Probiotics in the Treatment of Inflammatory Bowel Disease in Adulthood: A Systematic Review

Abstract

Background and aims: Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) characterized by chronic uncontrolled inflammation with an increasing prevalence in western countries. Standard medications are often associated with adverse side effects. Thus, alternative therapies such as probiotic treatment are of great interest. We aimed to review the effect of probiotics in IBD patients.

Methods: A systematic search strategy was carried out in PubMed in June 2021 and 22 studies published from 1997 to 2019 were included; they analyzed the influence of probiotics in adult IBD patients both in active and inactive stage of disease.

Results: Probiotic treatment in CD patients had no effect in 6 of 7 studies. Only in one study a positive effect of an adjunctive probiotic treatment next to standard treatment in CD patients was reported. In patients with active UC, a combination of standard treatment with probiotics resulted in improvement of the disease in 5 of 9 studies. Three of 7 studies among UC patients in remission demonstrated that probiotic treatment could be as effective as standard treatment. No clear evidence was found in studies comparing probiotics to placebo in inactive UC patients with ongoing standard medication.

Conclusion: There is no clear evidence of the benefit of probiotic treatment in CD patients. In contrast, combining standard treatment with probiotics might be an option to achieve remission in active UC patients.