Crohn’s Disease: #5 Probiotics

Escherichia Coli Nissle 1917: Mutaflor

Mutaflor is the only known Escherichia Coli probiotic. There have been many clinical trials demonstrating its effectiveness for Ulcerative Colitis, Chronic Constipation, Crohn’s Disease, Irritable Bowel Syndrome and many related conditions.

According to Wikipedia:

The Mutaflor strain was isolated by Professor Alfred Nissle in 1917 during the First World War. As such, the strain was named after him as Escherichia coli Nissle 1917.2 It has been clinically studied and reviewed for over 80 years to prevent and treat an assortment of gastrointestinal disorders.

Efficacy of Mutaflor for a variety of inflammatory bowel diseases has been tested through 80 years of clinical experience. There are numerous double-blind placebo-controlled studies showing the efficacy of Mutaflor in the treatment and prevention of gastrointestinal disorders.

Mutaflor (E. coli strain Nissle 1917) has no pathogenic characteristics: no production of enterotoxins (Shiga toxins, heat-stable and heat-labile toxins); no production of cytotoxins (CNF); no enteroinvasiveness; no pathogenic adhesion factors (e.g. no CFA I/II, P, M and S fimbriae); no hemolysins; no serum resistance; no uropathogenicity; no antibiotic-resistance genes.

Alternative Probiotics

The probiotics listed here are usually single species or unusual collection of species that have been demonstrated in medical studies to be effective in treating irritable bowel syndrome(IBS). Studies of the same probiotics for Crohn’s Disease are lacking, thus it is by inference only that they are recommended. Most commercial probiotics have failed to show any significant benefits in medical studies for IBS. Probiotics, like antibiotics are effective for some conditions and ineffectual for other conditions.
Bifidobacterium Infantis-35624

Some of the studies on PubMed are listed below. It is available as “Align Digestive Care Probiotic Supplement”

  • Fecal excretion of Bifidobacterium infantis 35624 and changes in fecal microbiota after eight weeks of oral supplementation with encapsulated probiotic.(2013)
  • Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis.
  • Bifidobacterium infantis 35624: a novel probiotic for the treatment of irritable bowel syndrome.
  • Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.
  • Probiotic Fermented Milk Containing Dietary Fiber Has Additive Effects in IBS with Constipation Compared to Plain Probiotic Fermented Milk.
  • Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.

Prescript Assist

This is an unusual commercial probiotic that lacks the traditional Lactobacillus species seen in most probiotics. It has had excellent results in the treatment of Irritable Bowel Syndrome. There have not been trials with other conditions. The species are listed below

  • Anthrobacter agilis,
  • Anthrobacter citreus,
  • Anthrobacter globiformis,
  • Anthrobacter luteus,
  • Anthrobacter simplex,
  • Acinetobacter calcoaceticus,
  • Azotobacter chroococcum,
  • Azotobacter paspali,
  • Azospirillum brasiliense,
  • Azospirillum lipoferum,
  • Bacillus brevis,
  • Bacillus marcerans,
  • Bacillus pumilis,
  • Bacillus polymyxa,
  • Bacillus subtilis,
  • Bacteroides lipolyticum,
  • Bacteriodes succinogenes,
  • Brevibacterium lipolyticum,
  • Brevibacterium stationis,
  • Kurtha zopfil,
  • Myrothecium verrucaria,
  • Pseudomonas calcis,
  • Pseudomonas dentrificans,
  • Pseudomonas flourescens,
  • Pseudomonas glathei,
  • Phanerochaete chrysosporium,
  • Streptomyces fradiae,
  • Streptomyces celluslosae,
  • Streptomyces griseoflavus

Some of the studies on PubMed are:

  • Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial. (2007)
  • Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study. (2005)
  • Lactobacillus Reuteri

Not Effective

Experience with Probiotics

Our experience is that taking two probiotics are the same time had less impact then just taking one. Probiotics will compete with other. More is not better. The best time to take the probiotics is shortly before bed. Often the probiotic will result in a headache for the first few days (the Mutaflor inserts actually cites that as a side effect). Some diarehha and unpleasant smells may occur for a few days — this is typically caused by the bacteria being displaced by the probiotic (which is a bacteria).

Our usual practise is to do a probiotic for 7-10 days and then change to a different probiotic, or to one of the above herbs.