Probiotics in ulcerative colitis (UC)

Points of note with respect to the diet of those with ulcerative colitis:

• neither elemental diets nor hyperalimentation with bowel rest are of benefit in ulcerative colitis, unlike in Crohn's disease.
  
  
• fish oil, or other forms of eicosapentanoic acids:
  • these divert arachidonic acid metabolites away from the pro-inflammatory leukotriene B4 to less inflammatory leukotrienes
  • various studies have shown the potential to modulate luminal and tissue eicosanoids in ulcerative colitis and to allow reduction of steroid therapy. However, long-term benefits have yet to been shown
  • the importance of dietary intake of PUFA has been gleaned from epidemiological observations that Eskimos have a low incidence of inflammatory bowel disease (IBD)
    
    
• probiotics - there is ongoing interest in the use of probiotics in the treatment of IBD.
  • is effective in maintaining remission in UC (1)
  • probiotics are live non-pathogenic organisms such as various Lactobacillus species, which aim to confer health benefits by improving the gut micro-organism environment

The European Society for Parenteral and Enteral Nutrition published the Guidelines for Clinical Nutrition Management of Inflammatory Bowel Disease, which confirm the remission-inducing effect of specific probiotic strains in patients with mild to moderate UC, with the use of Lactobacillus reuteri and VSL#3 being recommended (2)

Reference:

1. World Gastroenterology Organisation. Global guidelines: inflammatory bowel disease. Aug 2015 [internet publication].
2. Forbes A. et al. (2019). Corrigendum to “ESPEN guideline: clinical nutrition in inflammatory bowel disease” [clinical nutrition 36 (2017) 321-347]. Clin. Nutr. 38:1486.