Synopsis

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

Lactococcus rhamnosus (commonly referenced as Lactobacillus rhamnosus, particularly the GG strain) has been investigated as a probiotic for the management of Inflammatory Bowel Disorders (IBD), including Crohn’s disease and ulcerative colitis. Scientific evidence supporting its use is moderate: several clinical trials and meta-analyses have assessed its efficacy, particularly in maintaining remission and reducing the frequency of flares, especially in ulcerative colitis and pouchitis (inflammation of the ileal pouch, a complication following colectomy).

Most notably, L. rhamnosus GG has shown benefit in pediatric ulcerative colitis and in preventing pouchitis when used in combination with other probiotics (such as in the VSL#3 formulation). However, results are mixed: some studies demonstrate modest improvements in clinical and endoscopic remission rates, while others find no significant difference compared to placebo. The strain is generally well tolerated, and its proposed mechanisms include modulation of gut microbiota composition, enhancement of epithelial barrier function, and downregulation of pro-inflammatory cytokines.

Despite promising results, especially in certain subgroups of IBD patients, the overall quality of evidence is limited by heterogeneity in study design, small sample sizes, and variation in probiotic formulations. As such, L. rhamnosus is recognized in clinical guidelines as a possible adjunct in specific scenarios (such as pouchitis), but is not considered a primary therapy for IBD. Further large, well-designed trials are needed to clarify its role.

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