Bifidogenic growth stimulator for the treatment of active ulcerative colitis: a pilot study

Abstract

Objectives Experimental studies have shown that luminal antigens are involved in chronic intestinal inflammatory disorders. Bifidogenic growth stimulator (BGS) is a prebiotic preparation produced by Propionibacterium freudenreichii isolated from Swiss cheese. Previously BGS was shown to act in the colon as a growth stimulator of Bifidobacteria. This study investigated the efficacy and safety of BGS in the treatment of ulcerative colitis. Methods Twelve patients with mildly to moderately active ulcerative colitis received orally 4.5 g of BGS daily for 4 wk in an open-label treatment protocol while the baseline anti-inflammatory therapy was continued. The response to treatment was evaluated clinically and endoscopically. Concentrations of short-chain fatty acids and the composition of commensal bacteria, including Bifidobacteria, Enterobacteria and Bacteroides species, were studied in stool samples. Results Patients showed improvement in their clinical activity index scores, with a significant decrease in the score from 7.4 ± 2.8 to 4.7 ± 1.5 (mean ± standard error of the mean, P < 0.01). The endoscopic index score decreased from 4.4 ± 1.7 to 2.8 ± 1.8 ( P < 0.05) with treatment. Patients showed an increase in stool butyrate concentrations after BGS treatment ( P < 0.05). There were no significant changes in stool levels of bacteria as a result of BGS treatment. No side effects related to BGS were observed. Conclusions Oral BGS therapy may represent a non-toxic way to treat ulcerative colitis. However, controlled studies are needed to demonstrate its efficacy in the treatment of this disorder.