Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Lactobacillus species are widely studied probiotics and have been investigated for their potential in supporting or treating various forms of colitis, including ulcerative colitis and infectious colitis. The scientific rationale is based on their ability to modulate gut microbiota, enhance mucosal barrier function, and regulate immune responses. Several randomized controlled trials and meta-analyses suggest that certain Lactobacillus strains (often in combination with other probiotics) can help reduce disease activity, maintain remission, and improve symptoms in some patients with mild to moderate ulcerative colitis. Some strains, such as Lactobacillus rhamnosus GG and Lactobacillus casei, have shown promise in clinical studies, although results are not universally consistent and often depend on the specific strain and formulation used.

However, the overall quality of evidence is moderate. While systematic reviews and Cochrane analyses generally report some benefit, they also highlight heterogeneity in study designs, small sample sizes, and variability in outcomes. For Crohn’s disease, evidence is weaker, and guidelines do not routinely recommend probiotics including Lactobacillus for induction or maintenance of remission. The use of Lactobacillus in treating infectious colitis (e.g., C. difficile colitis) is also an area of active research, with some evidence for decreased recurrence risk when used as adjunctive therapy.

In summary, there is scientific evidence—though not definitive—for the use of certain Lactobacillus strains in the management of some forms of colitis, particularly ulcerative colitis, justifying a moderate rating of evidence.

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