The effect of a prebiotic with a probiotic on symptoms and quality of life in ulcerative colitis
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The medical management of ulcerative colitis in children often requires aggressive pharmacological therapy or colonic resection. We hypothesized that synbiotic therapy, consisting of B. longum R0175 and inulin would improve symptoms and quality of life (QOL) in children diagnosed with ulcerative colitis. Consenting pediatric subjects (8-18 years; n = 9) with ulcerative colitis in remission were provided synbiotic therapy, (Probiotic: Bifidobacterium longum R0175 2.0 x 1010 cfu/day; Prebiotic: 15 g/day of inulin) (n = 4) or placebo (maltodextrin + ascorbic acid capsule; 15 g/day of non-resistant maltodextrin) (n = 5) for ten months in a pilot study (Phase I). After ten months, the study was unblinded and synbiotic therapy was administered to eight pediatric subjects (Phase II). In attempt to increase sample size, three adult subjects with active UC were recruited and provided the synbiotic therapy (Phase III). In all phases of the research, QOL was measured using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). The SIBDQ was administered at baseline and every two months. Subjects kept a daily records of symptoms (stool consistency and frequency, presence of blood and mucous, presence of abdominal pain and overall feeling). Phase I QOL scores were significantly better for those receiving the synbiotic therapy versus the placebo (p = 0.014). Severe symptoms occurred in 60% of the control subjects, where as subjects receiving synbiotic therapy did not experience severe symptoms (p = 0.032). Phase II QOL scores were significantly better post-treatment with synbiotic therapy (p=0.034). One subject (steroid dependant) was able to wean off Prednisone® while receiving the synbiotic therapy; she remained in remission and was symptom free for over 26 months. In Phase III, synbiotic therapy did not induce remission in the adult subjects with active UC. No adverse effects were reported.Synbiotic therapy consisting of Bifidobacterium longum R0175 and inulin, when provided in addition to conventional treatment, appears to be a safe and effective strategy for managing pediatric ulcerative colitis in remission.Further clinical trials are warranted to confirm these preliminary results.
DegreeMaster of Science (M.Sc.)
SupervisorWhiting, Susan J.
CommitteeZello, Gordon A.; Hamilton, Donald L.; Dahl, Wendy
Copyright DateApril 2007
quality of life