Health Matters

Does eating fermented milk products like yoghurt help ulcerative colitis (UC) patients?

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Animal studies show that probiotics can help colitis (Kato et al, 2004). For example, scientists can give rats a vinegar-enema, to quickly causes colitis. However, if these rats are immediately given a colonic irrigation with lactobacillus-fermented oat-soup (oat yoghurt), colitis is almost completely prevented (Fabia et al, 1993)

Second, when Methotrexate, a chemotherapeutic drug is given to patients suffering arthritis, psoriasis, other inflammatory conditions, and some cancer patients (Cleveland Clinic, n.d.), severe colitis can result (Mao et al, 1996). Giving rats methotrexate also causes colitis. However, if these rats are fed ‘lactobacillus plantarum fermented oat-soup’ (oat yoghurt), colitis incidence and all associated ill-effects are significantly reduced (Mao et al, 1996).

Medical researchers conducted two small placebo-controlled human trials to look at the benefits of fermented milk (yoghurt) for UC patients.

The first trial looked at 20 UC patients whose symptoms had been brought under control using standard treatments. Scientists wanted to know if daily yoghurt could stop patients becoming symptomatic again.

This trial showed that taking yoghurt daily for 1 year allowed most patients to remain symptom free for that year. In patients not eating daily yoghurt, most had one or more relapses of UC during that year. Further, for patients who did relapse during this year, if the patient was taking yogurt daily, they generally had only one relapse, while those not taking yoghurt generally had two or more relapses (Ishikawa et al, 2003). So, eating daily yoghurt worked, preventing relapse in most patients, and significantly reducing the number of relapses if relapse did occur.

In a second (12 week) trial, the same researchers looked at 20 UC patients whose symptoms had initially been brought under control using standard treatments, but in whom UC symptoms had returned, while on medication. researchers wanted to know if eating yoghurt daily could reduce symptom severity or help patients become asymptomatic again.

Patients were kept on standard medications – mesalazine(5-ASA) or salazosulphapyridine (SASP) and given either placebo or yoghurt made of milk that had been fermented using a combination of 3 bacteria – Bifidobacterium (breve & bifidum) and Lactobacillus acidophilus (least 10 billion bacteria per 100ml bottle).

After 12 weeks patients in the group receiving yoghurt were more likely to:

  1. have symptom improvement, or
  2. be completely symptom free,

and their bowel walls tended to look much more healed when viewed by endoscope, and much less injured when bowel-tissue samples were viewed by microscope.

Finally, those eating daily yoghurt showed marked increases in small fatty acids content in stool. Small fatty acids (such as butyrate and propionate) help heal the bowel. Butyrate is the main energy source for the cells lining the colon, and it also reduces bowel inflammation caused by the immune system. In this way butyrate helps heal the bowel. No increases in small fatty acids were seen in the placebo group (Kato et al, 2004).

It helps to understand that the benefits seen in both trials above, were achieved without any attempts to improve patient diet. The researcher however noted that changing the diet to include prebiotic foods, for example, germinated barley seeds (one prebiotic food amongst many) would further help normalise bowel bacteria composition and thus likely make the yogurt treatment in UC patients even more effective (Ishigawa et al, 2004). This illustrates how a more wholistic approach, will likely lead to a more effective treatment for ulcerative colitis.

References

Fabia, R., Ar’Rajab, A., Johansson, M. L., Willen, R., Andersson, R., Molin, G., & Bengmark, S. (1993). The effect of exogenous administration of Lactobacillus reuteri R2LC and oat fiber on acetic acid-induced colitis in the rat. Scandinavian journal of gastroenterology, 28(2), 155-162. https://sci-hub.se/10.3109/00365529309096063

Cleveland Clinic. (n.d.). Methotrexate. https://my.clevelandclinic.org/health/drugs/20143-methotrexate

Ishikawa, H., Akedo, I., Umesaki, Y., Tanaka, R., Imaoka, A., & Otani, T. (2003). Randomized controlled trial of the effect of bifidobacteria-fermented milk on ulcerative colitis. Journal of the American College of Nutrition, 22(1), 56-63. https://sci-hub.se/10.1080/07315724.2003.10719276

Kato, K., Mizuno, S., Umesaki, Y., Ishii, Y., Sugitani, M., Imaoka, A., … & Arakawa, Y. (2004). Randomized placebo‐controlled trial assessing the effect of bifidobacteria‐fermented milk on active ulcerative colitis. Alimentary pharmacology & therapeutics, 20(10), 1133-1141. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2036.2004.02268.x

Mao, Y. I. L. E. I., Nobaek, S. O. R. E. N., Kasravi, B. E. H. Z. A. D., Adawi, D. I. Y. A., Stenram, U. N. N. E., Molin, G. O. R. A. N., & Jeppsson, B. E. N. G. T. (1996). The effects of Lactobacillus strains and oat fiber on methotrexate-induced enterocolitis in rats. Gastroenterology, 111(2), 334-344. https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2896%2900352-6

Article Written + Submitted by:

Andreas Klein Nutritionist + Remedial Therapist from Beautiful Health + Wellness
P: 0418 166 269

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