High doses of probiotics, the beneficial bacteria that naturally lives in the intestinal tract, help control pouchitis, an inflammation of the small intestine common in patients with inflammatory bowel disease, a new study reports. To summarize:

• As many as 50% of patients who undergo surgery for ulcerative colitis, develop pouchitis afterwards

• Symptoms of pouchitis include:

  • frequent and urgent bowel movements
  • abdominal cramping
  • bleeding

  • fever

• Most cases of pouchitis respond well temporarily to treatment with antibiotics, but the condition recurs 2 out of 3 times.

• Pouchitis has been linked to reduced levels of some bacteria normally found in the intestinal tract.

• In the study, 20 patients with chronic pouchitis received high-dose probiotics, while a 'control' group of another 20 patients received a placebo.

• Throughout the 9 months of treatment, 85% of the probiotic group remained symptom-free, as determined with endoscopies and histological testing every 2 months.

• All 20 people in the placebo group relapsed.

• The probiotic preparation used contained 500 billion organisms per gram including 4 strains of lactobacilli, 3 strains of bifidobacteria, and 1 strain of Streptococcus salivarius subsp. thermophilus

• Patients each received 6 grams daily of the probiotic.

• Fecal concentration of lactobacilli, bifidobacteria, and S. thermophilus increased significantly in those taking the probiotics.

• Benefits of the probiotics lasted only as long as patients continued taking them, with all patients relapsing within 4 months of discontinuation.

The researchers state that long-term use of the probiotics is safe. "Because it is a more natural therapy that enhances the body's normal protective factors, it has no side effects and can be administered for years."

Gastroenterology August 2000;119:305-309