Can probiotics stop Crohn's flare-ups?

[hareyan]

Some studies suggest people with Crohn's disease take probiotics to help manage the disease. But can probiotics stop flare-ups of Crohn's disease or inflammatory bowel disease (IBD)?

Probiotics no help for Crohn's

According to a study published August, 2013 from the American Gastroenterological Association (AGA), probiotics have shown promise for helping manage the disease, leading to a number of products on the market.

In their finding, published in the journal Clinical Gastroenterology and Hepatology, researchers tested the effect of the the probiotic S. boulardii to see if there was any effect on Crohn's disease for people whose condition was already in remission.

Continue reading the entire story in the original source at Emaxhealth about the study participants and the severity of their Crohn's at Can probiotics stop Crohn's flare-ups?

 

[Donjh]

FRom my personal experiance of having crohn's sense 69 and trying probiotic's to control it, didn't work for me in fact in the end made it worse I believe.

 

[hareyan]

Thank you for sharing Donjh, so basically this is what the study says.

 

[ellie]

I think it depends where your Crohn's is located - mine is colonic,and I think regular probiotics have helped me immensely.


HD

 

[DamnitCrohns]

To be honest i'm not sure if the S.boulardii im taking is doing anything at all, but i till have half a tub left so i've been taking them anyway. Whether or not i'll buy another one i'm not sure.

 

[hareyan]

It's interesting that regular probiotics have helped you. Do you mean like yogurts sold on grocery stores? I would like to know how many people use probiotics and have found it helpful or not helpful.

 

[Beach bum]

I take probiotics in a pill form and I really believe they help to keep me regular. I do know about it if I haven't taken them and I once bought some cheaper ones that didn't help as much.

 

[my little penguin]

DS has been on prescription strength vsl#3 DS which is suppose to help only UC.
It seems to help him in addition to humira.
He does have crohn's in his rectum as well as other areas .

 

[dave13]

I am in remission and I take 'Garden of Life' raw probiotics-ultimate care.I am recently diagnosed,11-13,with Crohn's.I have had a resection of my small intestine,about 8 inches. I see my GI in February and do not want to go on drugs.I can't prove they help me.I can say they do not adversely affect my Crohn's.I've only been taking them for three weeks or so.

 

[hareyan]

Wishing the best Dave13 and everyone.

 

[mnsun]

I think S. Boulardi is more for the colon or large intestines, and it hasn't done anything for me--except for the GOL Primal Defense Ultra which has it among its other strains and "HSO"s.

As for other strains, they definitely do positively have the effect of keeping me at 1 fully formed, if not nearly fully formed, BM a day. I NEED to take GOOD probiotics 1-3 times a day--somewhat dependent on my diet and unusual supplements. If I skip a day, my BMs will be unsightly.

However, I noticed some will lose there effect unless rotated with other multi-strain formulas throughout the day. I like to have three separate formulas on a daily basis--one dose of each at a different time, alternating these. GOL Primal Defense Ultra, Jarrow EPS, and NOW 8 Billion Acidophilus and Bifidus. One in morning on empty stomach, 1/2 hour before food; one midday on empty stomach; one before bed.

Probiotics and around 3 grams of omega 3 enteric coated fish oil daily have proven effective for 7+ years. Of course excercise and lifestyle contribute as well as a keen eye for food-like ingredients to avoid.

 

[kiny]

Probiotics have never helped me, in fact I felt worse when I used them.

I linked a study once that showed that probiotics did nothing to help crohn's disease.

I can't think of any reason why crohn's disease would be helped by probiotics. Just because something is a probiotic doesn't mean it's good for you.

Dysbiosis, well dysbiosis always happens in the presence of inflammation, intestinal TB causes disbiosis too, that doesn't mean it's directly related to crohn's disease. Dysbiosis doesn't have to have a negative connotation either, our body knows far better than us which bacteria it wants and which ones it doesn't, our immune system is in 24/7 communication with our indigenous gut flora. Why would you try to disrupt that by using pills with billions of bacteria without even knowing what you're taking in.

Crohn's disease tends to be most active in the ileum or beginning of the colon, there's not that much bacteria there compared to the lower colon, and the inlfmmation is transmural, not sure what the idea behind using probiotics is. A good way to give you stomach cramps maybe.

 

[kiny]

To be honest i'm not sure if the S.boulardii im taking is doing anything at all

It lowers your bank account and potentially makes you sicker, it doesn't help for crohn's disease at all. Been 2 studies about it.

It's really easy to get swepped away by hype and by people claiming that probiotics are good for crohn's disease patients. I have looked everywhere for proof, there are no real good studies I know of that show it helped, there is a lot of reason to be careful with probiotics since we don't handle bacteria very well.

I also disagree that they are harmless and can only help, probiotics interact with immune cells and release lots of substances in the blood.

 

[mnsun]

Kiny, I guess I can only speak from personal experience, but I'm sure others must have direct beneficial--and, yes, some negative (dependent on strains/potency/dietary interaction/unique biome profiles)--effects. I personally think the possible benefits one may notice depends directly on a) the portions of intestines inflammed and b) the strains and potency of probiotics used.

After asking people on this site, I do realize that both enteric fish oil and quality probiotics don't seem to benefit some people. I find it puzzling though because I have definite directly observable benefits from both.

Please, others chime in if you have specific beneficial or negative effects from specific probiotics.

 

[kiny]

I think probiotics should be only under prescription. The industry is completely unregulated.

While a normal person might not get sick from them, CD patients might get sick from them.

Yes the media and probiotics companies are all saying how wonderful they are.

They also did that with cigarettes. Also an unregulated industry.

This is the same reason I am 100% against fecal transplants until the data is in and we know it isn't actually harming people.

Primum non nocere. First, do no harm.

It's amazing that people manage to complain about:
-genetically modified foods, which is regulated
-artificial sweeteners, which are regulated

but they have no qualms swallowing millions of bacteria from a completely unregulated industry

It is much too easy to get swepped away by the hype. There is 0 credible evidence it helps..for anything.

You are also not just adding "good bacteria". There is no evidence these bacteria are good for you.
What is in probiotics is not the same as normal person's indigenous flora.
You are adding foreign bacteria and just hoping your body deals with them correctly.


Probiotics are not harmless. This is why your doctor isn't saying you should take probiotics.
It's unregulated and potentially harmful. It's a real shame that companies are targeting crohn's diseasse patients without having any clue whatsoever on the effects on those people.
It should be illegal to prey on people before having done the research.

This is from a meta review:

http://www.ncbi.nlm.nih.gov/pubmed/16698749

 

[nogutsnoglory]

It's true a lot of these supplements are mainly bacteria that lives in the colon but there are the Lacto bacteria that live in the small intestine. I think we don't fully know the role they play yet but why not put more good guys in? There are prob other benefits too.

 

[kiny]

good guys

People who are immunocompromised or on immunosupressants,
both present in crohn's disease, are unable to manage bacteria of any kind.
Probiotics has lead to disasters in studies.

"In the probiotics group, 9 patients developed bowel ischaemia (of whom 8 patients died),
compared with none in the placebo group (p = 0.004)"

http://www.ncbi.nlm.nih.gov/pubmed/18438065?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

People can and do die from probiotics with the right circumstances.

Many people are urgently asking for probiotics regulations. In the wrong hands, they are anything but harmless.


There are also probiotics that are genotoxic:

http://www.ncbi.nlm.nih.gov/pubmed/22895085

If you take out all the media hype, if you take out all the studies sponsored by probiotic companies.
You are left with very few studies that show any beenfit, for any disease or cindition, and quite a few that show negatives.

 

[nogutsnoglory]

But the study says it wasn't appropriate for this category of patients meaning those with this condition. The question is whether it is this isolated group or can be extended to others.

 

[kiny]

http://www.ncbi.nlm.nih.gov/pubmed/16116318

A randomized, double-blind trial of Lactobacillus GG
versus placebo in addition to standard maintenance therapy
for children with Crohn's disease.


The median time to relapse was 9.8 months in the LGG group
and 11.0 months in the placebo group (P=0.24);
31% (12/39) of patients in the LGG group developed a relapse
compared with 6/36 (17%) of the placebo group (P=0.18).


The probiotics group got higher relapse and faster relapse thatn the group wtihout.
The probiotics group was considerably worse off, using Lactobacillus rhamnosuss that are found in nearly every over the counter probiotic.

 

[ellie]

I have to agree that "probiotics" as a group are totally unregulated and not subject to usual medical trial standardization. I tend to be uneasy about tablets/capsules, etc, in the "natural remedies" aisle of the supermarket! (Particularly for people whose principal medical treatment causes immunosuppression!)
I think it's important to keep in mind that Crohn's can involve a variety of anatomical sites. People with small bowel (ileal) disease are unlikely to experience any benefit from probiotics.
For those with colonic disease, I can appreciate that altering the colonic flora may be beneficial, though probably not enough to "stop" a flare - there seems to be increasing interest in the microbiome recently, so hopefully there will be more scientific information soon. (I think there is medical literature demonstrating probiotics being helpful for "pouchitis" following colectomy)
Personally I believe they have been very helpful, but my maintenance medication is just Sulfasalazine, so no immunosuppression involved (technically in remission, histology biopsies normal). My approach is a couple of probiotic drinks daily(Yakult and another lactobacillus type), and usually some yogurt as well..



HD

 

[Igor_Passau]

Probiotics have never helped me, I felt worse when I used them.

 

[Jerzey]

Nope they did nothing to help me I tried for years