Chapter One
Probiotics, prebiotics and antibiotics
in inflammatory bowel disease
John H. Cummings and San Choon Kong
Division of Pathology and Neuroscience, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1
9SY, UK
Abstract. Probiotics and prebiotics are the sort of therapy that most patients with
inflammatory bowel disease (IBD) wish for. They are without significant side effects,
except possibly an increase in gas with prebiotics, and so far, appear to be entirely safe.
However, are they effective? More than a dozen studies using probiotics in IBD have now
been reported, and there is clear benefit in pouchitis and possibly also in Crohn's,
although there are so many clinical types of this condition that a clear indication has yet
to emerge. For ulcerative colitis (UC) more studies are needed. The use of prebiotics in
IBD is only just starting, although significant effects on both the luminal and mucosa associated
flora have been demonstrated in healthy subjects. Antibiotics offer more
certain hope in ...
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