Probiotics in inflammatory bowel disease: Does it work?

Table 1 Treatments used in inflammatory bowel disease and their side effects

Classes	Adverse effects	Ref.
Aminosalicylates	Mesalazine-nephrotoxicity and pancreatitis; sulfasalazine-blood dyscrasias	[10,11]
Antibiotics	Photosensitivity, tendonitis, tendon rupture, cartilage growth inhibition in fetuses and children oral candidiasis, gastrointestinal disorders, peripheral neuropathy	[14-16]
Corticosteroids	Acne, moon face and edema, sleep and mood disorders. Posterior subcapsular cataract, osteoporosis, myopathy, and susceptibility to infection. Acute adrenal insufficiency, arthralgia, increased intracranial pressure and pseudo-rheumatism syndrome	[7,20-22]
anti-TNF	Septicemia	[28]
Thiopurine	Hepatotoxicity, gastric intolerance and pancreatitis	[32]
Methotrexate	Nausea, vomiting and diarrhea	[34]

Table 2 Clinical activity of probiotics in inflammatory bowel disease

Probiotic	Clinical activity in IBD	Ref.
Escherichia coli Nissle 1917	Induction and maintenance of UC remission	[16,57,58,62]
VSL#3	Induction and maintenance of UC remission; prevention of relapses in chronic pouchitis	[65,66,68,69]
Saccharomyces boulardii	Clinical remission of UC	[68-70]
Bifidobacterium longum	Objective improvements in UC parameters	[71]
Lactobacillus acidophilus La-5 + Bifidobacterium BB-12	Probable improvement of intestinal parameters in IBD	[72]

UC: Ulcerative colitis; CD: Crohn’s disease; IBD: Inflammatory bowel disease.