Do probiotics have a role in the management of inflammatory bowel disease?

Inflammatory bowel disease treatments have generally revolved around immunological manipulations to reduce inflammation of the gastrointestinal tract. Bacterial interactions with the gastrointestinal epithelium may be a trigger for inflammatory changes which occur in the gut. Antibiotics have been shown to alter disease activity in Crohn's disease. Probiotics (live microorganisms) administered for therapeutic purposes have been proposed due to the possibility of their altering the interaction of the gut mucosa with enteric bacteria. Extensive randomized trials are lacking in this area at this time. Current trials indicate the possibility of maintaining remission in pouchitis (non-specific inflammation) and the potential for inducing and maintaining remission in ulcerative colitis. Trials in Crohn's disease have shown mixed results.