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Probiotics and Inflammatory Bowel Disease - What You Need to Know

Can't believe it's already beginning of September! Between some time off and working with clients, I didn't get to blogging last month as much as I would have liked but I set a goal to get myself back on track after Labour Day and here I am - right back to it. See goal setting works as it keeps you accountable even when life gets busy.

On to today's post all about probiotics and inflammatory bowel disease. There is so much buzz about probiotics in general, let alone as they relate to digestive health but today's blog post is all about inflammatory bowel disease which is actually a term that describes two related diseases known as Crohn's disease and Colitis disease. There are differences between the two diseases, but the benchmark in both is an element of inflammation in the digestive tract. Many people assume that taking probitiocs which help populate the gut with good bacteria would be a good thing if you had Crohn's or Colitis disease because it might help offset some of the trouble caused by inflammation - but is it?

In case you need a little refresher on the difference between Crohn's and Colitis disease, I've shared a great little video I initially stumbled across on the Crohn's and Colitis website that explains the two really well!

As a Registered Dietitian, I look for the evidence in research and also practice in a way where strategies should do no harm to my clients. In terms of evidence, there is some evidence for Colitis that there is a probiotic supplement that could be of benefit - that's right 'a' as in only one so far has positive results. Given that colitis is a condition localized to the colon, this makes sense as the colon is where bacteria are found in our digestive system and a probiotic supplement that provides good bacteria that can populate the colon where disease is present seems like a rather targeted strategy. Looking at the evidence it's important to note that one one supplement has positive results suggesting not all probiotics are alike and the strain or combination of bacterial strains in a supplement matters.

On the flip side, there is no good evidence to date that probiotic suppplements are of any benefit for those with Crohn's disease which is not localized to the lower end (colon) portion of the digestive system but can actually have impact anywhere in the GI system from mouth to anus or 'gum to bum' as is often referred. Ok, no proof in the pudding at this time, but given all the hype around probiotic supplements is there any risk? Well, back to my do no harm statement - there is a grey area which is for those taking medication for their inflammatory bowel disease that is immunosuppressive as we don't know for those who are taking drugs that alter the immune system process probiotics and therefore aren't sure if they are as equipped to handle ingestion of bacteria - remember, us Registered Dietitians factor in the 'do no harm' thing when it comes to advice we offer.

So what about all the food sources of probiotics or bacterial cultures? Is yogurt, kefir, kimchi and other bacteria containing foods off the table? The benefit for those living with inflammatory bowel disease hasn't been shown but it's believed food sources are of less concern for being harmful as the quantity of bacteria in food sources is typically far less than that found in probiotic supplements.

Bottom line: It's always a good idea to discuss probiotics (food and supplement forms) with your Family Doctor or Gastroenterologist who can help you make an informed decision about whether they are advised for you.

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