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Ulcerative Colitis and Probiotics

Many people are trying probiotics to ease the discomfort of ulcerative colitis.
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Murky Results in Some Clinical Trials of Probiotics continued...

For example, one study of 90 volunteers found significantly higher remission rates in people with ulcerative colitis who were given the beneficial bacteria E. coli Nissle. The higher the dose, the longer their remission -- good evidence that the friendly bacteria were effective. 

But other studies that looked at other bacteria haven't shown any benefits compared to placebos. A 2006 study of 157 ulcerative colitis patients found no difference between the placebo group and those given one of three different beneficial bacteria, although the findings did suggest that probiotics may have prolonged the length of remission.

Weighing the Advantages of Probiotics: Small Benefits but No Risk

Even if probiotics help, Fedorak points out, the evidence strongly suggests they're likely to offer only small benefits, certainly not a cure. For that reason, probiotics are not a replacement for conventional medication. They can be used along with prescription drugs, however. And there's certainly no evidence that they pose any risk at all -- except to your wallet. Since probiotic-containing products are not covered by health insurance, most ulcerative colitis patients end up paying out of pocket.

To make sure they're worth the expense, consider starting a food and symptom diary before you begin using probiotics. Then keep track of how you feel before and after you start taking them. After several weeks, try going off the product. If you notice an increase in symptoms, the probiotic may be helping. Begin using it again to see if you feel better.

Experts can offer little help on which products to choose. Unfortunately, there's no regulation of probiotics, so it's very hard to know what you're actually getting when you buy one. "I tell people to use a product that's refrigerated, which may give you a better chance at getting something with live culture," says dietitian Tracie Dalessandro, RD, author of What to Eat With IBD.

Whatever you choose to try, tell your doctor if you're using probiotics. It's important to discuss with your doctor any and all complementary remedies you're taking. "Most of us want to know what works and doesn't work for you," says Coyle. "So if you're using something and it's helping, tell your doctor."

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Reviewed on September 22, 2011
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