Study does NOT recommend probiotics for Crohn’s disease

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Are probiotics a waste of money? Little evidence to support use in treating digestive conditions such as Crohn’s disease, large-scale review concludes

  • Probiotics are microorganisms often said to improve gut health when consumed
  • The American Gastroenterological Association reviewed work into their effects
  • However, they found only three cases where evidence supported probiotic use 
  • They also recommend against their use by children with acute gastroenteritis

By Ian Randall For Mailonline

Published: | Updated:

There is not enough evidence to recommend probiotics as a treatment for Crohn’s disease and other digestive conditions, a large-scale study has concluded. 

Probiotics are microscopic living organisms — such as certain bacteria and yeasts — that can be found in found in some foods and dietary supplements.

They are often promoted with the claim that they can offer health benefits when consumed by restoring or enhancing the microbiota of one’s gut.

However, the guidelines released by the American Gastroenterological Association identified only three clinical scenarios where probiotic use might benefit patients.

There is not enough evidence to recommend probiotics, pictured, as a treatment for Crohn’s disease and other digestive conditions, a large-scale study has concluded (stock image)

‘Patients taking probiotics for Crohn’s, ulcerative colitis or irritable bowel syndrome should consider stopping,’ said guideline panel chair and gastroenterologist Grace Su of the University of Michigan, Ann Arbor.

‘The supplements can be costly and there isn’t enough evidence to prove a benefit or confirm lack of harm. Talk with your doctor.’

According to the new guidelines, gastroenterologists should only recommend probiotics to individual patients if there is clear benefit.

Furthermore, the researchers concluded, doctors should be aware of the fact that the effects of probiotics are not species-specific, but instead are strain- and combination-specific.

The guidelines drawn up by the researchers based on existing studies did, however, support the use of certain probiotic formulations in three settings.

These include the prevention of Clostridioides difficile infection in both adults and children who are taking antibiotics and the prevention of necrotizing enterocolitis in preterm, low birth-weight infants.

The final exception involved the management of pouchitis, a complication that can occur after the removal of the large intestine which sees the ‘pouch’ — a reservoir created to connect the small intestine with the anus — become inflamed.

The team recommended against using probiotics to treat acute infectious gastroenteritis in children — and said that they should not be given routinely to children who present to the emergency room with diarrhoea.

'Patients taking probiotics for Crohn's, ulcerative colitis or irritable bowel syndrome should consider stopping,' said guideline panel chair and gastroenterologist Grace Su of the University of Michigan, Ann Arbor. 'The supplements can be costly and there isn't enough evidence to prove a benefit or confirm lack of harm. Talk with your doctor'

‘Patients taking probiotics for Crohn’s, ulcerative colitis or irritable bowel syndrome should consider stopping,’ said guideline panel chair and gastroenterologist Grace Su of the University of Michigan, Ann Arbor. ‘The supplements can be costly and there isn’t enough evidence to prove a benefit or confirm lack of harm. Talk with your doctor’

‘While our guideline does highlight a few use cases for probiotics, it more importantly underscores that the public’s assumptions about the benefits of probiotics are not well-founded,’ Dr Su added.

‘There is also a major variation in results based on the formulation of the probiotic product.’

Additional, well-designed clinical trials will be needed to refine the new recommendations by the American Gastroenterological Association around probiotic use, the researchers concluded. 

The full findings of the study were published in the journal Gastroenterology.

What is Crohn’s disease?

Crohn’s disease is a long-term condition that causes inflammation of the lining of the digestive system.

Inflammation most commonly occurs in the last section of the small or large intestine but it can affect any part of the digestive system. 

Common symptoms can include:

  • diarrhoea
  • abdominal pain
  • fatigue (extreme tiredness)
  • unintended weight loss
  • blood and mucus in your faeces (stools)

Remission occurs when people with the disease go long periods of time without symptoms however these periods can be followed by flare ups of symptoms.  

Why it happens

The exact cause of Crohn’s disease is unknown. However, research suggests a combination of factors may be responsible. These include:

genetics – genes you inherit from your parents may increase your risk of developing Crohn’s disease

the immune system – the inflammation may be caused by a problem with the immune system that causes it to attack healthy bacteria in the gut

previous infection – a previous infection may trigger an abnormal response from the immune system

smoking – smokers with Crohn’s disease usually have more severe symptoms than non-smokers

environmental factors – Crohn’s disease is most common in westernised countries such as the UK, and least common in poorer parts of the world such as Africa, which suggests the environment has a part to play 

Source: NHS