Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Lactobacillus delbrueckii subsp. bulgaricus is a probiotic bacterium commonly used in the fermentation of yogurt. Its use in inflammatory bowel disorders (IBD), such as Crohn’s disease and ulcerative colitis, is based primarily on its general probiotic properties, including modulation of gut microbiota, enhancement of mucosal barrier function, and immunomodulatory effects. However, the specific evidence for L. delbrueckii bulgaricus in IBD is limited and mostly comes from studies of probiotic mixtures (such as VSL#3), which contain multiple strains including L. delbrueckii bulgaricus along with other lactobacilli, bifidobacteria, and streptococci.

Clinical trials with probiotic mixtures have shown some benefit in inducing or maintaining remission in ulcerative colitis, though the effect in Crohn’s disease is less clear. The benefit cannot be attributed to L. delbrueckii bulgaricus alone, as these studies do not isolate its effect from the other strains present. There is little direct clinical evidence of the efficacy of L. delbrueckii bulgaricus as a single agent in IBD. Most mechanistic studies are preclinical or in vitro, showing that the strain can influence immune responses and gut barrier integrity, but these findings have not been robustly confirmed in human IBD populations.

In summary, while there is a scientific rationale and some indirect clinical evidence supporting the use of L. delbrueckii bulgaricus in IBD (mainly as part of multi-strain probiotics), strong direct evidence is lacking, and its efficacy as a single-strain intervention remains unproven.

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