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    Probiotics and inflammatory bowel disease: from fads and fantasy to facts and future.

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    Authors
    Shanahan, Fergus
    Affiliation
    Department of Medicine, Clinical Sciences Building, Cork University Hospital,, Wilton, Ireland. F.Shanahan@ucc.ie
    Issue Date
    2012-02-03T15:10:12Z
    MeSH
    Digestive System/microbiology
    Evidence-Based Medicine
    Humans
    Inflammatory Bowel Diseases/*diet therapy/microbiology
    Probiotics/*therapeutic use
    Symbiosis
    
    Metadata
    Show full item record
    Citation
    Br J Nutr. 2002 Sep;88 Suppl 1:S5-9.
    Journal
    The British journal of nutrition
    URI
    http://hdl.handle.net/10147/209024
    DOI
    10.1079/BJN2002624
    PubMed ID
    12215176
    Abstract
    Probiotic therapy is attracting the renewed interest of clinicians and basic investigators from a variety of traditional research disciplines. While the theoretical rationale for modifying the commensal flora of the gastrointestinal tract in specific circumstances appears sound and requires scientific pursuit, the field of probiotics has been clouded by exaggerated claims from some quarters. In general, many of the claims for therapeutic efficacy have not been well substantiated, but the field is now poised for evaluation within the realm of evidence-based medicine. Alterations in commensal bacterial flora within the gastrointestinal tract are associated with susceptibility to pathogens such as Clostridium difficile and there is persuasive evidence that the normal flora may participate in the pathogenesis of inflammatory bowel disease and other chronic diseases in genetically susceptible individuals. This has prompted various strategies to fortify or otherwise modify the enteric flora by dietary supplements containing probiotic formulations. Detailed comparisons of probiotic performance amongst different bacterial strains have not been performed in vivo in man or under clinical trial conditions, and the level of scientific characterisation of individual organisms has been variable. In addition, it cannot be assumed that the same probiotic is equally suitable for all individuals. Moreover, the heterogeneity of clinical disorders such as Crohn's disease and ulcerative colitis implies that strain-specific properties may be required for subset-specific categories of patients. While cocktails of probiotics offer convenience, therapeutic progress may require clarification of the mechanism of probiotic action and may be delayed until individual bacterial components have been rigorously studied. More importantly, the full potential of therapeutic manipulation of the enteric flora with probiotics or other strategies may not be optimally realised until the composition and metabolic activities of the normal flora are better understood.
    Language
    eng
    ISSN
    0007-1145 (Print)
    0007-1145 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1079/BJN2002624
    Scopus Count
    Collections
    Cork University Hospital

    entitlement

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