The clinical effects of probiotics for inflammatory bowel disease: A meta-analysis

Medicine (Baltimore). 2018 Dec;97(51):e13792. doi: 10.1097/MD.0000000000013792.


Background: As the exact pathogenesis of inflammatory bowel disease (IBD) is not known, there is increasing evidence of clinical trials and animal models that indicate the beneficial effects of probiotics.

Methods: Multiple databases were adopted to search for the relevant studies involving the comparison between probiotics and control groups. Review Manager 5.0 was used to assess the efficacy among included articles. Risk of bias for the articles included was also conducted.

Results: Finally, 10 studies eventually met the inclusion criteria and 1049 patients were included. The meta-analyses showed that no significant differences of remission, relapse, and complication rate between Escherichia coli Nissle 1917 and mesalazine groups (RR = 0.94, 95%CI [0.86, 1.03], P = .21; RR = 1.04, 95%CI [0.82, 1.31], P = .77; RR = 1.12, 95%CI [0.86, 1.47], P = .39, respectively). Despite the fact that no significant differences of remission, relapse, and complication rate were observed in overall meta-analysis results between probiotics and placebo group, the subgroup analyses suggested that VSL#3 presented a higher remission rate and lower relapse rate (RR = 1.67, 95%CI [1.06, 2.63], P = .03; RR = 0.29, 95%CI [0.10, 0.83], P = .02, respectively).

Conclusion: Some types of probiotics, such as E coli Nissle 1917 and VSL#3, could be used as alternative therapy for patients with IBD.

Publication types

  • Meta-Analysis

MeSH terms

  • Case-Control Studies
  • Female
  • Humans
  • Inflammatory Bowel Diseases / therapy*
  • Male
  • Probiotics / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Recurrence
  • Remission Induction
  • Treatment Outcome