Probiotics and fecal microbiota transplantation could help induce remission in patients with ulcerative colitis, according to a systematic review and meta-analysis of randomized controlled trials.

There is “abundant evidence” that the intestinal microbiome plays an integral role in the pathogenesis of ulcerative colitis, said Mina Fransawy Alkomos, MD, from New York City Health and Hospitals Corporation and Ain Shams University, Cairo.

Several studies have shown that strategies to manipulate the microbiome — through diet, probiotics, antibiotics, or fecal microbiota transplantation — might modulate disease activity, but the results are “controversial.”

To clarify the role of microbiota treatment for ulcerative colitis, the researchers reviewed 16 relevant randomized controlled trials that used markedly different protocols. “Overall, probiotics were effective for clinical remission and clinical response in ulcerative colitis.”

“The problem that we have with the studies is the diversity of probiotics,” said Alkomos, who cautioned that more study is needed. Encouraging in this analysis was that there was a “signal of benefit” reported.

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