In my previous post, I explored the relationship between ulcerative colitis (UC) and gut bacteria in a review paper from some years ago. Here, the theme of "treatment" continues.
A UK microbiology team, led by Sandra Macfarlane at the University of Dundee, pored over the UC research and became convinced that UC has something to do with the body overreacting to its normal gut bacteria. Basically, it's a case of the gut is crying wolf, saying, "Hey, there's something wrong with this bacteria in here!" even when everything's fine.
We already know that "Biff" (Bifidobacterium) has a calming effect on the gut. In general, a healthy Biff population makes it less likely that the gut will get all inflamed and upset.
The researchers compared small pieces of rectal tissue from people with UC and people without UC. Indeed, they found that those with UC had a lot less Biff than healthy people - about 30 times less.
The team thought they would use this information about the lack of Biff to design a treatment for UC. But instead of just using a probiotic pill containing Biff, they thought they would boost Biff's power by using a prebiotic.
A prebiotic is something in the diet that encourages the growth of good bacteria. Using a prebiotic along with a probiotic is akin to adding fertilizer if you want to grow a healthy plant.
Now, we get to do some fun bacterial math! Guess what happens when we combine a PRObiotic with a PREbiotic?
PRObiotic + PREbiotic = SYNbiotic
That's right, a treatment that combines a PROBIOTIC with a PREBIOTIC substance is called SYNBIOTIC treatment.
These clever researchers tested their synbiotic therapy on 18 patients for one month. They had the test patients take a capsule of Biff along with a sachet of prebiotic powder twice a day. The results were good - the synbiotic therapy resulted in higher numbers of Biff and reduced inflammation (when compared to a placebo therapy).
One step back here: I told you that a prebiotic is "something in the diet". So why didn't the researchers use natural prebiotic foods instead of little sachets that contain the same substance (which, if you care, was oligofructose-enriched inulin)?
I emailed these researchers to ask that very question. Sandra Macfarlane says, "We chose sachets so that we could determine the exact amount of prebiotic the patients were receiving and that they complied with the protocol." She adds, "This would be difficult to do using a foodstuff."
So those of you who want to simulate this treatment at home - **with the permission of your doctor, of course** - you're welcome to try using a "foodstuff" rather than a sachet of prebiotic.
I found one more study from a different lab that supported synbiotic treatment for keeping UC in remission. Some Japanese researchers took it upon themselves to compare: (1) Probiotic treatment alone, (2) Prebiotic treatment alone, and (3) Synbiotic treatment, in a randomized controlled trial. The 120 patients received one of the three treatments above; they completed quality-of-life questionnaires before, during, and after their treatment.
The result? SYNBIOTIC therapy had the greatest impact on their quality of life.
Since I don't have ulcerative colitis, I couldn't tell you whether this research has made its way into the clinic or not. But it's certainly good to know it's out there.
Macfarlane, S., Furrie, E., Kennedy, A., Cummings, J., & Macfarlane, G. (2007). Mucosal bacteria in ulcerative colitis British Journal of Nutrition, 93 (S1) DOI: 10.1079/BJN20041347
Furrie, E. (2005). Synbiotic therapy (Bifidobacterium longum/Synergy 1) initiates resolution of inflammation in patients with active ulcerative colitis: a randomised controlled pilot trial Gut, 54 (2), 242-249 DOI: 10.1136/gut.2004.044834
Fujimori S, Gudis K, Mitsui K, Seo T, Yonezawa M, Tanaka S, Tatsuguchi A, & Sakamoto C (2009). A randomized controlled trial on the efficacy of synbiotic versus probiotic or prebiotic treatment to improve the quality of life in patients with ulcerative colitis. Nutrition (Burbank, Los Angeles County, Calif.), 25 (5), 520-5 PMID: 19201576