Probiotics In Inflammatory Bowel Disease Research Articles

Efficacy and safety of probiotics in IBD: An overview of systematic reviews and updated meta-analysis of randomized controlled trials.

Probiotics show promise in inflammatory bowel disease (IBD), yet knowledge gaps persist. We performed an overview of systematic reviews and an updated metanalysis of randomized controlled trials (RCT) assessing the effect of probiotics on Crohn's disease (CD) and ulcerative colitis (UC). MEDLINE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched up to September 2023. Primary outcomes were clinical remission and recurrence; secondary outcomes included endoscopic response and remission, and adverse events. We calculated odds ratios (OR) using a random-effects model in R. The quality of systematic reviews was assessed using the AMSTAR-2; the trials' risk of bias was evaluated using the Cochrane Collaboration tool. Evidence certainty was rated using the GRADE framework. Out of 2613 results, 67 studies (22 systematic reviews and 45 RCTs) met the eligibility criteria. In the updated meta-analysis, the OR for clinical remission in UC and CD was 2.00 (95% CI 1.28-3.11) and 1.61 (95% CI 0.21-12.50), respectively. The subgroup analysis suggested that combining 5-ASA and probiotics may be beneficial for inducing remission in mild-to-moderate UC (OR 2.35, 95% CI 1.29-4.28). Probiotics decreased the odds of recurrence in relapsing pouchitis (OR 0.03, 95% CI 0.00-0.25) and trended toward reducing clinical recurrence in inactive UC (OR 0.65, 95% CI 0.42-1.01). No protective effect against recurrence was identified for CD. Multi-strain formulations appear superior in achieving remission and preventing recurrence in UC. The use of probiotics was not associated with better endoscopic outcomes. Adverse events were similar to control. However, the overall certainty of evidence was low. Probiotics, particularly multi-strain formulations, appear efficacious for the induction of clinical remission and the prevention of relapse in UC patients as well as for relapsing pouchitis. Notwithstanding, no significant effect was identified for CD. The favorable safety profile of probiotics was also highlighted.

Impact of probiotics on inflammatory bowel disease - a systematic review

Introduction: Inflammatory bowel disease (IBD) is a chronic nonspecific inflammatory disease of the gastrointestinal tract that includes ulcerative colitis (UC) and Crohn's disease (CD). Both disease entities have many features in common, such as a basis of chronic inflammation, similar clinical symptoms as well as periods of remission and relapse. The difference between them lies in the lesions location. Treatment of IBD is primarily based on reducing inflammation and maintaining as long a remission time as possible. Increasing evidence is being attributed to the therapeutic potential of probiotics in IBD.
 Purpose: This review aims to present the preventive and therapeutic effects of probiotic use in IBS through an analysis of recent studies.
 Methods: A review of recent literature was conducted to investigate the impact of probiotic use on the treatment of IBD.
 Results: In studies, probiotics help induce and maintain remission in patients with mild to moderate ulcerative colitis, especially when used in combination therapy. In contrast, the usage of probiotics in Crohn's disease does not provide due benefit: it does not induce or prolong remission.
 Conclusions: In conclusion, the effect of probiotics on IBD is inconclusive. Some probiotics, particularly the VSL#3 probiotic blend, have shown decent effects on induction and remission in patients with mild to moderate UC. However, no therapeutic effect has been demonstrated in patients with Crohn's Disease. Therefore studies under more restrictive and standardized conditions are required.

P793 Efficacy and safety of probiotics in inflammatory bowel disease: an umbrella review and updated meta-analysis of randomized controlled trials

Abstract Background Probiotics hold potential in IBD, yet knowledge gaps persist. We aimed to perform an umbrella review of systematic reviews and updated metanalysis of all RCT assessing the effect of probiotics in on Crohn’s disease (CD) and ulcerative colitis (UC). Methods We searched MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials until September 2023 for systematic reviews and randomized controlled trials (RCT). Primary outcomes were clinical response and remission; secondary outcomes included endoscopic response, remission, and side effects. We calculated odds ratios using a random-effects model in R. Quality was assessed using the AMSTAR-2 (systematic reviews) and Jadad scale (RCTs), the Cochrane Collaboration tool was used to grade trials’ risk of bias. Results Out of 2613 search results, 67 studies (22 systematic reviews and 45 RCTs) met eligibility criteria. In the updated meta-analysis, the OR for clinical remission was 1.88 (95%CI 1.20-2.93, I2=60% - Figure 1). However, the positive effect was statistically significant only for UC (OR 2.00, 95% CI 1.28-3.11, I2=57%) but not for CD. Likewise, probiotics significantly decreased the odds of clinical recurrence in UC patients (OR 0.65, 95%CI 0.42-1.01, I2=52%) and in relapsing pouchitis (OR 0.03, 95%CI 0.00-0.25, I2=64%), but not in CD. The De Simone formulation consistently outperformed other probiotics in achieving remission and preventing recurrence in UC. On the other hand, the use of probiotics was not associated with better endoscopic outcomes. The occurrence of both mild and severe adverse events was comparable to control group. Conclusion Our results support the use of probiotics for patients with UC, both for the induction of clinical remission and for the prevention of relapse, as well for patients with previous diagnosis of pouchitis, and reinforces their good safety profile.

Probiotics in the Treatment of Inflammatory Bowel Diseases.

Inflammatory bowel diseases (IBD) are chronic, incurable inflammatory condition of the gut. They comprise Crohn's disease and ulcerative colitis. Crohn's disease (CD) may affect any tract of the gastrointestinal (GI) tract and is a transmural inflammatory condition; ulcerative colitis (UC), on the other hand, is limited to the mucosal layer of the rectum and colon. Treatment options available for both IBD are notoriously loaded with potentially serious side effects and risks. Although the pathogenesis of IBD involves a complex interaction between genetic, environmental, microbial and immunological factors, there is evidence that the interplay between the microbiota and the GI mucosa has a preponderant role. It is therefore no surprise that in recent years, a growing interest for effective and safer alternatives has focused on the potential role of prebiotics and-especially-probiotics.The mechanisms of action underlying the potential benefits of probiotics in IBD have been largely and quite extensively investigated in vitro and in vivo experiments. In terms of clinical evidence, the results of trials in the induction of remission of active CD or the maintenance of its remission with probiotics have been so far largely disappointing, to the point that their use in this disease cannot be at present recommended.On the contrary, for the treatment as well as for maintenance therapy of UC, there is clinical evidence of efficacy for some specific strains or multi-strain preparations.It is evident that this is a rapidly evolving and promising field; more data are very likely to yield a better understanding on what strains and in what doses should be used in different specific clinical settings, as we expect new and exciting developments of precision and even personalized therapy by the fast-growing field of probiogenomics.

A Comprehensive Analysis of Efficacy and Safety of Probiotics in Inflammatory Bowel Disease

A Comprehensive Analysis of Efficacy and Safety of Probiotics in Inflammatory Bowel Disease

Effects of Probiotics in Adults with Gastroenteritis: A Systematic Review and Meta-Analysis of Clinical Trials.

Probiotics have been widely used in gastroenteritis due to acute and chronic illnesses. However, evidence supporting the effectiveness of probiotics in different health conditions is inconclusive and conflicting. The aim of this study was to review the existing literature on the effects of probiotics on gastroenteritis among adults. Only original articles on clinical trials that demonstrated the effects of probiotics in adults with gastroenteritis were used for this analysis. Multiple databases, such as PubMed, Google Scholar, MEDLINE and Scopus databases, were searched for the data. The study followed standard procedures for data extraction using a PRISMA flow chart. A quality appraisal of the selected studies was conducted using CADIMA. Finally, a meta-analysis was performed. Thirty-five articles met the selection criteria; of them, probiotics were found effective in the treatment and/or prevention of chronic inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease in 17 (49%), and the treatment of pouchitis in 4 (11.4%), antibiotic-induced diarrhea in 3 (8.6%), Helicobacter pylori infection in 2 (5.7%) and diverticulitis in 1 (2.9%), while the remaining 7 (20%) were ineffective, and 1 study's results were inconclusive. The meta-analysis did not demonstrate any significant protective effects of probiotics. Having a τ2 value of zero and I2 of 6%, the studies were homogeneous and had minimum variances. Further studies are suggested to evaluate the beneficial effects of probiotics in IBDs and other chronic bowel diseases.

Ameliorating inflammation in an in vitro model by screening the anti-inflammatory and immunomodulatory roles of putative probiotics in inflammatory bowel disease

IBD is considered a relapsing disease with relapsing phases. Probiotics are beneficial microorganisms that modulate inflammatory signaling pathways. Our aim was to identify the precise molecular effects of probiotics on inflammatory signaling pathways during the presence of inflammation. Evaluation of the expression of JAK/STAT and inflammatory genes after treatment of the HT -29 cell line with the sonicated pathogens and probiotics, simultaneously was performed by quantitative real-time polymerase chain reaction (qPCR) assay. The production of IL-6 and IL-1β after administration of probiotics was conducted by means of cytokine assay. The probiotic cocktail resulted in the downregulation of TIRAP, IRAK4, NEMO, and RIP genes in the NF-кB pathway compared with Sonicat-treated cells. The expression of JAK/STAT genes was various after probiotic treatment. The application of probiotics has been observed to result in a notable decrease in the production of IL-6 and IL-1β. The investigated probiotic cocktail, especially Bifidobacterium spp. showed anti-inflammatory effects on HT -29 cells via modulation of JAK/STAT and NF-кB signaling pathways. The use of probiotics with the least side effects could be considered a suitable treatment for patients with inflammatory bowel disease, even at the beginning of inflammation.

Role of probiotics in inflammatory bowel disease

Inflammatory bowel disease (IBD) consists of ulcerative colitis (UC) and Crohn’s disease (CD). The global incidence of IBD is increasing recently. Westernization is hypothesized to play role in this phenomenon. Inflammation is the basic etiology of IBD. Genetic and environmental factors are important determinants of IBD. Gastrointestinal microorganism is a component of the environmental factors. Balanced-state microorganism environment is important to maintain normal gastrointestinal function. Dysbiosis, an imbalance in beneficial and pathogenic gastrointestinal microorganism, may elicit inflammation and result in IBD. Dysbiosis causes increased pro-inflammatory activity, decreased anti-inflammatory activity, disrupted gastrointestinal mucosal barrier, and prolonged inflammation. Probiotics are hoped to mend the dysbiosis and alleviate inflammation along with disease course. Studies in human reported that administration of probiotics along with standard therapy for UC gives promising result. In contrast, probiotics have little or no positive effect in CD. Probiotics as adjunctive therapy may be considered in managing patients with UC but not with CD.

Role of probiotics in inflammatory bowel disease

Inflammatory bowel disease (IBD) consists of ulcerative colitis (UC) and Crohn’s disease (CD). The global incidence of IBD is increasing recently. Westernization is hypothesized to play role in this phenomenon. Inflammation is the basic etiology of IBD. Genetic and environmental factors are important determinants of IBD. Gastrointestinal microorganism is a component of the environmental factors. Balanced-state microorganism environment is important to maintain normal gastrointestinal function. Dysbiosis, an imbalance in beneficial and pathogenic gastrointestinal microorganism, may elicit inflammation and result in IBD. Dysbiosis causes increased pro-inflammatory activity, decreased anti-inflammatory activity, disrupted gastrointestinal mucosal barrier, and prolonged inflammation. Probiotics are hoped to mend the dysbiosis and alleviate inflammation along with disease course. Studies in human reported that administration of probiotics along with standard therapy for UC gives promising result. In contrast, probiotics have little or no positive effect in CD. Probiotics as adjunctive therapy may be considered in managing patients with UC but not with CD.

A Potential Role of Plant/Macrofungi/Algae-Derived Non-Starch Polysaccharide in Colitis Curing: Review of Possible Mechanisms of Action.

Multiple in vitro and in vivo model investigations have suggested a broad spectrum of potential mechanisms by which plant/macrofungi-derived non-starch polysaccharides may play a role in the treatment of inflammatory bowel disease (IBD). This article reviews the in vivo and in vitro evidence of different plant-derived polysaccharides for IBD therapy. Their underlying mechanisms, particularly the molecular mechanisms associated with protective effects in the treatment and prevention of IDB, have been well summarized, including anti-inflammatory, epithelial barrier repair, and the regulation of intestinal flora. Emerging studies have observed the potent role of probiotics in IBD, particularly its ability to modulate gut microbiota, a well-known key factor for IBD. In summary, plant/macrofungi-derived polysaccharides have the potential to be a promising agent for the adjuvant treatment and prevention of IBD and will contribute to the design of well-designed clinical intervention trials that will ultimately improve the therapy of IBD.

Regulation of gut microbiota-bile acids axis by probiotics in inflammatory bowel disease.

Inflammatory bowel disease (IBD) is characterized by chronic and relapsing inflammation of gastrointestinal tract, with steadily increased incidence and prevalence worldwide. Although the precise pathogenesis remains unclear, gut microbiota, bile acids (BAs), and aberrant immune response play essential roles in the development of IBD. Lately, gut dysbiosis including certain decreased beneficial bacteria and increased pathogens and aberrant BAs metabolism have been reported in IBD. The bacteria inhabited in human gut have critical functions in BA biotransformation. Patients with active IBD have elevated primary and conjugated BAs and decreased secondary BAs, accompanied by the impaired transformation activities (mainly deconjugation and 7α-dehydroxylation) of gut microbiota. Probiotics have exhibited certain positive effects by different mechanisms in the therapy of IBD. This review discussed the effectiveness of probiotics in certain clinical and animal model studies that might involve in gut microbiota-BAs axis. More importantly, the possible mechanisms of probiotics on regulating gut microbiota-BAs axis in IBD were elucidated, which we focused on the elevated gut bacteria containing bile salt hydrolase or BA-inducible enzymes at genus/species level that might participate in the BA biotransformation. Furthermore, beneficial effects exerted by activation of BA-activated receptors on intestinal immunity were also summarized, which might partially explain the protect effects and mechanisms of probiotics on IBD. Therefore, this review will provide new insights into a better understanding of probiotics in the therapy targeting gut microbiota-BAs axis of IBD.

Presume Why Probiotics May Not Provide Protection in Inflammatory Bowel Disease through an Azoxymethane and Dextran Sodium Sulfate Murine Model.

Recent studies have shown dysbiosis is associated with inflammatory bowel disease (IBD). However, trying to restore microbial diversity via fecal microbiota transplantation (FMT) or probiotic intervention fails to achieve clinical benefit in IBD patients. We performed a probiotic intervention on a simulated IBD murine model to clarify their relationship. IBD was simulated by the protocol of azoxymethane and dextran sodium sulfate (AOM/DSS) to set up a colitis and colitis-associated neoplasm model on BALB/c mice. A single probiotic intervention using Clostridium butyricum Miyairi (CBM) on AOM/DSS mice to clarify the role of probiotic in colitis, colitis-associated neoplasm, gut microbiota, and immune cytokines was performed. We found dysbiosis occurred in AOM/DSS mice. The CBM intervention on AOM/DSS mice failed to improve colitis and colitis-associated neoplasms but changed microbial composition and unexpectedly increased expression of proinflammatory IL-17A in rectal tissue. We hypothesized that the probiotic intervention caused dysbiosis. To clarify the result, we performed inverse FMT using feces from AOM/DSS mice to normal recipients to validate the pathogenic effect of dysbiosis from AOM/DSS mice and found mice on inverse FMT did develop colitis and colon neoplasms. We presumed the probiotic intervention to some extent caused dysbiosis as inverse FMT. The role of probiotics in IBD requires further elucidation.

Probiotics in the Treatment of Inflammatory Bowel Disease in Adulthood: A Systematic Review.

Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) characterized by chronic uncontrolled inflammation with an increasing prevalence in western countries. Standard medications are often associated with adverse side effects. Thus, alternative therapies such as probiotic treatment are of great interest. We aimed to review the effect of probiotics in IBD patients. A systematic search strategy was carried out in PubMed in June 2021 and 22 studies published from 1997 to 2019 were included; they analyzed the influence of probiotics in adult IBD patients both in active and inactive stage of disease. Probiotic treatment in CD patients had no effect in 6 of 7 studies. Only in one study a positive effect of an adjunctive probiotic treatment next to standard treatment in CD patients was reported. In patients with active UC, a combination of standard treatment with probiotics resulted in improvement of the disease in 5 of 9 studies. Three of 7 studies among UC patients in remission demonstrated that probiotic treatment could be as effective as standard treatment. No clear evidence was found in studies comparing probiotics to placebo in inactive UC patients with ongoing standard medication. There is no clear evidence of the benefit of probiotic treatment in CD patients. In contrast, combining standard treatment with probiotics might be an option to achieve remission in active UC patients.

Efficacy and safety of probiotics in the induction and maintenance of inflammatory bowel disease remission: a systematic review and meta-analysis.

Probiotics have been widely used in the treatment of inflammatory bowel disease (IBD) due to their special conditioning effects on the intestinal flora, but their efficacy in inducing and maintaining remission is still controversial. In the present study, we analyzed randomized controlled trials (RCTs) on the treatment of probiotics in IBD to systematically evaluate the efficacy of probiotics on the induction and maintenance of remission of IBD. PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Wanfang, and Weipu databases were searched for RCTs on the treatment of probiotics in IBD induction and/or maintenance of remission. Two researchers independently extracted literature data and cross-checked the extracted data. The Cochrane bias risk assessment tool and the Jadad score were used to evaluate the quality of the literature. RevMan 5.20 software was used for the meta-analysis. A total of ten RCTs were included, which included 777 patients with ulcerative colitis (UC) and Crohn's disease (CD). Meta-analysis showed that there was no significant difference between the clinical recurrence rate of probiotics in the CD remission phase and the control group [relative risk (RR): 0.80, 95% confidence interval (CI): 0.61-1.06, P=0.12]. The clinical recurrence rate of UC in remission phase, the efficacy of probiotics compared with control group were not significantly different (RR: 1.07, 95% CI: 0.80-1.42, P=0.65). The induction remission rate of UC during the active phase, the efficacy of probiotics is better than that of the control group (RR: 1.47, 95% CI: 1.09-1.98, P=0.01). In the present study, a systematic analysis of the efficacy of probiotics in CD and UC found that probiotics can induce remission during the active period of UC, but have no obvious therapeutic advantage in maintaining CD and UC remission.

Uso de probióticos na nutrição de cães com Doença Inflamatória Intestinal (DII) – uma atualização

Canine Inflammatory Bowel Disease (IBD) is the term used to designate a group of chronic intestinal diseases, manifested by persistent or recurrent gastrointestinal signs. Known symptoms are vomiting, diarrhea, changes in appetite and weight loss. Treatment consists of a diet combined with antibiotic therapy and immunosuppressive drugs. It is currently known that changes in the microbiota profile can be used as way to prevent digestive disorders, since some probiotics offer benefits to patients with IBD, reducing symptoms and improving their immunity, however, can say that there is still no consensus regarding the recommendation of the use probiotics in inflammatory bowel diseases.

Can control of gut microbiota be a future therapeutic option for inflammatory bowel disease?

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract encompassing two main clinical entities, Crohn’s disease and ulcerative colitis. Accumulated evidence indicates that an aberrant immune activation caused by the interplay of genetic susceptibility and environmental impact on the gut microbiota may be involved in the pathogenesis of IBD. Rapid advances in next-generation sequencing technology have enabled a number of studies to identify the alteration of the gut microbiota, termed dysbiosis, in IBD. Moreover, the alteration in the metabolites derived from the gut microbiota in IBD has also been described in many studies. Therefore, microbiota-based interventions such as fecal microbiota transplantation (FMT) have attracted attention as a novel therapeutic option in IBD. However, in clinical trials, the efficacy of FMT for IBD remains controversial. Additional basic and clinical studies are required to validate whether FMT can assume a complementary role in the treatment of IBD. The present review provides a synopsis on dysbiosis in IBD and on the association between the gut microbiota and the pathogenesis of IBD. In addition, we summarize the use of probiotics in IBD and the results of current clinical trials of FMT for IBD.

Cell Wall Contents of Probiotics (Lactobacillus species) Protect Against Lipopolysaccharide (LPS)-Induced Murine Colitis by Limiting Immuno-inflammation and Oxidative Stress.

Currently, there are no effective therapeutic agents to limit intestinal mucosal damage associated with inflammatory bowel disease (IBD). Based on several clinical studies, probiotics have emerged as a possible novel therapeutic strategy for IBD; however, their possible mechanisms are still poorly understood. Although probiotics in murine and human improve disease severity, very little is known about the specific contribution of cell wall contents of probiotics in IBD. Herein, we investigated the protective effects of cell wall contents of three Lactobacillus species in lipopolysaccharide (LPS)-induced colitis rats. LPS-sensitized rats were rendered colitic by colonic instillation of LPS (500µg/rat) for 14 consecutive days. Concurrently, cell wall contents isolated from 106 CFU of L. casei (LC), L. acidophilus (LA), and L. rhamnosus (LA) was given subcutaneously for 21days, considering sulfasalazine (100mg/kg, p.o.) as standard. The severity of colitis was assessed by body weight loss, food intake, stool consistency, rectal bleeding, colon weight/length, spleen weight, and histological analysis. Colonic inflammatory markers (myeloperoxidase activity, C-reactive protein, and pro-inflammatory cytokines) and oxidative stress markers (malondialdehyde, reduced glutathione, and nitric oxide) were also assayed. Cell wall contents of LC, LA, and LR significantly ameliorated the severity of colitis by reducing body weight loss and diarrhea and bleeding incidence, improving food intake, colon weight/length, spleen weight, and microscopic damage to the colonic mucosa. The treatment also reduced levels of inflammatory and oxidative stress markers and boosted anti-oxidant molecule. In conclusion, cell wall contents of LC, LA, and LR attenuate LPS-induced colitis by modulating immuno-inflammation and oxidative stress.

Role of Probiotics and Their Metabolites in Inflammatory Bowel Diseases (IBDs)

Inflammatory Bowel Disease (IBD) is a term used to describe a group of complex disorders of the gastrointestinal (GI) tract. IBDs include two main forms: Crohn’s Disease (CD) and Ulcerative Colitis (UC), which share similar clinical symptoms but differ in the anatomical distribution of the inflammatory lesions. The etiology of IBDs is undetermined. Several hypotheses suggest that Crohn’s Disease and Ulcerative Colitis result from an abnormal immune response against endogenous flora and luminal antigens in genetically susceptible individuals. While there is no cure for IBDs, most common treatments (medication and surgery) aim to reduce inflammation and help patients to achieve remission. There is growing evidence and focus on the prophylactic and therapeutic potential of probiotics in IBDs. Probiotics are live microorganisms that regulate the mucosal immune system, the gut microbiota and the production of active metabolites such as Short-Chain Fatty Acids (SCFAs). This review will focus on the role of intestinal dysbiosis in the immunopathogenesis of IBDs and understanding the health-promoting effects of probiotics and their metabolites.

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

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.

Probiotics in Inflammatory Bowel Disease: Are We Back to Square One?

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the alimentary tract whose incidence has been increasing over the past few years. Even though there is a complex interplay of several factors in the pathogenesis of IBD, a decrease in the diversity of intestinal microbiome is commonly found in patients. Extensive research is directed towards the alteration of this microbiome to improve the symptoms of IBD. Probiotics, prebiotics, antibiotics, and diet are studied in this regard extensively. Among them, probiotics have gained more interest as some of the studies showed them to be effective in decreasing gut inflammation in vitro and in vivo. Although there is no cure for IBD as of today, the available medications do decrease gut inflammation and help prolong remission and decrease relapse rates. But their side effects preclude their long-term use. Probiotics may be a ray of hope among IBD patients as they are apparently safe. This article reviews each of the available literature from the past 10 years to see if there is any certain role of probiotics in induction, maintenance of remission, prevention of relapse, and improvement in the quality of life in IBD patients.