Probiotics for Crohn’s Disease and IBS

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Probiotics are living bacteria and yeasts that can potentially improve certain health conditions when taken, some common bacteria species Probiotic supplements include are Lactobacillus and Bifidobacterium . Probiotics are available at pharmacies, health stores and supermarkets, as capsules or powders. Probiotics are added to some foods such as probiotic yoghurt or fermented milk drinks ,and they are naturally present in fermented foods such as sauerkraut, kombucha and kefir.

Bacteroides and Firmicutes, Actinobacteria and Proteobacteria make up the groups of the most common bacteria in the human gut. This appears not to be the situation for all individuals, potentially factors such as genetic susceptibility and inheritance factors can change this profile and facilitate the occurrence of IBD.

Probiotics have also been investigated for the treatment of ulcerative colitis, Crohn’s disease, and IBS.

The decrease of Bacteroides and Firmicutes groups, as well as the increase of Proteobacteria and Actinobacteria, stand out as the main differences in the microbiota from feces and intestinal mucosa of IBD affected individuals. The  presence of pathogenic microorganisms might also contribute to IBD , Mycobacterium avium paratuberculosis, Salmonella, Campylobacter, and Fusobacterium nucleatum have all been associated with IBD.  E. coli is also implicated in IBD development, and studies have also correlated IBD relapses to Clostridium difficile infection.  Enterobacteriaceae and Streptococcus might also play a role in dysbiosis and development of IBD. From this it can be seen that there are many potential contributors to IBD in the microbiome, and likely there will be more uncovered as research continues.

Some studies have looked at the protective role of gut microbiota against IBD.  A decreased abundance of Faecalibacterium prausnitzii  and butyrate producing bacteria have been noted in IBD, and it is thought that their presence may  offer some protection against inflammatory damage.  It has also been observed that there are differences in the composition of the microbiome of IBD patients when comparing active and inactive phases of the disease.

My experience with Probiotics

In my experience probiotics have been a key part of my Crohn’s disease management, and to me this makes sense, as I think changes in the intestinal microbiota play a key role in the development of IBD.

When using probiotics to help manage my Crohn’s, I have found that some form of cycling tends to be more beneficial. When using probiotics over an extended period there seems to be a reduction in efficacy, and I think this is due to the competitive environment of bacteria in the gut, where initially the beneficial bacteria being taken in probiotics initially displaces, or even kills, some of the bacteria contributing to the IBD condition, this situation reaches a new equilibrium over time, and then the benefits seen drop off as the disease contributing bacteria reestablishes itself in the new gut environment.

I have tried many different probiotic blends, and they have been mostly helpful, some definitely haven’t, but identifying exactly which strains or additives have caused this can be difficult. I suspect that prebiotic additives such as oligosaccharides in some blends may be responsible.

The particular strain that has been most helpful for me is Lactobaccilius paracasei. This strain has been shown to have some in vivo immunomodulatory properties to prevent intestinal inflammation. It was also demonstrated that a Lactobaccilius paracasei strain  was able to limit Helicobacter infection in humans as certain helicobacter species have been shown to be IBD-eliciting strains too.

I have used Now Foods Probiotic 10 – 100 Billion CFU, as it contains a Lactobaccilius paracasei strain, and has a high CFU count. I have found taking probiotics first thing in the morning (before eating) with plenty of water to be most effective for me (possibly because this moves them through the acidic environment of the stomach quicker)

Now Probiotic-10

Probiotics are safe for most people, but side effects can occur.  Common side effects are an increase in gas, bloating, constipation and thirst.

Some people may react to other ingredients used in probiotic supplements or to naturally occurring amines that may be in probiotic foods. If this occurs, stop using the probiotics.