Using Probiotics for Crohn's ... Video Transcript

Participants

Toby Graham MD, Stephen McClave MD, Gary Zaloga MD

Summary

Yogurt, probiotics and nutritional therapy can be a comfort to people living with inflammatory bowel disease. Listen to experts discuss this approach to treating people with Crohn's and colitis.

Webcast Transcript

ANNOUNCER: Medical therapy is essential in the management of Crohn's disease and ulcerative colitis, what's called inflammatory bowel disease, or IBD. But nutrition can also play a role in the treatment of IBD, and one nutritional approach is the use of probiotics.

TOBY GRAHAM, MD: Probiotics are good bacteria. They are the type of bacteria that we have in our intestine that help to regulate the growth of other bacteria and help to keep a balance in the bowel.

ANNOUNCER: Some doctors say yogurt from the supermarket can be an effective probiotic therapy. Others say only special formulations, ordered through the internet or bought at health food stores, contain enough bacteria, and the right kind.

STEPHEN McCLAVE, MD: There are many ways that probiotics exert their beneficial effect. One of them is that the good bacteria actually may protect the patient against the effects of the bad bacteria. In other words, a bad bacteria can actually produce toxins. A good bacteria like E. coli produces a substance, a polysaccharide, that will coat that toxin.

ANNOUNCER: So called "good" bacteria also displace "bad" bacteria that might otherwise cause IBD flare-ups.

STEPHEN McCLAVE, MD: These good bacteria that we're giving physically displace the bad bacteria. There's a limited amount of space in the GI tract. By giving good bacteria, it limits the amount of room that a bad bacteria has.

ANNOUNCER: The use of probiotics, and sugars called "pre-biotics" that feed the so-called "good" bacteria, have been largely the domain of alternative, or complementary medicine. But doctors say scientific studies are demonstrating the value of probiotics.

For some time, now, doctors have widely recognized that probiotics can calm an inflammation called pouchitis, which is a common complication of surgery for ulcerative colitis.

TOBY GRAHAM, MD: The first observation that they had with the probiotics was that if indeed they used probiotics in the diet they were able to decrease the number of recurrences of pouchitis that individuals would have, thereby decreasing the number of courses of antibiotics that had to be used. And there is recent data that has actually extended that observation, and we now know that we have a very good chance of preventing or reducing the frequency of the development of pouchitis if we use probiotics in sufficient doses.

ANNOUNCER: Nutritional therapy also plays a role in emergency treatment for people with IBD. Feeding by tube directly into the stomach, what's called enteral feeding, or by vein, directly into the bloodstream., called parenteral feeding, may sometimes be necessary to give the digestive system a chance to heal.

STEPHEN McCLAVE, MD: The situations in which we need specialized nutritional support may be simply that they're so sick that we can't get them calmed down with the normal medications. Then, putting them on specialized nutrition support just helps out the medications and getting the patient cooled down and reducing the inflammation.

ANNOUNCER: Enteral or parenteral feeding is also used to help prevent stunted growth in children with IBD. Doctors treat Crohn's disease and ulcerative colitis with strong medicines, and even surgery in some circumstances.

But clinical experience, and research, shows there may also be a role for nutritional approaches... including the use or probiotics.