Should supplemental probiotics (or certain strains?) be avoided in patients with Crohn's disease?

The microbiome of patients with Crohn’s disease is known to be different than healthy controls. This difference is frequently called dysbiosis. The fecal microbiota in patients with CD has been shown to have less complexity and less stability of dominant species of bacteria compared to the healthy controls. However, all of the studies to date have investigated the inclusion of probiotics to treat and support remission, none have been conducted on those to avoid in CD pts.

Evidence from genetic and clinical studies point to the importance of gut barrier function and gut bacteria in the pathogeneses of CD. And research has shown that adding healthful bacteria to the digestive tract, can reduce both intestinal inflammation and abnormalities of the immune system. This could minimize symptoms of Crohn's disease, such as gastrointestinal irritation, diarrhea, and stomach upset. However, research conducted on the benefits of probiotics in treating Crohn’s symptoms has not shown consistent results. Problems with probiotic research include the lack of knowledge about which probiotic to choose and at what dose. For probiotics to have a role in the management of Crohn’s disease, more research is needed to align the pathogenic mechanism of the disease with the actions of the probiotics. Nevertheless, patients and physicians alike remain interested in the potential of probiotics for use in the management of IBD.

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This question was answered by Leah Linder, ND