Irritable Bowel Syndrome Message Boards | Probiotics Prove Just As Effective As a Popular Prescription Drug for Ulcerative Colitis

12.10.04 -- Probiotics Prove Just As Effective As a Popular Prescription Drug for Ulcerative Colitis

By Greg Arnold, DC, CSCS, October 21, 2004, abstracted from "Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine" in the November 2004 issue of Gut

Inflammatory bowel disease (IBD) includes a number of chronic, relapsing inflammatory disorders involving the gastrointestinal tract. It is estimated that more than 600,000 people in the United States have some form of inflammatory bowel disease.1 Classically, inflammatory bowel disease includes ulcerative colitis and Crohn's disease.

Ulcerative colitis (UC) presents as inflammation extending throughout the entire colon. Research increasingly suggests that the inflammation associated with UC and IBD is related to an overabundance of "bad" bacteria and a deficiency of "good bacteria" known as probiotics.(2, 3) Now a new study4 has found probiotics act just as well as prescription drugs in helping relapses in UC.

Researchers studied 327 IBD patients, with 162 receiving 200 mg Escherichia Coli Nissle once daily while 165 received 500 mg mesalazine, a prescription drug regarded as the "gold standard" for treating IBD, three times daily for one year. Patients were assessed were regularly assessed for signs of relapse using the Rachmilewitz clinical and endoscopic activity indices, and according to histology at the end of the study.

Compared to the relapses of patients on mesalazine (38/112 = 33.9 percent), the probiotic group had a similar percentage of relapse (40/110 = 36.4 percent). "The probiotic drug E. coli Nissle 1917 shows efficacy and safety in maintaining remission equivalent to the gold standard mesalazine in patients with UC" and that these results re-emphasize "the pathogenetic significance of the enteric flora."

Although both groups tolerated their treatment well with no reported adverse side effects, a note of caution should be raised about mesalazine, since it has been the subject of research regarding dangerous side effects that include pancreas and kidney damage,5 making probiotics all the more reasonable as an effective option for UC.

Reference:
1 Botoman VA. Management of inflammatory bowel disease. Am Fam Physician. 1998 Jan 1;57(1):57-68, 71-2

2 Kanauchi, O. Modification of intestinal flora in the treatment of inflammatory bowel disease. Curr Pharm Des. 2003;9(4):333-46

3 Linskins, RK. The bacterial flora in inflammatory bowel disease: current insights in pathogenesis and the influence of antibiotics and probiotics. Scand J Gastroenterol Suppl. 2001(234):29-40

4 Kruis S. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut 2004 Nov; 53(11): 1617-23

5 Sulphasalazine and mesalazine: serious adverse reactions re-evaluated on the basis of suspected adverse reaction reports to the Committee on Safety of Medicines. Gut 2002 Oct; 51(4): 536-9

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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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