Ulcerative colitis: Do probiotics help?
Eating a healthful diet, reducing stress, finding alternatives to medication, and adopting natural solutions are among the methods used.
Some people with ulcerative colitis (UC) use what are called probiotics, which contain good bacteria, as a means of helping control their symptoms and flares.
Ulcerative colitis is treatable and can be managed. Without treatment, potentially fatal complications, such as bleeding, can arise.
What are probiotics?
Probiotics are similar to the good bacteria already found in the intestines.
The lower digestive tract is home to a diverse and complex community of good and bad bacteria that aid digestion and keep the gut healthy.
There are more bacteria in the intestines than there are cells in the human body.
Sometimes, however, the bad bacteria outnumber the good bacteria, which disrupts gut health. This imbalance of bacteria is thought to be a potential cause of UC, so increasing the number of good bacteria may help.
Probiotics are good bacteria and are similar or identical to the bacteria already found in the body's intestines. This means, in theory, they can help restore the balance of bacteria in the digestive tract.
Too much bad bacteria
When there are too many bad and not enough good bacteria in the gut, problems with digestion can develop. These include:
Food and supplements
Eating an unhealthful diet can cause an imbalance of bacteria, but a person can offset this by eating foods high in probiotics or taking supplements. As a result, the person may see an improvement in overall digestive health.
Some yogurts contain probiotics, which may help maintain a balance of good and bad bacteria in the body.
Foods that contain probiotics include:
- some cheeses
- some yogurts
- lactobacillus milk or kefir
Probiotics are also available in a range of over-the-counter supplements.
Not all probiotics work in the same way, and they may affect the body differently. Before taking any supplements, a person should talk to a doctor or dietitian to find out which will be most effective, particularly regarding UC.
Do probiotics work?
In theory, probiotics could have a positive effect on UC, as they help balance good and bad bacteria. And many people with UC include probiotics in their diets, believing they help keep their digestive tract healthy.
Unfortunately, however, there is limited evidence or research on probiotics, or their overall effectiveness in relieving flares and symptoms of UC, while those studies that have been done have returned mixed results.
One study found that there was no evidence of additional benefit when adding probiotics to other therapies. However, probiotics were more effective than placebo (no other therapy) in maintaining remission.
This high variability in results per person make it difficult to say for sure if probiotics are helpful or not for UC. Many studies that have been conducted also have a commercial bias that may influence what they report. This can mean some doctors or dietitians will not recommend probiotics for UC.
Are there any side effects?
Rather than relying solely on probiotics, people with UC can use them in addition to other measures, such as medications and lifestyle changes.
There are no official guidelines that recommend use of probiotics, none of which are regulated as drugs by the U.S. Food and Drug Administration (FDA), due to lack of reliable evidence. This does not mean they do not work, rather that it is difficult to prove and quantify any effect.
There is little to no evidence to suggest that taking probiotics has any negative effect. They are considered safe to take as a supplement or added food source.
However, evidence suggests that even if probiotics offer a benefit to UC flares, it is likely to be only small. So, people should not rely on probiotics alone, but should use them alongside other measures, such as diet, lifestyle changes, and medications.
Probiotics are live bacteria, and though they are considered beneficial to most people, they may cause issues for anyone with a compromised immune system. In this case, a person should discuss the use of them with a doctor first.
People with UC who are thinking about including probiotics should also consider the following:
- The FDA do not regulate probiotics: Many people do not find this a problem, but it is important to note. Medications fall under the mandate of the FDA, which sets strict rules for clinical studies, and what a drug can claim to do. Producers of probiotic supplements do not need to conduct clinical trials and can make claims about the effectiveness of their product that may or may not be true. Careful research of the company that is offering probiotics should be a first step for any person considering probiotic supplements.
- The quality of probiotics: Because the FDA do not regulate probiotics, the quality of the products can vary greatly. Some less reputable companies may not be using correct bacteria or the ones they claim they are. It is possible also that the bacteria are not live or effective.
- False claims: Probiotic manufacturers can make far more claims about their products than a company producing medication. Just because a company says the probiotic will help UC, it does not mean it is true. Misleading claims and labels add confusion, and some people build up hope in a product that ultimately has no positive effect.
- Choosing the correct probiotic: Not all probiotics are the same or offer the same benefits. One way to ensure a probiotic will have a positive impact on UC is to ask questions and do research into both the probiotic and company offering it. A doctor should be able to recommend a good probiotic that may help UC.
- Further research is needed: As mentioned above, there is limited research available on probiotics in general and how they relate to UC specifically. Further research needs to be done on how different probiotics affect specific gastrointestinal issues. Once there is conclusive evidence on what they can do, scientists can develop better treatments using probiotics.
Probiotics and other medications
When treating UC, a doctor will help develop a treatment plan that includes lifestyle changes and medication.
As there is limited information on whether probiotics interfere with other medication, it is important for an individual to talk to the doctor before adding probiotics to their routine.
Foods to avoid
People with ulcerative colitis are advised to avoid or limit the following:
- dairy products
- gassy foods
- high-fat foods
- large meals
It is best to drink plenty of water.