Probiotics, prebiotics, synbiotics: ecological treatment for inflammatory bowel disease?

Ecological treatment may be beneficial in patients with ulcerative colitis A clinical study published previously in Gut suggests for the first time that an ecological treatment combining a prebiotic mixture of fructo-oligosaccharides (FOS) of different chain length with a Bifidobacterium longum (a synbiotic) could have therapeutic benefits in the distal colon of patients with acute ulcerative colitis.1 In this randomised double-blind pilot trial, a marked decrease in endoscopic lesions in the distal colon was observed in the ecological treatment group but not in the placebo group. The biological markers of inflammation in the mucosa, tumour necrosis factor α, interleukin (IL) 1-α and the human β-defensins 2, 3 and 4, decreased (ie, were ameliorated) in the group receiving the ecological treatment. This study will probably not convince most clinicians because of the low number of subjects, the use of concomittent treatments and the lack of histological inflammation score. However, pilot studies such as this one will hopefully bridge the expanding animal data and still limited human clinical research and help select products for powered randomised controlled trials. Many ecological treatments have now been shown to be effective in the treatment of experimental inflammatory bowel disease (IBD) in rodents.2 The term probiotic defines “live microorganisms which when administered in adequate amounts confer a health benefit on the host”. Efficient probiotic strains have been found in different bacterial genera including bifidobacteria, …