Estimated reading time: 6 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
What do you know about probiotics? After vitamins and minerals, they are among the most commonly used dietary supplement. A live culture of microorganisms, common probiotics include yogurt, some soft cheeses, and kimchi! They may be used to help treat certain digestive conditions, including ulcerative colitis (UC). UC is a long-term condition that causes inflammation and sores in the colon. This chronic disease can be triggered by various factors, including infections, certain medications, and environmental exposures.
While treatments like medications and surgery can help manage the symptoms, there is no cure for UC. This has led many people to explore alternative therapies, such as probiotics and prebiotics, to help manage their condition. The American Gastroenterological Association (AGA) recommends the use of probiotics and prebiotics in adults and children with ulcerative colitis only in the context of a clinical trial due to the limited evidence available. The recommendations for the use of prebiotics and probiotics in patients with UC are nuanced and depend on the specific context and formulation. Here, we can look at what probiotics and prebiotics are and how they can affect the body. Let’s dive into how they might help and what the experts say.
What Are Probiotics and Prebiotics?
Probiotics
Probiotics are live microorganisms, often referred to as "good bacteria," that provide health benefits. They help maintain a healthy balance of gut bacteria, which is important for digestion and overall gut health. Common sources of probiotics include yogurt, kefir, sauerkraut, kimchi, and other fermented foods. They are also available as dietary supplements in various forms like capsules, tablets, and powders.
Prebiotics
Prebiotics, on the other hand, are types of dietary fiber that feed the good bacteria in your gut. They help these beneficial bacteria grow and thrive. Prebiotics are found in foods like bananas, onions, garlic, leeks, asparagus, artichokes, and whole grains like oats and barley.
How Do Probiotics Help with Ulcerative Colitis?
UC is characterized by inflammation in the colon, which can cause symptoms like abdominal pain, diarrhea, and bleeding. Researchers believe that an imbalance in the gut microbiota (the community of bacteria living in the gut) may play a role in triggering and maintaining this inflammation. The standard treatment approach of UC is focused around two things: treating active flare-ups and preventing future ones. Studies have found that probiotics have no effect on stopping active flare-ups. However, they may be able to prevent future events!
Probiotics can help by adding beneficial bacteria to your gut, which can help balance the gut microbiota and reduce inflammation. They can also enhance the gut lining’s defense. This will prevent harmful bacteria from entering the intestinal wall and causing inflammation.
Which Probiotics Are Most Effective?
Research has identified a few probiotics that show promise for treating UC. It should be noted that these probiotics have only been shown to be effective in a clinical trial setting. You should still keep to the AGA recommendation that they only be taken during a clinical trial.
- E. coli Nissle: This non-pathogenic strain of E. coli has been shown to help induce and maintain remission in UC patients. Studies suggest it can be as effective as traditional UC medications like mesalazine.
- VSL#3: A combination of eight different probiotics, VSL#3 has shown to be effective in inducing remission and maintaining it. It also helped with certain symptoms, such as rectal bleeding.
However, not all probiotics are the same. Just as some studies show the probiotics above to be effective, others have found different combinations to have no effect. It is important to choose strains that have been proven effective in clinical trials. Always talk to your doctor before starting any new supplement regimen.
How to Take Probiotics for UC
When considering probiotics for UC, there are a few key things to remember.
- Duration: It often takes time for probiotics to establish themselves in your gut. You might need to take them for at least 7 to 10 days, with some studies recommending up to 6 to 8 weeks.
- Consistency: To maintain their benefits, you need to keep taking probiotics regularly. Stopping them might disrupt the gut bacteria balance, potentially leading to a flare-up.
- Form: While taking probiotics orally is common, some studies suggest that rectal administration could be more effective. This allows the probiotic to bypass stomach acid, allowing more bacteria to reach the intestines.
The Role of Prebiotics in UC Management
Prebiotics are important for supporting the growth of beneficial bacteria in the gut. By consuming prebiotic-rich foods, you help nourish the good bacteria, promoting a healthier gut environment. While prebiotics are generally safe, they might not be suitable for everyone, especially those with conditions like irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO). Always check with your doctor before adding prebiotics to your diet.
What Do Doctors Recommend?
Doctors generally advise caution when considering probiotics and prebiotics for treating UC. They contain living bacteria, so those with weakened immune systems might be at a higher risk of infection. Here’s what you should keep in mind.
- Consult Your Doctor: Before starting any new treatment, discuss it with your gastroenterologist. They can help you choose the right type of probiotic or prebiotic and monitor your progress.
- Quality Matters: Since probiotics are not strictly regulated by the FDA, it is important to choose reputable brands. Your doctor can help you find high-quality products with proven efficacy.
- Complement, Not Replace: Probiotics and prebiotics should complement, not replace, your standard UC treatments. Always follow your doctor’s advice regarding medications and other therapies.
While probiotics and prebiotics show promise in managing UC, they are not a cure and should be used as part of a comprehensive treatment plan. They may help reduce inflammation, improve gut health, and possibly extend the time between flare-ups. If you’re considering probiotics or prebiotics for your UC, have a thorough discussion with your doctor! Together, you can make an informed decision that best supports your health and well-being.
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