Nutritional Sciences Division, Kings College London, London, UK.
Inflamm Bowel Dis. 2010 Dec;16(12):2099-108. doi: 10.1002/ibd.21286.
The use of complementary and alternative medicine in inflammatory bowel disease (IBD) has been extensively studied. However, the use of probiotics and prebiotics is poorly documented, despite evidence of efficacy of particular probiotic strains in specific forms of IBD.
A case-control study comprising interviewer-administered questionnaires was conducted in IBD patients and healthy controls. Data regarding use and knowledge of probiotics and prebiotics, demographic, and clinical information were collected.
In total, 334 participants (234 IBD, 100 controls) were interviewed. Significantly more IBD patients than controls had ever used probiotics to manage their health (Crohn's disease [CD] 43%, ulcerative colitis [UC] 51%, controls 21%, P < 0.001). Prebiotic use was negligible. On logistic regression analysis, having UC (odds ratio [OR] 4.30, 95% confidence interval [CI] 2.27-8.12) or CD (OR 3.05, 95% CI 1.66-5.60) were the strongest predictors of probiotic use. Within IBD patients the strongest predictor of probiotic use was current steroid use (OR 2.4, 95% CI 1.11-5.18). IBD patients had greater probiotic knowledge scores than controls (P = 0.003), although 20% of IBD probiotic users could not provide a definition of a probiotic. Less than half of IBD probiotic users discussed probiotic use with healthcare professionals, with commercial advertising being the primary source of information.
Patients with IBD use probiotics to manage their health but frequently choose strains without evidence of efficacy in IBD. Patients rely on nonclinical sources of information and often do not disclose probiotic use to healthcare professionals. Conventional healthcare providers should inquire about probiotic use among their patients and offer evidence-based advice.
在炎症性肠病（IBD）中，补充和替代医学的应用已经得到了广泛的研究。然而，尽管有特定益生菌菌株在特定形式的 IBD 中的疗效证据，但益生菌和益生元的应用却很少有记录。
这项病例对照研究包括对 IBD 患者和健康对照者进行访谈员管理的问卷调查。收集了关于益生菌和益生元的使用和知识、人口统计学和临床信息的数据。
共对 334 名参与者（234 名 IBD 患者，100 名对照者）进行了访谈。与对照组相比，IBD 患者中使用益生菌来管理其健康的比例显著更高（克罗恩病 [CD] 43%，溃疡性结肠炎 [UC] 51%，对照组 21%，P < 0.001）。使用益生元的比例可以忽略不计。在逻辑回归分析中，患有 UC（比值比 [OR] 4.30，95%置信区间 [CI] 2.27-8.12）或 CD（OR 3.05，95% CI 1.66-5.60）是使用益生菌的最强预测因素。在 IBD 患者中，当前使用类固醇是使用益生菌的最强预测因素（OR 2.4，95% CI 1.11-5.18）。IBD 患者的益生菌知识得分高于对照组（P = 0.003），尽管 20%的 IBD 益生菌使用者无法提供益生菌的定义。不到一半的 IBD 益生菌使用者与医疗保健专业人员讨论过益生菌的使用情况，商业广告是信息的主要来源。
IBD 患者使用益生菌来管理其健康，但经常选择在 IBD 中没有疗效证据的菌株。患者依赖于非临床信息来源，并且经常不向医疗保健专业人员透露益生菌的使用情况。传统的医疗保健提供者应该向他们的患者询问益生菌的使用情况，并提供基于证据的建议。
