Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

Abstract

Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD.Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics.Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.

Probiotic supplementation as a supportive treatment in inflammatory bowel diseases - literature overview

“…Additionally, in combination with mesalazine, probiotics significantly improved symptoms of rectal bleeding and bowel movement frequency compared to mesalazine alone [23]. A study conducted in a murine model of ulcerative colitis (T-bet-/-Rag2-/-) showed that Bifidobacterium lactis reduces inflammation and colitis in the early stages of the disease and decreases the amount of Enterobacteriaceae, which appear to contribute to the development of intestinal disease [24].…”

Probiotics for the treatment of ulcerative colitis: a review of experimental research from 2018 to 2022

“…Given the pathophysiological importance of the gut microbiome in UC, the hypothesis that altering the gut microbiota may be a viable way to treat UC is gaining attention ( Paramsothy et al, 2017 ). Based on a cross-sectional study, among patients with a high disease activity index (DAI), frequent defecation, severe abdominal pain, and a history of related surgery, the frequency of probiotics being prescribed increased, indicating that probiotics are now being recognized in the treatment of UC ( Kim and Cheon, 2022 ). Although the current evidence base supporting the use of probiotics in patients with UC is thin, probiotics are often widely used as adjunctive therapy and are often recommended by physicians, and they are generally considered to be safe ( Abraham and Quigley, 2017 ).…”