Probiotics & IBD - What are probiotics? Should we be taking them? How to choose one?
Background
Did you know there are as many microbes in our body as human cells?
Our body is full of trillions of microbes – bacteria, fungi, yeasts – that are collectively known as our microbiome and help to keep us healthy. The more we learn about them the more we realise they are fundamental to our existence. These microbes are found in our gut but also on our skin, in our mouth, urinary tract, vagina and lungs.
The best way we can support our gut microbes is through eating a diverse range of foods and fibres. In addition to this, in some conditions and for some people, a probiotic may be helpful at supporting gut health and reducing symptoms.
What is a probiotic?
The definition of a probiotic is ‘a live microorganism that, when administered in adequate amounts, confers a health benefit on the host’.
Its all in the name
Probiotics are known by their genus, species and strain e.g. Lactobacillus rhamnosus GG.
We can liken probiotics to animals to help us understand why the type of probiotic we choose is so important; when choosing an animal we need to decide what genus we want (e.g. dog), species (e.g. terrier) and subspecies/strain (e.g. jack russell) depending on our needs and what job we want that animal to be good at!
We need to ensure we choose the right animal for the right job; for example, you wouldn’t choose a chihuahua for crowd control, you’d need a German shepherd. The same way we use different animals for different jobs, different genus, species and strains of probiotics have evidence to be useful for specific conditions or symptoms.
Should we take a probotic if we have IBD?
Some evidence suggests probiotics may be helpful in Ulcerative Colitis and in the treatment and prevention of pouchitis in people with a J-Pouch. However, at the moment there is very little evidence to support their use in Crohn's Disease.
Some evidence suggests probiotics may be helpful in IBS so if someone with IBD in remission is also experiencing IBS symptoms they may be helpful.
How to choose a probiotic
With thousands of probiotics now available on the market its hard to know what to choose. There is very little regulation around supplements and probiotics so we have no idea what is really in many of them and whether they even work.
This is why its important we always follow the evidence and choose evidence based products and probiotic strains. When we look at the evidence there are actually only a handful of brands in the UK that are backed by clinicial trial data showing they are effective.
Checklist when choosing a probiotic:
Evidence - is there any evidence that a probiotic/product is helpful for my condition/symptoms? usprobioticguide.com is a useful resource.
Type - which genus, species and strain does the evidence suggest? Choose a type that has been shown to be effective in studies for the specific condition and symptoms you are dealing with.
Amount - Be sure the product contains at least the level of probiotics that was used in the study. These are shown as CFU (colony forming units - the number of viable bacteria in the product).
Safety - ALWAYS check with your IBD team before starting any kind of supplement. If you are in a flare or are taking immune modulating medications (steroids, immunosupressants, biologics) a probiotic may not be safe for you to take.
Probiotic Product Red Flags
Not listing the full name of the bacterial strains on the ingredients - remember we need to know the genus, species and strain - this is most commonly Lactobacillus/Bifidobacterium (genus), followed by another name (species) then a number or letters (strain).
Not clearly showing the evidence behind their product on their website - we want to see actual papers/references not just words or client testimonials.
Making claims about their product that sound too good to be true (they probably are and may be in breach of advertising regulations too!)
If you would like support with your IBD and whether or not a probiotic may be helpful for you we can help you.
We are a nutrition and dietetics clinic specialising providing exceptional care to improve the quality of life of people living with IBD. We bring clarity around food and IBD and remove uncertainty and fear around food.
Our IBD specialist Nutritionist (Clemmie) and specialist gastroenterology and IBD Dietician (Jess) both have IBD too so ‘get it’ and are so passionate about helping others with IBD.
If you would like support with your IBD please book a call with Clemmie via the button below so we can find out more about you, discuss how we can help and take you through our appointment options.
Disclaimer: All content found on the nalmclinic.com website, including: text, video, or other formats have been created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor, consultant or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
We are all wonderfully unique and what works for one person may not work for another so please seek help and advice before changing your diet to work out the right way forward for you.