Beneficial Effects of Probiotic Bifidobacterium and Galacto-Oligosaccharide in Patients with Ulcerative Colitis: A Randomized Controlled Study

Abstract

Background/Aim: In previous studies, we described the beneficial effects of bifidobacteria-fermented milk in patients with ulcerative colitis (UC). Here, we examined the effects of a live Bifidobacterium breve strain Yakult, a probiotic contained in bifidobacteria-fermented milk, and galacto-oligosaccharide (GOS) as synbiotics in UC patients. Methods: Forty-one patients with mild to moderate UC were assigned to two groups; one group was treated with the synbiotics and the other was not (control). The treatment group ingested 1 g of the probiotic powder (10⁹ CFU/g) three times a day, and 5.5 g of GOS once a day for one year. At the start and the end of this study, colonoscopic index and the amount of myeloperoxidase in a lavage solution were used as disease activity indices. Bacterial counts in the feces at the start and the end of this study were also examined. Results: After a one-year treatment with the synbiotics, the clinical status of the UC patients as assessed by colonoscopy, significantly improved. Furthermore, the amount of myeloperoxidase in the lavage also decreased in these patients after the synbiotic treatment. The synbiotics significantly reduced the fecal counts of Bacteroidaceae and fecal pH. Conclusion: Administration of live B. breve strain Yakult and GOS can improve the clinical condition of patients with UC. These results encouraged us to perform a large-scale randomized, placebo-controlled trial.

The intestinal microbiota and its role in human health and disease

“…Synbiotics consisted from Bifidobacterium breve and galacto-oligosaccharide (38) or Bifidobacterium longum and psyllium (39) also ameliorated colitis or patient's qualityof-life. However, only a few clinical trials have suggested beneficial effects of prebiotics in UC patients.…”

Diverse galactooligosaccharides consumption by bifidobacteria: implications of β-galactosidase—LacS operon

“…11) Moreover, GOS and bifidobacteria are also given in a combined treatment referred to as a synbiotic, with the aim of enhancing the effect of exogenous bifidobacteria. [15][16][17][18] In this context, synbiotic administration of live Bifidobacterium breve strain Yakult and GOS to patients with ulcerative colitis has improved their clinical condition. 18) Although the above-mentioned GOS effects on endogenous and exogenous bifidobacteria have been well documented, several questions remain unraveled.…”

“…[15][16][17][18] In this context, synbiotic administration of live Bifidobacterium breve strain Yakult and GOS to patients with ulcerative colitis has improved their clinical condition. 18) Although the above-mentioned GOS effects on endogenous and exogenous bifidobacteria have been well documented, several questions remain unraveled. For one, it is not known why the response to GOS consumption is subject to considerable individual variation.…”

Uso de probióticos en síndrome de intestino irritable y enfermedad inflamatoria intestinal: una revisión de la literatura

“…El estudio de Ishikawa y colaboradores en Japón mostró el éxito de esta conducta en el mantenimiento de la remisión, con una reducción significativa de las exacerbaciones, y posibles efectos preventivos en recaídas con el uso de un suplemento de leche fermentada con bifidobacteria (simbiótico) 100 mL/día durante 1 año en 41 pacientes. Hallazgo reafirmado en un nuevo estudio realizado por el mismo autor en 2011, con evidencia de mejoría clínica, colonoscópica y disminución de niveles de mieloperoxidasa en 21 pacientes (p <0,05) (42,43). En el mismo país, el estudio de Fujimori con 31 pacientes comparó Bifidobacterium longum 2 x 10 9 UFC y 8 g de psyllium (prebiótico) con simbiótico únicamente y encontró mayor impacto con manejo combinado, con remisión mantenida durante las 4 semanas de tratamiento (p=0,03) (44).…”