trial found that one year after the study, people who received the probiotic reported significant reductions in flatulence and maintained a better overall intestinal function.
B. infantis
A team from the Alimentary Pharmabiotic Centre at Ireland’s University College Cork reported that irritable bowel syndrome patients who consumed a Bifidobacterium infantis drink every day for eight weeks experienced fewer overall symptoms, abdominal pain and discomfort. At the American College of Gastroenterology meeting in 2005, a study was presented that showed Bifidobacterium infantis significantly reduced symptoms of irritable bowel syndrome in 165 women in four weeks. The probiotic was able to normalize bowel movements in the women who had either constipation or diarrhea. These results are the same as previous results in which Bifidobacterium infantis taken daily for eight weeks reduced overall irritable bowel syndrome symptoms, abdominal pain and discomfort. The relief experienced with probiotic supplementation is similar to that seen with the approved irritable bowel syndrome pharmaceuticals Zelnorm (tegaserod) and Lotronex (alosetron).
L. salivarius
L. salivarius may help people with irritable bowel syndrome. In an eight-week double-blind, placebo-controlled trial L. salivarius was found to be superior in causing improvements in patients to B. infantis.
B. lactis
Bifidiobacteria lactis 35624 appears to alleviate irritable bowel symptoms and affect inflammation. This probiotic species positively changes the ratio of good to bad inflammatory chemicals (e.g., IL-10 to IL-12), promoting healthy inflammation in the intestines.
Safety in IBS
The use of probiotics in people suffering from irritable bowel syndrome has been very successful and presents no safety concerns. As this therapy is also inexpensive compared to pharmaceutical alternatives, probiotics hold promise as a future therapy for irritable bowel syndrome patients.
Prebiotics and IBS
Prebiotics may also offer some help to those suffering from irritable bowel syndrome. A number of studies have looked at the ability of prebiotics to improve symptoms in those suffering from irritable bowel syndrome—the results are promising. In particular, prebiotics offer a safe way to improve health in those suffering from irritable bowel syndrome-related constipation.
Probiotics for the treatment of irritable bowel syndrome has shown promising results in clinical trials. Over two dozen trials have attempted to address this issue. Few trials that compare probiotic species or use combinations of species have been conducted to date to help us make a conclusive recommendation of which species will offer the best effects for those with irritable bowel syndrome. However, many species have been shown in clinical trials to offer benefits to those with irritable bowel syndrome. As such, one can assume that supplementation with a diversity of probiotics that are known to be beneficial can offer the best health benefits to irritable bowel syndrome patients. The use of probiotics has resulted in improvements in irritable bowel symptoms in many studies and clinical case reports. The therapy is safe and relatively inexpensive. Prebiotics should also be considered in an irritable bowel syndrome treatment plan.
INFLAMMATORY BOWEL DISEASE
It is estimated that two million people worldwide are affected by inflammatory bowel disease (IBD). Inflammatory bowel disease is the name of a group of disorders that cause the intestines to become inflamed. There are two clinical phenotypes of inflammatory bowel disease: ulcerative colitis and Crohn’s disease. Both include inflammation in the intestine. In ulcerative colitis, the inflammation is limited to the colon. In Crohn’s disease, inflammation may also be present in the small intestine. Symptoms of inflammatory bowel disease involve disruption in bowel habits and mucosal inflammation. It is thought to be caused by environmental substances, including your diet and intestinal microflora. Disturbance of intestinal microflora, i.e., dysbiosis, is a key factor causing inflammatory bowel disease.
To what degree the environment causes inflammatory bowel disease is uncertain. However, if environmental causes of inflammatory bowel disease can be eliminated, then treatments to help rebuild a healthy microflora may be very successful. As such, dietary changes, probiotics and prebiotics could be very successful treatments for inflammatory bowel disease if it is caused by an unhealthy microflora (intestinal dysbiosis). Reducing the intake of proteins and processed foods, particularly those containing sulfates, can help reduce fermentation that results in the creation of some toxic compounds (ammonia, endotoxins) in the gastrointestinal tract. Another way to reduce the production of toxic compounds in the gastrointestinal tract is to ensure probiotics are present. Probiotics have positive effects that increase the ability of the intestinal mucosa’s to filter out toxins, preventing them from getting into your blood. You can increase the amount of probiotics in your intestine by supplementing with them or eating foods that contain prebiotics that promote the growth of probiotics. Prebiotics are dietary components used to fight dysbiosis. Prebiotics can selectively promote probiotics, a perfect way to fight dysbiosis.
The
etiology of inflammatory bowel disease likely involves three factors:
• your susceptibility
• the health of your intestinal mucus lining
• your current level of probiotics.
The development of irritable bowel disease may be caused by an intolerance to normal microbes by the immune system.
There are many theories as to the cause of inflammatory bowel disease; however, a growing number of experts are giving the intestinal microflora a second look. Research in both animals and humans with inflammatory bowel disease suggest that the microflora is one of the factors involved in the tissue damage seen in this disease. In susceptible individuals, inflammatory bowel disease may arise due to a breakdown in their immune system, which does not tolerate the microbes that live in their intestine and reacts to them as if they were not helpful, but harmful. The drugs that are used today to treat irritable bowel disease try to reduce the ability of your immune system to attack the microbes in your intestines, thus relieving some of the symptoms, but this also reduces your ability to fight disease in other parts of your body. These drugs suppress your immune system, making it easier for you to get sick. Using probiotics and prebiotics to help change the type of microbes in your intestines might stop the immune system from attacking and reducing the irritable bowel disease symptoms. Probiotics and prebiotics may be a good option to try when using drugs, as they may help reduce symptoms of the disease and can help protect you while your immune system is weak.
Research to date has shown that probiotics do not cure inflammatory bowel disease. Yet probiotics do significantly prolong remission, which can increase your quality of life. By changing the intestinal flora with the use of probiotics and prebiotics you may be able to reduce the symptoms of irritable bowel disease.
CROHN’S DISEASE
What is Crohn’s disease? Crohn’s disease is a chronic inflammatory disease involving the small and large intestine, but which can affect other parts of the digestive system as well. It is named for Burrill Crohn, the American gastroenterologist who first described the disease in 1932. Crohn’s disease is usually diagnosed in people in their teens or 20s, but can be diagnosed at any point in life. It can be a chronic, recurring condition, or it can cause minimal symptoms with or without medical treatment, depending on the person.
What is the relationship between microbes and Crohn’s disease? This relationship is not completely understood. Researchers have discovered that some strains of Escherichia coli, a bad microbe, may be involved in Crohn’s disease. Other microbes are thought to be beneficial and protective to the intestinal tract: Bifidobacteria and Lactobacilli.
Several randomized control trials have looked at the ability of probiotics to help people with Crohn’s disease. The evidence strongly supports the use of probiotics in those suffering from Crohn’s disease. Both Lactobacilli and Bifidobacteria have been shown to support a healthy intestinal tract and reduce problems with Crohn’s disease. This makes sense that both families of probiotics are helpful, if you remember that Crohn’s disease infects both the small intestinal tract and the colon (the two locations where these probiotics love to live).
Some promising results have been seen when the probiotic Lactobacillus rhamnosus GG was used in combination with immunomodulatory drugs such as Prednisone in people with Crohn’s disease. The study found an improvement in symptoms in one week. There also appeared to be an improvement in the health of the gut barrier. This means that fewer bad microbes or allergens were able to irritate the intestines.
Other probiotics including L. salivarius and Saccharomyces boulardii have shown promising preliminary results in Crohn’s disease studies and may be helpful in promoting general intestinal health. In fact, both lactic acid bacteria L. rhamnosus GG and L. salivarius UCC 118, as well as Escherichia coli Nissle are currently thought to be effective in maintaining remission of inflammatory bowel disease.
Lactobacillus plantarum may also offer some help to intestinal tracts plagued by inflammatory diseases such as Crohn’s disease. Critically ill, antibiotic-treated inflammatory bowel disease patients were supplemented with L. plantarum. The probiotic was able to live in the colon, where it reduced the number of bad microbes (enterobacteriacea). This is helpful as fewer bad microbes mean less toxins to irritate the colon and cause symptoms. Daily use of L. plantarum may offer some help in critically ill, antibiotic-treated inflammatory bowel disease patients.
Bifidobacterium, which mostly live in the colon, are also thought to be of help for Crohn’s disease sufferers. Research has investigated Bifidobacterium species (B. breve, B. infantis, B. longum) and found they may have a beneficial effect by controlling immune factors, called cytokine transcription factors, within the mucus of the intestines. In Crohn’s disease it is the inflammation that causes the symptoms—less inflammation means happier intestines. Bifidobacterium also appears to help control immune cells in the intestinal mucus, which are called T cells. By controlling the inflammation in the intestinal mucus, Bifidobacteria may be able to reduce symptoms and problems associated with inflammatory bowel diseases like Crohn’s disease. Bifidobacteria are a promising Crohn’s disease therapy.
Both Lactobacilli and Bifidobacteria species are helpful in those with Crohn’s disease. How about a combination of two probiotic families? A combination probiotic called VSL#3, which includes L. casei, L. plantarum, L. acidophilus, L. bulgaricus, B. longum, B. breve, B. infantis, S. thermophilus, E. coli Nissle 1917 and S. boulardii, has also shown positive results in alleviating symptoms of inflammatory bowel disease. Many different probiotics are known to be helpful for those with Crohn’s disease.
A Unique Prebiotic for IBD
Interesting research on germinated barley foodstuff (GBF) was published in 2000. GBF is a prebiotic whose unique characteristics make it highly suitable for applications in irritable bowel disease. GBF is converted in the body by probiotics of the Eubacterium and Bifidobacterium genus into butyrate, which causes anti-inflammtory effects in the intestines and accelerates intestinal epithelial cell growth, i.e., helps the intestinal lining heal quickly.
Prebiotics may also offer some help for people with Crohn’s disease. Prebiotics help feed probiotics in the intestintal tract, improving their numbers. As such, prebiotics may be a good addition to the diet of people with Crohn’s disease as healthy populations of probiotics is known to help them feel better.
PROBIOTIC ROCKETS FOR TREATMENT
The next stage in inflammatory bowel disease research may involve genetically modified probiotics. We can send humans to the moon in rockets. Soon we may also be able to send treatments to the gut in probiotics. Probiotics can be the rocket for treatments. Advances in technology are trying to create organisms that can cure disease. Probiotics can be altered into genetically modified organisms that can deliver important substances to the intestines to help fight disease.
Let’s explain how this might work. Crohn’s disease involves many chemicals that promote inflammation. Some chemicals in the body can stop inflammation. Interleukin-10 (IL-10) is an inflammatory chemical that can stop inflammation and reduce symptoms of Crohn’s disease and other inflammatory bowel diseases. Researchers have been able to genetically engineer Lactococcus lactis to deliver IL-10. The L. lactis was altered by researchers to be able to deliver interleukin-10 in the gut to help reduce inflammation there. It was tested in the lumen of mice with inflammatory bowel disease. L. lactis is a good probiotic to choose as it does not cause disease, is non-invasive and does not colonize in the body, so it cannot grow and create more IL-10. L. lactis has been safely used for years in the production of fermented foods. In this experiment, after two weeks of use, the probiotic significantly reduced the inflammation in the intestines. Perhaps future advances in this technology will allow us to cure Crohn’s disease and other inflammatory bowel diseases with the help of this and other genetically modified probiotics.
ULCERATIVE COLITIS
Ulcerative colitis is a type of inflammatory bowel disease that affects the large intestine and rectum. The cause of this disease is unknown. It may affect any age group, although its occurence peaks at ages 15 to 30 and then again at ages 50 to 70. The disease usually begins in the rectal area and may eventually extend through the entire large intestine. The disease causes inflammation to the intestinal wall. Repeated inflammation causes the wall to thicken and scar tissue to develop. The tissue of the colon can even die or become infected with bacteria in severe cases of the disease.
Ulcerative colitis is a chronic disease with frequent relapses. In humans with ulcerative colitis, the inflammation occurs where there is the highest bacterial concentration—the colon and rectum. The usual therapy for ulcerative colitis is a combination of drugs called sulfasalazine and glucocorticosteroids. The aim and hope of this therapy is to stop the inflammation and keep the person in a state of remission. However, a large number of patients become resistant or intolerant to sulfasalazine, and this treatment no longer offers help.
Probiotics can also cause remission of ulcerative colitis. A number of trials have found single probiotic strains to help improve health in people with inflammatory bowel disease such as ulcerative colitis. Probiotics are well supported as a way to help people with this disease.
What about using multiple species to treat ulcerative colitis? In a clinical trial, a probiotic mixture including four strains of Lactobacilli, three strains of Bifidobacteria and Streptococcus thermophilus was given to a number of ulcerative colitis patients. This high dosage, multi-strain probiotic mixture improved the number of patients and duration of their remission, and decreased inflammation.
A review of all of the clinical research on the use of probiotics in people with ulcerative colitis suggests that high-dose, multi-strain probiotic mixtures are more effective at reducing inflammation and increasing remission length than single probiotic strains. Of note, the probiotic Escherichia coli has also been used in a number of clinical trials and reportedly maintains remission in ulcerative colitis patients.
POUCHITIS
Patients with ulcerative colitis sometimes have part of their colon removed to treat the disease. In this surgery, physicians will sometimes create an internal pouch, called an ileoanal pouch, to prevent the need to wear an external appliance to store stool (fecal waste). Sometimes the lining of this internal pouch becomes inflamed. This complication is known as pouchitis. Thirty-two percent of patients with an ileoanal pouch have had at least one episode of pouchitis. Pouchitis can cause symptoms similar to ulcerative colitis, such as crampy abdominal pain, diarrhea, dehydration, increased frequency of stool, fever, bleeding and joint pain. Typically, pouchitis is treated with the short-term use of antibiotics. Antibiotics are generally effective at reducing inflammation and promoting remission in these people. However, there are side effects of using antibiotics. including an increased risk of diarrhea and an increased risk of complications in the intestines due to the loss of probiotics.
Probiotics are leading the way for a new treatment option for pouchitis. Probiotics not only promote remission of pouchitis, they also appear to have preventative effects. Clinical trials have found that probiotics have the ability to maintain remission in patients suffering from recurrent pouchitis. A number of randomized, placebo-controlled trials involving patients with recent remission from pouchitis due to antibiotic use have found that probiotics can help maintain remission for at least a year.
It appears that supplementing with probiotics of multiple species has a greater positive effect on pouchitis than taking only a single species. A high dosage of a probiotic mixture including four different strains of Lactobacillus, three Bifidobacteria strains and Streptococcus thermophilus was used in a randomized, placebo-controlled study and found to be effective at maintaining antibiotic-induced remission in patients with pouchitis. The probiotic treatment also reduced the likelihood of relapse.
Another popular multi-strain probiotic combination called VSL#3 has been found to be effective against pouchitis remisison. VSL#3 is a combination of L. casei, L. plantarum, L. acidophilus, L. bulgaricus, B. longum, B. breve, B. infantis and S. thermophilus. In a large clinical trial, volunteers were given pharmaceuticals to induce remission of their pouchitis and then randomly given either VSL#3 or placebo. Of the patients getting no probiotics, 100% experienced relapse. Only 15% of the patients taking probiotics experienced relapses of pouchitis. Probiotics can decrease the likelihood of relapse in patients in remission of pouchitis.
On the contrary, research investigating the effects of a single probiotic, Lactobacillus rhamnosus GG, did not show a clinical effect on pouchitis. Perhaps this particular strain is not helpful or the symptoms of pouchitis can only be helped by the presence of multiple probiotic species.
When all of the scientific literature is considered, it is easy to conclude that there is an advantage to taking several probiotic strains at high doses to treat pouchitis. Researchers also suggest that probiotics may reduce the risk of developing pouchitis in patients undergoing ulcerative colitis surgery.
Of note, probiotics are not effective in inducing remission from pouchitis. Remission can be induced by antibiotic use. Clinical trials have shown that remission can be effectively maintained with probiotic use. Many studies have reported that both probiotics and antibiotics can be used at the same time, and this is a safe and effective means of treatment in many disease conditions. Of note, they should be taken a few hours apart to avoid interaction. The use of both may offer the best solution to patients with pouchitis.
SUMMARY
Probiotics love to live in the intestinal tract, where they offer many healthy benefits to all of us. Changes in the number and type of microbes in the intestines have many negative affects on your health. One of the most common health problems in Western civilization is inflammation in the intestines. This can cause a wide array of symptoms. Irritable bowel syndrome is a term used to explain chronic unhealthy and unhappy symptoms in the intestines. There is no known cause of this illness. Probiotics have been found to improve the health of those suffering from irritable bowel syndrome. Many species are known to reduce symptoms and a combination of a number of these species is currently thought to offer the most help to people with irritable bowel syndrome. Prebiotics may also be helpful.
A large body of evidence suggests that your intestinal microflora is a factor in inflammatory diseases of the intestinal tract. Inflammation in the intestinal tract can become chronic. Inflammatory bowel diseases include Crohn’s disease, irritable bowel disease and ulcerative colitis. People with irritable bowel disease seem to have unusual microbe populations in their intestines. This suggests that changing the type and quantity of probiotics in the intestines likely will help those with irritable bowel disease.
Crohn’s disease is a chronic inflammatory disease that affects both the small and large intestine. Both Lactobacillus and Bifidobacterium species have been found in clinical studies to effectively benefit individuals with inflammatory bowel disease. Single strains appear to have beneficial effects as do multi-strain probiotic combinations. No one strain is known to be the best; however, it appears that a combination of Lactobacilli and Bifidobacteria is ideal as these species love to live in both areas of the intestines affected by these diseases.
The use of probiotics as an extra therapy for inflammatory bowel diseases has been well studied. These studies suggest that high doses of multi-species probiotics are effective in decreasing inflammation in people with inflammatory bowel disease.
Pouchitis, a complication experienced in patients with an ileoanal pouch, can maintain remission with probiotics. The use of probiotics at the same time as antibiotics may be of benefit to patients with pouchitis. High-dosage, multi-strain products appear to be the best choice for those with pouchitis.
Prebiotics help make positive changes to the microflora in the intestines. As such, prebiotics are thought to help with many of these diseases of the intestinal tract. Those with inflammatory bowel diseases should consider adding prebiotics to their diet or taking them as supplements to help improve their intestinal health.
