What is the evidence for the use of probiotics in the treatment of inflammatory bowel disease?

Aims and objectives. The purpose of this article is to investigate the use of probiotics in the treatment of inflammatory bowel disease. Background. Probiotics have been successfully used to treat various acute illnesses such as Clostridium difficile infection, rotovirus diarrhoea and traveller's diarrhoea. Recently, some studies have reported success with probiotics in the treatment of chronic intestinal diseases such as inflammatory bowel disease. Design. Literature review. Methods. A literature search was performed to include studies on Bifidobacteria-fermented milk, Escherichia coli, Lactobacillus, Saccharomyces boulardii, VSL #3 and probiotic use. Results of the literature are analysed, and a discussion is made regarding evaluation of the literature and implications for care. Results. The majority of probiotics studied have proven to have beneficial effects in the treatment of inflammatory bowel disease, especially when taken as a dietary adjunctive to standard treatment. All probiotics studied, with the exception of Lactobacillus GG and LA1, demonstrated positive results. Conclusions. The increasing use of probiotics combined with the insufficient knowledge regarding the use of probiotics in treating inflammatory bowel disease requires that future multilevel, multicentre large randomised control trials be conducted to understand better the specific measures and effectiveness of such treatment. Relevance to clinical practice. Given that few clinical trials exist to study the potential role of probiotics in the treatment of inflammatory bowel disease, it is imperative that healthcare providers become knowledgeable about the use of probiotics and their effects on inflammatory bowel disease.