Clinical effects and gut microbiota changes of using probiotics, prebiotics or synbiotics in inflammatory bowel disease: A systematic review and meta-analysis
Abstract
Purpose Probiotics have been reported to be beneficial for inflammatory bowel disease (IBD), but the types, number of strains, dosage, and intervention time of probiotics used remain controversial. Furthermore, the changes of gut microbiota in IBD's patients are also intriguing. Thus, this meta-analysis was to explore the clinical effects and gut microbiota changes of using probiotics, prebiotics and synbiotics in IBD.Methods The search was performed in PubMed, Web of Science and the Cochrane library from inception to April 2020. Qualified randomized controlled trials were included. IBD's remission rate, disease activity index and recurrence rate were extracted and analyzed. Changes in the gut microbiota of patients with IBD are comprehensively described.Results Thirty-eight articles were included. Probiotics, prebiotics and synbiotics can induce/maintain IBD's remission and reduce ulcerative colitis (UC) disease activity index (RR = 1.13, 95% CI 1.02, 1.26, P < 0.05; SMD = 1.00, 95% CI 0.27, 1.73, P < 0.05). In subgroup analyses of IBD remission rate and UC disease activity index, we obtained some statistically significant results in some subgroup (P < 0.05). To some extent, probiotic supplements can increase the number of beneficial bacteria (especially Bifidobacteria) in the intestinal tract of patients with IBD.Conclusions Our results support the treatment of IBD (especially UC) with pro/pre/synbiotics, and synbiotics are more effective. Probiotic supplements that are based on Lactobacillus and Bifidobacterium or more than one strain are more likely to be beneficial for IBD remission. The dose of 10 10-10 12 CFU/day may be a reference range for using probiotics to relieve IBD.
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Six recent meta-analyses showed that probiotic strains induce remission in IBD, with much evidence of efficacy for ulcerative colitis but less evidence for Crohn's disease.
“although six recent meta-analyses [114,115,116,117,118] showed that probiotic strains induce remission in IBD, with much evidence of efficacy for ulcerative colitis (UC) but less evidence for Crohn’s disease (CD) [116,117].”
From The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties (2024) · cites this paper as [118]
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- Authors
- Zhang, X.-F., Guan, X.-X., Tang, Y.-J., Sun, J.-F., Wang, X.-K., Wang, W.-D., & Fan, J.-M.
- Affiliations
- Zhengzhou University (CN)
- ORCID
- Venue
- European Journal of Nutrition
- Published
- 2021-02-08
- Volume
- 60
- Issue
- 5
- Pages
- 2855-2875
- ISSN
- 1436-6207 (ISSN-L)
- 1436-6215
- OpenAlex
- W3126487719
- Cited by
- 193
- References
- 84
- Citations by year
- 2026: 26 · 2025: 38 · 2024: 46 · 2023: 35 · 2022: 35 · 2021: 13
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Update notices
- correction (2021-05-24)
- Open access
- closed
- Locations
- European Journal of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (31372453)
- Science and Technology Department of Henan Province (152102310260)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- inflammatory bowel disease, probiotics, prebiotics, synbiotics, gut microbiota, ulcerative colitis, remission, disease activity index, recurrence, Bifidobacterium
- MeSH terms
- Gastrointestinal Microbiome, Humans, Inflammatory Bowel Diseases, Probiotics, Prebiotics, Synbiotics
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