Background Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD.
Methods This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups.
Results In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics.
Conclusion Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.
Citations
Citations to this article as recorded by
The role of the fecal microbiota in inflammatory bowel disease Rami Khalaf, Martina Sciberras, Pierre Ellul European Journal of Gastroenterology & Hepatology.2024; 36(11): 1249. CrossRef
Probiotics for the treatment of ulcerative colitis: a review of experimental research from 2018 to 2022 Cuilan Huang, Wujuan Hao, Xuyang Wang, Renmin Zhou, Qiong Lin Frontiers in Microbiology.2023;[Epub] CrossRef
Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.
Background :The incidence of Ulcerative colitis (UC) in Korea are low compared with those of Western countries, but have been increasing rapidly during the past decades. Clinical characteristics of UC in Asian population are not well recognized. Therefore we investigated the clinical course of UC in Korea.
Material and Methods:We retrospectively analyzed 211 UC patients first diagnosed and long term follow up colonoscopic examined at Yeungnam University Medical Center between 1989 and 2006. We reviewed extension of lesion by follow up endoscopic finding and symptom depend on treatment.
Results :The male to female ratio was 1 : 1.1 and the median age at diagnosis was 46.0 years (range, 17-83 years). At diagnosis, proctitis was noted in 70 patients (33.2%), proctosigmoiditis in 40 (19%), left-sided colitis in 22 (10.4%), extensive colitis in 79 (37.4%). Further extension in the colon was most frequently observed in patients with proctitis (22.8%). In the patients initially diagnosed with proctitis, 28.6% of the patients were not taking any kind of medication for UC and 54 patients (77%, treatment group 34 patients, untreatment group 20) had not progressed during the observation period (56 months, range 2-193 months). The maximal extent of the disease was not affected by treatment (P = 0.99).
Conclusion :The initial extent of the disease in Korean UC patients was similar to that found in other Western studies. In the present study, most of limited UC(proctitis, proctosigmoiditis, 77-82%) did not progress to extensive colitis regardless of treatments, but large scale multicenter analysis was needed.