Ulcerative colitis (UC) is a type of inflammatory bowel disease. A person might wonder: Can probiotics help manage the symptoms?
The human gut contains 200–1,000 species of bacteria. Some of them are helpful, while others are not. The balance of these bacteria, known as the gut microbiota or gut flora, is essential for maintaining gut health and may support health throughout the body.
Currently, it is not clear whether foods and supplements that contain probiotics can help manage UC. But some scientists are looking at the possibility of developing probiotics as a drug treatment for the condition.
This article explores why probiotics might help manage UC and why it is essential to speak with a doctor before using them. We also look into sources of probiotics.
Probiotics are live bacteria that may help balance the gut microbiota. They occur in some foods and are also available as supplements.
UC is a chronic gastrointestinal disease that involves inflammation in the gut. Symptoms include abdominal pain, bloating, diarrhea, and bleeding from the rectum.
The gut contains a diverse and complex community of helpful and harmful bacteria — the gut microbiota. These bacteria aid digestion and help keep the gut healthy.
An imbalance in the populations of these bacteria
Some
One view is that a specific genetic feature allows “bad” bacteria to trigger a lasting inflammatory response in the mucus of the gut. In theory, changing the bacteria could make the gut flora less aggressive — less likely to trigger this response — and may also reduce UC symptoms.
For these reasons, researchers have investigated whether treatments involving probiotics might help manage UC. Also, people with the condition sometimes include probiotics in their diets to ease the symptoms.
Probiotics are similar or identical to helpful bacteria in the intestines. In theory, they may improve UC symptoms by helping balance the gut flora.
Through these mechanisms, probiotics can help prevent some types of bacteria from triggering and maintaining an inflammatory response in the intestines.
Pros
Cons
It’s also important to use the proper form and dose of probiotics because stomach acid kills most bacteria before they reach the gut. Over-the-counter (OTC) supplements and dietary sources of probiotics may not deliver effective doses.
Overall, if a person wants to use probiotics to treat UC, it is crucial that they speak with a doctor first. A doctor can provide the best guidance about which type to try. Some types may help, but others may be ineffective or possibly harmful.
A doctor can also explain whether a suitable type and dose of probiotic is available and, if so, where to find it.
Misleading expectations
Producers of probiotics may market them as the answer to UC, but people should be wary of false claims.
Any benefits of probiotics in their most available forms — those in foods or supplements — are likely to be small. Most probiotics will not reach the gut, and a person needs a specific type of probiotic to meet specific health needs. It is unlikely that a food or supplement will happen to contain the right type.
Anyone using probiotics for UC should get the go-ahead from their doctor and should also be using other treatment strategies, such as dietary changes and medications.
Probiotics occur naturally in some foods, and manufacturers add them to other foods. These products
- fermented milk
- cheese
- ice cream
- buttermilk
- milk powder
- yogurts
- soy-based products, including nutrition bars
- juices
- sauerkraut
- kimchi
- miso
- tempeh
Probiotics are also available in a range of OTC supplements. Commonly available
The Food and Drug Administration (FDA) does not regulate supplements or probiotics. As a result, manufacturers can vary the ingredients and may make claims that are not true. The quality and contents of supplements can vary widely, and companies may make marketing claims that are not based on scientific evidence.
Anyone interested in trying probiotics should first consult a doctor. Next, research suppliers thoroughly to be sure that they sell reliable products. Before making a purchase, check that the product provides the specific type of probiotic that the doctor recommended.
It is also worth remembering that no OTC product is likely to have the same effect as the specifically targeted and pharmaceutical-grade probiotics that researchers use in clinical trials.
The best way to make sure a person gets a steady supply of healthy bacteria to their gut is to regularly eat a variety of foods that contain probiotics.
However, if a person wants to take probiotics supplements, research shows that taking at least
Prebiotics are fermentable fibers that the body does not digest. They may help change the gut microbiota in a way that benefits people with UC.
To be a prebiotic, a substance must meet the following criteria:
- A person’s body must not absorb it as it passes through the small intestine.
- Bacteria in the intestine must selectively ferment it.
- It must be able to make the gut microbiota healthier.
Fibers that have these properties are present in:
- wheat
- chicory
- bananas
- onions, garlic, and leeks
- asparagus
Food manufacturers also extract prebiotics from chicory roots and add them to other products, such as candies, baked goods, fruit juices, and spreads.
Prebiotics can stimulate the gut to produce healthy bacteria. They may also prevent unhealthy bacteria from multiplying.
However, they may increase the risk of flatulence, bloating, diarrhea, and abdominal pain, which may be especially problematic for people with UC.
Learn more about the difference between probiotics and prebiotics.
Generally, synbiotics are substances that contain a combination of probiotics and prebiotics.
In 2019, the
ISAPP did this to clarify that exactly what strains of each go into the mixture is important for maximizing the benefit to health.
Synbiotics are a relatively new use of probiotics and prebiotics, so more research is necessary to judge their effect. However, existing research suggests that synbiotics may help reduce inflammation in people with UC by lowering inflammatory markers and reducing the number of gut bacteria linked to inflammation.
Probiotics appear to be safe overall, though there is limited evidence to support or refute this.
Possible adverse effects
- an increased risk of infection, especially for people with weakened immune systems
- the transfer of antibiotic-resistant genes
- a reaction to other ingredients in a product
- a rash or nausea, according to one
2018 review
Check with a doctor before taking probiotics or adding probiotic-rich foods to the diet. Some medications for UC suppress the immune system, and using probiotics may increase the risk of infection.
Meanwhile, it is still unclear how specific probiotics may interact with medications.
Also, some foods that contain probiotics, such as cheese, may not be suitable for people with UC — dairy products and high fat foods may make the symptoms worse.
Here, learn more about the possible adverse effects of probiotics.
Which probiotic is best for ulcerative colitis?
A 2023 study found that the following probiotic strains had the best effect in terms of helping improve the diversity of gut bacteria, reduce inflammatory markers, protect the colon, and increase markers that support a healthy gut:
- L. rhamnosus
- E. faecium
- L. reuteri
- L. acidophilus
- L. coryniformis
How do I cure my ulcerative colitis?
There is no cure for UC, but people can manage the condition with treatment and lifestyle strategies.
Some scientists believe that probiotics may help treat UC, but researchers have yet to identify an effective probiotic-based treatment.
Evidence for using supplements or eating foods that contain probiotics is limited. Also, probiotics may increase the risk of infection and have negative effects on people with UC.
A person should speak with a doctor before trying probiotic supplements or adding probiotic-rich foods to their diet. A doctor can provide detailed guidance on which type and dosage of probiotic might help.