Synopsis

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

Probiotics, which are live microorganisms that confer health benefits to the host when administered in adequate amounts, have been studied for their potential role in treating colitis, particularly ulcerative colitis and, to a lesser extent, Crohn's disease. The rationale is based on the understanding that gut microbiota dysbiosis (an imbalance in intestinal bacteria) is associated with inflammatory bowel diseases (IBD) like colitis. Multiple randomized controlled trials and meta-analyses have evaluated the use of various probiotic strains (such as Lactobacillus, Bifidobacterium, and Escherichia coli Nissle 1917) in IBD. Generally, evidence is stronger for ulcerative colitis than for Crohn's disease. For example, E. coli Nissle 1917 has shown efficacy comparable to mesalazine in maintaining remission in ulcerative colitis, while multi-strain probiotics (e.g., VSL#3) have demonstrated benefit in inducing and maintaining remission in some patients. However, the evidence is mixed, with some studies showing no significant benefit, and the effectiveness appears to depend on the specific strain, dosage, and patient population. Overall, the scientific community recognizes a moderate level of evidence supporting the use of certain probiotics in colitis, but they are not a replacement for standard therapies. Guidelines suggest probiotics may be considered as adjunct therapy in specific cases, particularly for mild to moderate ulcerative colitis.

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