Ulcerative colitis: an infection characterized by sustained broken mucus barrier.

"To reduce medication for patients with ulcerative colitis (UC), we need to establish the etiology of UC. The intestinal microbiota of patients with inflammatory bowel disease (IBD) has been shown to differ from that of healthy controls and abundant data indicate that it changes in both composition and localization. Small intestinal bacterial overgrowth is significantly higher in IBD patients compared with controls. Probiotics have been investigated for their capacity to reduce the severity of UC. The luminal surfaces of the gastrointestinal tract are covered by a mucus layer. This normally acts as a barrier that does not allow bacteria to reach the epithelial cells and thus limits the direct contact between the host and the bacteria. The mucus layer in the colon comprises an inner layer that is firmly adherent to the intestinal mucosa, and an outer layer that can be washed off with minimal rinsing. Some bacteria can dissolve the protective inner mucus layer. Defects in renewal and formation of the inner mucus layer allow bacteria to reach the epithelium and have implications for the causes of colitis. In this review, important elements of UC pathology are thought to be the intestinal bacteria, gut mucus, and the mucosa-associated immune system." - http://www.ncbi.nlm.nih.gov/pubmed/25071341

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Thank you for this!

I think Old Mike posted this same thing recently. I'm guessing that that is why there haven't been many replies. I didn't read the full article but from this abbreviated portion it does not prove that colitis is caused by a bacterial imbalance, it just proves that in people with IBD there is a bacterial imbalance. But, this may be the result of UC, not the cause. I don't think it has ever been proven if it is the chicken or the egg. What I found most interesting is that here they are talking about the small intestine whereas when we talk about UC we are basically always talking about the large intestine. It would be interesting to know about the microbial makeup of the small intestine for those UC patients who have already had surgery. Also, once the barrier has been damaged in IBD patients I don't think there has ever been any sure fire ways to repair it. While probiotics often help our condition I don't think it is proven that they are actually guaranteed to repair the barrier. In this abstract, I wonder which barrier they are referring to - the small intestine, the large intestine, or both? Also again, if we get our large intestine under control, I wonder if those who suffer from "IBS" are actually suffering from this small intestinal problem outlined here?

Old Mike said...
probiotics can cause problems,including massive infection although rare.

I've never seen any studies about that, on the contrary they all support probiotics:

Decrease in lactobacilli concentration in colonic biopsies from patients with active UC. 55, 56

Lactobacillus GG has resulted in an increase in the intestinal IgA immune response in CD patients.57

Lactobacillus reuteri was shown to prevent the development of acetic acid induced colitis. 58

Lactobacillus reuteri was shown to prevent the development of methotrexate induced colitis in rats. 59 This latter could be even more effectively attenuated by Lactobacillus plantarum.

Lactobacillus species was able to prevent the development of spontaneous colitis in IL-10 deficient mice. 60

Lactobacillus plantarum was able to attenuate an established colitis in the same knockout model. 61

Studies linked here: http://gut.bmj.com/content/48/1/132.full#ref-55

I said infection from probiotics was rare.

Another problem with probiotics is that many are not human strain.

Another problem is that many if not all are transient.

We have thousands of different types bacteria in our guts,the best probiotic is probably FT,but even that causes problems, can make some people very sick,we have some who got sick on this site. Works well for c diff infection,not as good as hoped for UC,helps some at this point in time.

Not saying not to take them,if they help fine,if they cause a problem get off of them.

Not the be all and end all for UC.

We have a member Probiotic, at one point he was taking 80 or so dollars a day worth of probiotics,

he now has no colon. They never bothered him but they did not work.

Perhaps expensive poo.

Just about everything works to improve mouse colitis.

 

Old Mike

http://ajcn.nutrition.org/content/83/6/1256.full

here is a new human trial on Nissle 1917 one of the best UC probiotics,and it is human strain.

didn't work,larger number of withdrawals, I might guess some adverse events.

http://www.ncbi.nlm.nih.gov/pubmed/24972748

Post Edited (Old Mike) : 8/7/2014 6:28:30 PM (GMT-6)

Old Mike said...
I said infection from probiotics was rare.
Another problem with probiotics is that many are not human strain.
Another problem is that many if not all are transient.

I posted a half-dozen pro-probiotic studies.

Where are the anti-probiotic studies?

Gary: In the abstract they mention.

Small intestinal bacterial overgrowth is significantly higher in IBD patients compared with controls.

I guess they are also saying that with UC you can also have SIBO due to a slower transit time caused by

cytokines and lowered antioxidant levels.

http://www.ncbi.nlm.nih.gov/pubmed/24456736

but if you look at this one the SIBO incidence in UC is much less than crohns.

http://www.ncbi.nlm.nih.gov/pubmed/23649377

I would guess SIBO is going to make your UC symptoms somewhat worse, and it might be a good

idea to eat foods,and perhaps psyllium that move things along faster.

Cant say I have looked into SIBO in UC other than passing, and that was years ago.

Looks to be a result of the UC.

Old Mike

 

"I most often get questions regarding probiotics- so clearly the public interest is high. Unfortunately, concrete human evidence that is reproducible and consistent among a defined set of probiotic microbes is not yet clear. However, one thing is certain, probiotics have never been shown to cause problems or worsen disease." - Dr. Suzanne Devkota

/www.youtube.com/watch?v=NpcK-HX9G2o

One case stated "This case report highlights the potential risk of Lactobacillus bacteremia in immunosuppressed patients with severe active ulcerative colitis." - http://www.ncbi.nlm.nih.gov/pubmed/23426446

But with regards to remission "Probiotic treatment was more effective than placebo in maintaining remission in ulcerative colitis" - http://www.ncbi.nlm.nih.gov/pubmed/20397271