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Review
. 2023 Feb 8;11(2):494.
doi: 10.3390/biomedicines11020494.

The Role of Probiotics in Inducing and Maintaining Remission in Crohn's Disease and Ulcerative Colitis: A Systematic Review of the Literature

Georgios Vakadaris  1 , Christos Stefanis  1 , Elpida Giorgi  1 , Merkourios Brouvalis  1 , Chrysoula Chrysa Voidarou  2 , Yiannis Kourkoutas  3 , Christina Tsigalou  4 , Eugenia Bezirtzoglou  1
Affiliations
Review

The Role of Probiotics in Inducing and Maintaining Remission in Crohn's Disease and Ulcerative Colitis: A Systematic Review of the Literature

Georgios Vakadaris et al. Biomedicines. .

Abstract

Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract affecting millions of patients worldwide. The gut microbiome partly determines the pathogenesis of both diseases. Even though probiotics have been widely used as a potential treatment, their efficacy in inducing and maintaining remission is still controversial. Our study aims to review the present-day literature about the possible role of probiotics in treating inflammatory bowel diseases in adults. This research was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We included studies concerning adult patients who compared probiotics with placebo or non-probiotic intervention. We identified thirty-three studies, including 2713 patients from fourteen countries. The role of probiotics in Crohn's disease was examined in eleven studies. Only four studies presented statistically significant results in the remission of disease, primarily when used for three to six months. On the other hand, in twenty-one out of twenty-five studies, probiotics proved effective in achieving or maintaining remission in ulcerative colitis. Supplementation with Bifidobacterium sp. or a combination of probiotics is the most effective intervention, especially when compared with a placebo. There is strong evidence supporting the usage of probiotic supplementation in patients with ulcerative colitis, yet more research is needed to justify their efficacy in Crohn's disease.

Keywords: Bifidobacterium spp.; Crohn’s disease; Lactobacillus spp.; inflammatory bowel diseases; probiotics; symbiotic treatment; ulcerative colitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of studies selection.
Figure 2
Figure 2
Probiotic efficacy according to type of probiotics in ulcerative colitis.
Figure 3
Figure 3
Probiotic efficacy according to duration of treatment in ulcerative colitis.
Figure 4
Figure 4
Probiotic efficacy according to type of probiotics in Crohn’s disease.
Figure 5
Figure 5
Probiotic efficacy according to duration of treatment in Crohn’s disease.
Figure 6
Figure 6
(a) Probiotic supplementation and potential mechanisms in human gut; (b) potential probiotic mechanisms in IBD after probiotic supplementation “Reproduced with permission from Pavel, F.M et. al.], Diagnostics 11(6):1090; published by MDPI, Basel, Switzerland, 2021 [70]”.
See this image and copyright information in PMC

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