Review Article

Potential Application of Probiotics in the Prevention and Treatment of Inflammatory Bowel Diseases

Table 2

Examples of human clinical trials (randomized controlled trials) that have demonstrated that probiotics improve inflammatory bowel diseases including Crohn’s Disease (CD), Irritable Bowel Syndrome (IBS), Pouchitis (PCH) and Ulcerative Colitis (UC).

DiseaseResultsProbioticReference

CDRelapse in 6% of patients supplemented with probiotic strain versus 38% with conventional treatment onlyS. boulardii[44]
CDMedian pediatric CD activity index scores at 4 weeks were 73% lower than baseline and intestinal permeability improved in an almost parallel fashion.
The number of specific antibody secreting cells in the IgA class to 𝛽 -lactoglobulin increased significantly from 0.2 (0.04–1.3) to 1.4 (0.3–6.0)/106 cells and to casein from 0.3 (0.1–1.4) to 1.0 (0.2–4.8)/106 cells.
Lactobacillus GG [25, 45]
IBSAlleviation of IBS symptoms and normalization of the ratio of an antiinflammatory to a proinflammatory cytokines in patients receiving probiotic strain versus placebo groupB. infantis 35624[46]
IBSRelapse in 20% of patients in probiotic group versus 93% in the placebo group. The probiotic impeded the activation of NF- 𝜅 B, decreased the expressions of TNF- 𝛼 and IL-1 𝛽 and increased the expression of IL-10BIFICO (3 bifidobacteria species) [7]
IBSThe total symptom score (abdominal pain + distension + flatulence + borborygmi) was reduced 42% in the probiotic group compared with 6% in the placebo groupL.rhamnosus GG, L.rhamnosus Lc705, P. freudenreichii spp shermanii JS, B. breve Bb99[23]
IBSThe probiotic + prebiotic treatment showed short-term and long-term reductions in IBS symptomsPrescript-Assist (probiotic+prebiotic complex containing 29 soil-based, pH-resistant microflora)[47]
IBSThe probiotic + prebiotic treatment was associated with significant reductions in 3 subsyndromic factors of IBS: general ill feelings/nausea, indigestion/flatulence, and colitisPrescript-Assost [48]
PCHThe probiotic mixture was effective in maintaining antibiotic introduced remission for at least a year in patients with recurrent or refractory pouchitis (85%) versus 6% in the placebo groupVSL#3 (probiotic preparation containing 3 B., 4.L and 1 St. strains)[49]
PCH10% of patients treated with probiotics had an episode of acute pouchitis compared with 40% treated with placebo. Treatment with probiotic improved Inflammatory bowel disease Questionnaire score versus placeboVSL#3[22]
UCSigmoidoscopy scores were reduced in probiotic group compared with placebo. TNF- 𝛼 and IL-1 𝛼 were reduced after treatment with probioticSymbiotic therapy (B. longum and Synergy 1) [6]
UCThe probiotic treatment was just as effective as the conventional treatment (mesalazine) in maintaining remissionE. coli Nissle 1917[50]
UCProbiotic supplementation improved remission compared to conventional treatment (balsalazide) aloneVSL#3[51]
UCProbiotic preparation maintains remission (75%)VSL#3[20]
UC62% of patients showed improvement of symptoms and 0% showed relapse of intestinal disease while on probioticsVSL#3[52]