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Crohn's Disease Forum » Books, Multimedia, Research & News » Effect of Probiotics on Inducing remission and Maintaining Therapy in UC, CD and Pouchitis


12-29-2014, 02:09 PM   #1
DustyKat
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Effect of Probiotics on Inducing remission and Maintaining Therapy in UC, CD and Pouchitis

Effect of Probiotics on Inducing remission and Maintaining Therapy in Ulcerative Colitis, Crohn's Disease, and Pouchitis: Meta-analysis of Randomized Controlled Trials.

Abstract Only:

Background:

Whether probiotics are beneficial at all stages of treatment in inflammatory bowel disease or superior to placebo remains controversial.

Methods:

Two reviewers independently selected randomized controlled trials comparing probiotics with controls in inflammatory bowel disease and extracted data related to remission/response rates, relapse rates, and adverse events. Subanalyses were also performed.

Results:

Twenty-three randomized controlled trials with a total of 1763 participants met the inclusion criteria. From the meta-analysis, probiotics significantly increase the remission rates in patients with active ulcerative colitis (UC) (P = 0.01, risk ratio [RR] = 1.51). The remission rates were significantly higher in patients with active UC treated with probiotics than placebo (P < 0.0001, RR = 1.80). Unfortunately, subgroup analysis found that only VSL#3 significantly increased the remission rates compared with controls in patients with active UC (P = 0.004, RR = 1.74). Interestingly, VSL#3 (P < 0.00001, RR = 0.18) also significantly reduced the clinical relapse rates for maintaining remission in patients with pouchitis. No significantly different adverse events were detected between probiotics and controls in the treatment of UC (P = 0.94, RR = 0.99) or CD (P = 0.33, RR = 0.87).

Conclusions:

Administration of probiotics results in additional benefit in inducing remission of patients with UC. VSL#3 are beneficial for maintaining remission in patients with pouchitis. And, probiotics can provide the similar effect as 5-aminosalicylic acid on maintaining remission of UC, although no additional adverse events presented.

http://journals.lww.com/ibdjournal/A...ion_and.4.aspx
There is an erratum included in the link that does not appear to have impacted the end results of the study.
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12-29-2014, 03:08 PM   #2
VeganOstomy
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I think it's important to note that only VSL#3 has been clinically shown to benefit people with IBD - you can't get any off the shelf probiotic and expect it to produce the same results.
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12-29-2014, 03:19 PM   #3
DustyKat
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I spoke with the kids GI about probiotics and VSL#3 in particular. His opinion of its use in Crohn’s would appear to concur with this study, that being for Crohn’s there is no convincing evidence that it is beneficial.
12-29-2014, 03:21 PM   #4
VeganOstomy
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I spoke with the kids GI about probiotics and VSL#3 in particular. His opinion of its use in Crohn’s would appear to concur with this study, that being for Crohn’s there is no convincing evidence that it is beneficial.
Anecdotally, I'd agree, as I experienced no benefits from a multitude of probiotics (not VSL#3).

It is interesting how some treatments and mechanisms only affect UC but not Crohn's and the other way around (like smoking, for example).
12-31-2014, 11:18 PM   #5
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Vsl#3 Ds works well for Ds
He has crohns ....but the area we were having a lot of issues controling were his rectum ( rare for crohns ) and sigmoid colon .
So Gi thought in his case that was why it worked so well .
His other meds work on the rest of his gut .
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01-01-2015, 02:25 PM   #6
7vNH
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I think it's important to note that only VSL#3 has been clinically shown to benefit people with IBD - you can't get any off the shelf probiotic and expect it to produce the same results.
This is true, especially since in the VSL#3 study, they took an insanely large number of colony forming units (CFU's). Most OTC pills that have "a lot" of CFU's have 5 billion. One single VSL#3-DS packet contains 900 billion!

I am fairly confident that if there were a study that used that many CFU's of off the shelf probiotic, at least some strains of them would show a result similar to VSL#3 (and some strains might even show a better result).
01-19-2015, 04:55 PM   #7
JMC
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It is interesting how some treatments and mechanisms only affect UC but not Crohn's and the other way around (like smoking, for example).
That is because they are very different diseases with very different etiologies. Although they are grouped together under the IBD banner, they should not be considered as related diseases.
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Crohn's Disease Forum » Books, Multimedia, Research & News » Effect of Probiotics on Inducing remission and Maintaining Therapy in UC, CD and Pouchitis
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