Probiotics in the Treatment of Crohn’s Disease
Alterations in the bacterial milieu of the gut are common in Crohns disease. The use of various probiotic bacteria to promote a balance of appropriate intestinal flora has yielded mixed results. Mechanisms associated with the beneficial effects of probiotic therapy in Crohn’s Disease include:

(1) inhibition of pathogenic bacteria via growth suppression or epithelial binding
(2)  improved epithelial and mucosal barrier function; and
(3) altered immuno-regulation via stimulation of secretory IgA or reduction in TNF-alpha.

Saccharomyces boulardii
Plein et al demonstrated the efficacy of Saccharomyces boulardii (Sb) in a randomized, double-blind, placebo-controlled study of 20 Crohn’s Disease patients. Patients were given 250 mg Sb three times daily for 10 weeks and evaluated via bowel movement frequency and the CDAI index. Patients receiving Sb experienced a significant reduction in frequency of bowel movements (from 5.0 to 3.3 per day) and CDAI index (193 to 107) by week 10 of treatment.

Another study utilizing Saccharomyces boulardii therapy in 32 Crohn’s Disease patients demonstrated a significant benefit of a combination of Saccharomyces boulardii and mesalamine compared to mesalamine alone. Relapse in the mesalamine-only group was 37.5 percent at six months compared to only 6.25 percent in the mesalamine-plus Saccharomyces boulardii group.

E. coli (Nissle strain)
Pathogenic E. coli that adhere to and invade intestinal epithelial cells (IEC) have been isolated from ileal lesions of Crohns patients. Boudeau et al demonstrated the in vitro ability of a non-pathogenic E. coli strain (Nissle 1917) to prevent pathogenic E. coli strains from adhering to and invading IEC. When IEC were co-infected with probiotic Nissle strain and pathogenic E. coli, the Nissle strain exhibited a dose- and time-dependent adhesion to IEC, which prevented adhesion of various pathogenic E. coli strains by 78.0- 99.9 percent.

When IEC were pre-incubated with Nissle strain E. coli and pathogenic strains were added later, adhesion and invasion of pathogenic strains was inhibited by 97.2-99.9 percent. Malchow et al conducted a double-blind, randomized, placebo-controlled trial investigating the efficacy of E. coli Nissle strain 1917 for inducing and maintaining remission in 28 patients with colonic Crohns disease.

Patients were randomized to either 60 mg prednisolone daily (with a standard tapering schedule) plus twice daily doses of 2.5 x1010 probiotic Nissle strain E. coli (treatment group) or identical prednisolone therapy plus placebo (placebo group). The rate at which remission was achieved was comparable in both groups (85.7% for treatment patients versus 91.7% for placebo patients), but only 33.3 percent of patients in the E. coli treatment group relapsed at one year, compared to 63.6 percent in the placebo group.

Lactobacillus GG
Malin et al investigated the effect of oral Lactobacillus GG on the intestinal immunological barrier in a small study of 14 children with CD and seven control patients (hospitalized for investigation of abdominal pain but with no evidence of intestinal disease). Lactobacillus GG was administered to patients and controls at 1010 colony forming units mixed in liquid twice daily. Lactobacillus GG therapy significantly increased the IgA immune response in Crohns patients compared to controls, resulting in an improved mucosal barrier.

Another study of Lactobacillus GG demonstrated that administration in children with mildto- moderate stable Crohn’s Disease improved gut barrier function and clinical status after six months of therapy.228 However, a randomized, double-blind, placebo-controlled trial of 45 post-surgery Crohns patients given Lactobacillus GG for one year did not show it to be more effective than placebo in preventing disease recurrence.229

Constipation in Crohn’s disease is usually a symptom of obstruction in the small intestine. Constipation can be a symptom of UC, but not as common as diarrhea. Can occur during flare-ups. May occur when the inflamed rectum triggers a reflex response in the colon that causes it to retain the stool.

Patients with irritable bowel syndrome often have fluctuating symptoms over long periods of time. Patients may experience gas, bloating, dyspepsia, constipation, diarrhea, flatus, diarrhea alternating with constipation, and the passage of mucous in the stools. Crampy abdominal pain may be present. It is the goal of physicians to assess these complex symptoms and address these complaints by performing appropriate medical tests.

Patients with constipation predominant irritable bowel syndrome should be treated with an increase in fiber. If the fiber content of their stool is increased and patients continue to experience constipation, addition of non-stimulant laxatives can be instituted. These are stool softeners, such as Colace or Surfak. Others such as milk of Magnesia or lactulose may be useful.

Patients with constipation, and the above complaints, are usually not treated with tricyclic antidepressants because of the possibility of exacerbating their constipation. Constipation means different things to different people. For many people, it simply means infrequent stools.

For others, however, constipation means hard stools, difficulty passing stools (straining), or a sense of incomplete emptying after a bowel movement. The cause of each of these “types” of constipation probably is different, and the approach to each should be tailored to the specific type of constipation. Crohn’s disease, ulcerative colitis, chronic constipation, GERD, irritable bowel syndrome, dyspepsia and other gastrointestinal problems can cause pain, discomfort, adverse complications and disruption of your normal activities.

Clinical trials allow you to play an active role in your healthcare and give you access to new research treatments before they are available to the general public. Mitamins custom make quality formulas for the treatment of Constipation & Crohn’s Disease with vitamins. A Constipation & Crohn’s Disease formula will be made to suit you, using quality brand name ingredients. Mitamins produce custom made vitamin and supplement formulas to suit your individual health needs conveniently in one formula, one bottle and one dosage. Constipation is a symptom of Crohn’s disease but it’s not as common as diarrhea. It often occurs during a flare up, and is characterized by having a bowel movement less than three times within a week.

Constipation can be very uncomfortable and cause bloating, straining and the feeling of a full bowel.Constipation is quite common, and is something the average person experiences regardless if they suffer from an inflammatory bowel disease (IBD), or other digestive condition.  Constipation results when the colon absorbs too much water from the waste material or the colon’s muscle contracts slowly or is sluggish. This causes stool to dramatically slow down on its journey through the colon.

The outcome of constipation is often dry, hard, pebble-like stool that is difficult to pass. Causes of constipation may differ depending on the person. For instance, while constipation may be a result from a poor diet in one person, it could be the result of taking medication in another. Therefore, in order to treat constipation, a Crohn’s sufferer should first learn about the most common causes of constipation and then assess their condition.