Synbiotic Therapy Improves Quality of Life and Reduces Symptoms in Pediatric Ulcerative Colitis

Abstract

The management of ulcerative colitis in children often requires aggressive pharmacological therapy or colonic resection. The authors hypothesized that synbiotic therapy would improve symptoms and quality of life in children diagnosed with ulcerative colitis. Pediatric study participants (8-18 years; n = 9) with ulcerative colitis in remission were provided synbiotic therapy (Bifidobacterium longum R0175 20 billion cfu/d, 15 g/d of inulin; n = 4) or placebo (maltodextrin + ascorbic acid capsule; 15 g/d of non-resistant maltodextrin; n = 5) for 10 months in a pilot study (phase I). At 10 months, the study was unblinded and synbiotic therapy was administered to 8 pediatric study participants (phase II). Quality of life was measured using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). The SIBDQ was administered at baseline and every 2 months. Study participants kept a daily record of symptoms. Phase I quality-of-life scores were significantly better for those receiving the synbiotic therapy versus the placebo (P = .014). Severe symptoms occurred in 60% of the control study participants, whereas no study participants receiving synbiotic therapy experienced severe symptoms (P = .032). Phase II quality-of-life scores were significantly better posttreatment with synbiotic therapy (P = .034). No adverse effects were reported. Synbiotic therapy (B longum R0175 + inulin), when provided in addition to conventional treatment, appears to be a safe and effective strategy for managing pediatric ulcerative colitis in remission.