S3195 Probiotics or Againstbiotics: The Use of Probiotics in Inflammatory Bowel Disease

Abstract

INTRODUCTION: The use of probiotics for inflammatory bowel disease (IBD) is controversial. Currently, the American College of Gastroenterology only recommends the specific probiotic VSL#3 for treatment and prevention of pouchitis. Recently, the American Academy of Family Physicians placed a Grade 1A recommendation for probiotic use in all patients with IBD. Differing recommendations can lead to uncertainty about the use of probiotics. This study evaluated probiotic use in IBD patients at a university medical center. METHODS: An IRB approved, retrospective chart review of all IBD patients seen at a university gastroenterology clinic during the past decade was conducted. Patient age, gender, self-described ethnicity, IBD type, medications and probiotic use were obtained. The GI physician gender and whether a primary care or GI physician documented probiotic use were noted. A confidential data based was created. Statistical analysis was performed with significance set at P < 0.05. RESULTS: Medical records of 392 IBD patients (218 females, 174 males; mean age 44.4 years) were reviewed. 204 were white, 99 African American, 11 Asian, 78 undefined. 279 had ulcerative colitis (52 with a J-pouch), 96 Crohn’s disease and 19 microscopic colitis. 52 of 393 (13.3%) IBD patients used probiotics, including 11 of the 52 (21.2%) patients with a J-pouch. Females were significantly more likely to use probiotics compared to males (17.0% vs 8.62%, P = 0.016). White patients were more likely than patients of other ethnicities to use probiotics. (P = 0.051).There was no significant difference in probiotic use based upon IBD type or medications. Patients of female GI physicians compared to male GI physicians were significantly more likely to use probiotics (19.5% vs. 10.8%, P = 0.031). GI physicians compared to primary care physicians more frequently documented probiotic use in IBD patients (92.3% vs 19.2%; P = 0.0001). CONCLUSION: Probiotics are increasingly being used by IBD patients. This study revealed that females and whites were more likely to incorporate probiotics into their IBD treatment regimen. In addition, patients of female physicians were more likely to use probiotics. GI physicians more often documented probiotic use in IBD patients compared to primary care physicians. While this study is limited based on single institution design, it provides a foundation for further research. Increased investigations are needed to evaluate the efficacy and use of probiotics in IBD.