Probiotics in inflammatory bowel disease: Does it work?

Abstract

The number of patients with inflammatory bowel disease (IBD), a group of diseases mainly represented by Crohn’s disease (CD) and ulcerative colitis (UC), has increased in recent decades. As a consequence, the number of people undergoing any drug treatment against these diseases has expanded. However, IBD conventional therapies present several limitations, which lead researchers to look for better alternatives to improve the quality of life of patients. Moreover, microbiome imbalance seems to play a crucial role in the pathogenesis of IBD, since important alterations in bacterial, viral, protist and fungal populations are observed in the gut microbiota of affected individuals. Given the importance of such life forms in that context, the use of probiotics becomes a plausible alternative for treating affected patients. Trials have been developed aiming the evaluation of probiotics potential to induce and to maintain remission in CD and UC. Regarding the tested microorganisms, various non-pathogenic bacteria and fungi have been assessed. However, consistent results have been obtained only with some of them, including Escherichia coli Nissle 1917, VSL#3, Saccharomyces boulardii, Lactobacillus, and Bifidobacterium. Therefore, this minireview aims to explore the role of microbiota in the genesis of such a disorder and to compile the most concrete data on probiotic-related efficiency in IBD treatment.

Keywords: Inflammatory bowel disease; Probiotics; Crohn’s disease; Ulcerative colitis

Core tip: The clinical management of ulcerative colitis and Crohn’s disease represent a major challenge in the gastroenterology field since conventional therapies present several limitations. Interestingly, changes in gut microbiota are linked to the development of these diseases. In this sense, the use of probiotics becomes a plausible alternative for treating affected individuals. Although several microorganisms have been tested for this purpose, satisfactory results have been obtained only with a portion of them. Therefore, this minireview aims to explore the role of microbiota in the pathogenesis of inflammatory bowel disease and to compile the most concrete data on probiotics efficiency in its treatment.