Can Probiotics Help Ibd
Most probiotics have not been shown to work for Crohns disease or ulcerative colitis. VSL 3# is the only probiotic that has been shown to be of benefit for some people in order to prevent pouchitis after colectomy. Probiotics have been shown to be harmful in rare cases for people who are very sick. Talk to your doctor before starting a probiotic.
Efficacy And Safety Of Probiotics Combined With Traditional Chinese Medicine For Ulcerative Colitis: A Systematic Review And Meta
- 1School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 2Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 3Department of Pharmacy, Sichuan Provincial Orthopedic Hospital, Chengdu, China
- 4Health Preservation and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
Background: The combination of probiotics and traditional Chinese medicine is a prospective therapy for ulcerative colitis , and its efficacy and safety need to be urgently evaluated.
Objective: This study aims to comprehensively assess the efficacy and safety of probiotics combined with TCM for the treatment of UC.
Methods: The Pubmed, EMBASE, Cochrane library, China Academic Journals , Wan-fang database, Chinese biomedical literature service system , and Chinese Science and Technology Journals were searched. Subgroup analysis were designed in accordance with different control drugs, treatment courses, and types of probiotics. The Review Manager software was utilized for statistical analysis.
It is suggested that probiotics combined with TCM could effectively control clinical symptoms, inhibit intestinal inflammatory response, and finally slow down the disease progress and reduce the disease recurrence with less adverse events. The mixture of different probiotics used in conjunction with individually tailored TCM is a potential clinical strategy for UC.
Study Selection And Data Extraction
Two researchers will independently conduct the literature retrieval, literature screening, data extraction and quality evaluation procedures. In case of disagreements, they will consult other researchers and negotiate using the original data. The 2 researchers will identify relevant literature by reading the titles, abstracts, and full-texts of the studies retrieved during the searches with reference to the eligibility criteria mentioned above. The process of study selection will be summarized in the PRISMA flowchart in Fig. Fig.1.1. The search results will be managed by NoteExpress 2.0 . The following information will then be extracted from the studies selected for inclusion using a preestablished literature extraction table: author, article title, year of publication, contact information, country, sample size, participants, diagnosis criteria, baseline characteristics, study design, randomization method, blinding, experimental intervention, control intervention, duration, treatment frequency, outcomes, adverse events, etc. The original authors of any articles which are found to have missing information will be contacted as much as possible in an attempt to obtain the data, or to perform data conversion. If the data does not prove to be available, the study in question will be discarded.
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Integration Of Chinese Medicine And Western Medicine
The basis of a western medicine approach to treat ulcerative colitis is formed by local/oral use of aminosalicylates and corticosteroids. Sometimes surgery is needed if medical management has not achieved a satisfactory response in either acute or chronic conditions. Immunosuppressants may be required for frequent relapse conditions.
Chinese herbs and acupuncture can help control the condition and prevent aggravation and subsequently reduce symptoms. Combination of Chinese herbs and acupuncture can help to reduce colon inflammation, and modulate the immune response to prevent further relapsing of the condition. With a holistic view of the whole person, a favourable clinical outcome can be achieved, and the patient can slowly be tapered off the use of corticosteroid and other medications.
Icipants And Data Collection
We surveyed IBD patients meeting at patient workshops organized by the German Crohns and Ulcerative Colitis Association . The DCCV is a national organization established by patients and for patients with Crohns disease and Ulcerative Colitis . The patient workshops of the DCCV take place regularly in different regions of Germany and are open to the public. Normally experts are invited to give lectures on recent developments in diagnostic and therapeutic possibilities in order to inform patients. Three of these workshops took place in different German federal states . A questionnaire was handed out to all participants of the workshops. The questionnaires were distributed on the tables in the convention hall and had to be completed during the workshop or were to be returned by mail.
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Regulation Of Intestinal Barrier
Normal gut bacteria play a role in protecting intestinal barrier. Alterations and disruptions to the intestinal barrier are observed in patients with UC . Several studies have reported gut microbiota and its metabolites altered intestinal permeability and promoted the level of intestinal tight junction proteins, such as claudin, and zonula occludens 1 . It has been reported that TCM could protect intestinal barrier via microbiota.
Qingchang Wenzhong decoction , a classical Chinese herbal formula, exerts beneficial effects on UC. Sun et al. reported enhanced expression levels of intestinal tight junction proteins and increased numbers of goblet cells in QCWZD-treated mice. They also observed increased amount of Lactobacillus and inhibited pathogenic species, such as Bacteroides and Streptococcus. To further confirm that QCWZD could improve the intestinal barrier by altering the gut microbiota, they applied fecal microbiota transplantation and found fecal transplantation from QCWZD-treated mice could accelerate intestinal epithelial wound healing .
The total flavone of Abelmoschus manihot , the major pharmacological component of Flos Abelmoschus manihot, has been used in the alleviation of UC. Wang et al. found that TFA promoted the level of MUC2, KLF4, and ZO-1 proteins and ameliorated gut microbial dysbiosis. Furthermore, TFA fecal microbiota transplantation alleviated intestinal barrier impair in UC mice .
Inclusion And Exclusion Criteria
This study included clinical studies of UC with CHM intervention published in English and Chinese up to November 25, 2020. We included studies on subjects given the diagnosis of UC defined by clear diagnostic criteria or references, regardless of age, gender, course of disease and severity. The CHM interventions are typically administered as either single herbs or formulas , which may have been administered alone or in combination with other interventions of conventional Western Medicine or CAM. No limitation on their formulation, preparation, dosage, dosage form or route of administration. The control intervention could be active, conventional medicine, placebo, no treatment, or other CAM treatments, etc. There were no limitations in the assessed outcomes. We considered randomized controlled trials , quasi-randomized controlled trials, non-randomized controlled trials, observational clinical studies including the control group, casecontrol studies for inclusion. We excluded the following studies: repeated and withdrawal publications, studies with non-CHM interventions, comprehensive interventions focused on pharmacological treatment rather than CHM, plant extracts , clinical studies without a comparison or control group, study protocols, reviews, case series, case reports, abstracts or full-text reports not found, non-human studies, and non-English or non-Chinese language reports.
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What Can Cause Ulcerative Colitis
The exact cause of the condition is unknown, but researchers believe that there are a number of factors involved. Ulcerative colitis is thought to be what is known as an autoimmune condition. Some researchers believe that the bodys immune system reacts to a virus or bacterium by causing ongoing inflammation in the intestinal wall. Others believe that no infection is involved and the immune system just malfunctions by itself. A major theory is that the immune system mistakes harmless bacteria inside the colon as a threat and attacks the tissues of the colon, causing it to become inflamed.
Exactly what causes the immune system to behave this way is unclear. Most experts think a combination of genetic and environmental factors is involved.
It is believed that ulcerative colitis is not directly caused by emotional distress or sensitivity to certain foods or food products, though these factors may trigger symptoms in some individuals.
Chinese Herbal Medicine For Ulcerative Colitis
- Apart from what has been traditionaly established in Chinese medicine, this combination has proved to have excellent efficacy in evaluations. Please see the table below for details.
- Patients Evaluated: 227 | Fully Recovered: 136 | Seen Improvement: 86 | Overall Success Rate: 98.0 %
- All of the herbs in this formulation have been in use for thousands of years in China and are proven to be safe. Chinese herbs work in a non-invasive way utilizing the natural healing powers of the body and hence work without any side effects.
- Our herbal remedies come in pill form in convenient dosage for easy administration.
- Two month’s supply for a full course of treatment costs USD 74.95 only. We do not charge any shipping costs or have any other hidden costs.
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Avoid Foods That May Exacerbate Uc Symptoms
Because a healthy diet is a cornerstone for overall health, its no surprise that it tops Sniders list of natural remedies for ulcerative colitis. Diet is a foundational treatment for patients with ulcerative colitis, he says, adding that theres often a dietary component to the disease.
According to a review published in October 2014 in Clinical Gastroenterology and Hepatology, people who reported a diet high in fats were more likely to have a relapse of UC. Other studies highlighted in the paper suggested avoiding greasy foods, dairy products, caffeine, and raw fruits and vegetables if you have ulcerative colitis. But the review notes that theres no one-size-fits-all diet for UC, so youll have to figure out what works best for you through trial and error.
It helps to keep a food diary to discover which foods are best for you. Snider says it cant hurt to limit certain foods, and then if your symptoms improve according to your symptom diary, to continue doing so. He also notes that its worthwhile to avoid sugar because its effect on the pancreas hinders the output of anti-inflammatory enzymes.
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Regulation Of Microbiota Metabolites
Gut microbiota metabolites, such as short-chain fatty acids and bile acids closely affect the development of IBD. Multiple studies showed lower relative abundance of SCFA-producing bacteria, for instance, Faecalibacterium, Clostridium clusters IV and XIVb, Roseburia, Odoribacter, and Leuconostocaceae in UC patients . TCM has been found to adjust the gut flora structure and metabolic profiles . It is reported that SCFAs exert their effects through activating G-protein-coupled receptors and inhibiting histone deacetylases .
Recent studies showed that many TCMs could enrich the abundance of SCFA-producing bacteria in models of UC. A recent animal study found that indigo naturalis could ameliorate intestinal dysbiosis. It elevated the level of fecal butyrate and the abundance of Ruminococcus_1 and Butyricicoccus. Furthermore, an increased level of short chain fatty acid-associated receptors GPR41 and GPR43 was found .
Shenling Baizhu San exhibits efficacy in treating UC for centuries . SLBZS administration enhanced the amount of SCFA-producing bacteria, such as Prevotella and Oscillospira, and decreased pathogenic bacteria including Desulfovibrio and Bilophila . Baicalin is an active component derived from Huangqin, a traditional herb medicine extensively used for UC. Our study found that baicalin increased the amount of butyrate-producing bacteria such as Butyricimonas spp., Roseburia spp., and Eubacteria spp. and level of fecal butyrate .
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How We Can Help Acupuncture For Colitis
Dr. Jim Xing of our clinic has gained rich clinical experience in assitsing patients with ulcerative colitis throughout his thirty years of practice. He has a keen interest in the area, reads many ancient, classic and present TCM books, and collects related articles to find as many theories regarding the treatment of this condition as possible.
He strives to achieve success in helping patients who suffer from the condition through the use of acupuncture for colitis. According to TCM, most of the symptoms result from blocked energy along energy pathways of the body, which are unblocked when acupuncture needles are inserted along these invisible pathways during acupuncture for colitis. Acupuncture for colitis may also help to regulate the bodys immune system and improve the general constitution. In addition, Chinese herbal medicine may be able to target the root cause of the disease and improve ones general wellbeing, further allowing the body to effectively undergo its recovery from ulcerative colitis.
Dr. Xings approach generally consists of two phases: in the active phase, the main task is to eliminate the pathogen and relive symptoms. In the convalescence phase, the top priority is to strengthen constitutional weaknesses and repair internal damage.
Information Sources And Search Strategy
We will systematically search PubMed, Web of Science, MEDLINE, CINAHL, the Cochrane Library, Embase, China National Knowledge Infrastructure , Chinese Biomedical Literature database , and WANFANG database for related randomized controlled trials that compared one TCM intervention with another or with 5-ASA in the treatment of mild-to-moderate UC. The temporal interval is limited from the time that the databases created to February 2019.
The searches were restricted to papers that were published in English or Chinese. The search strategy will be conducted independently by 2 authors who are experienced in the information retrieval and combine free text words and medical subject headings regarding Chinese medicine,traditional Chinese medicine,Chinese herbal,Ulcerative colitis, UC,Inflammatory bowel disease,IBD, and randomized controlled trials. MeSH and subheadings were combined with AND or OR. Furthermore, we will also retrieve the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov to identify ongoing trial registers. We will manually search related systematic reviews/meta-analyses and bibliographies of included studies to identify additional potential studies. The preliminary search strategy for PubMed is summarized in Table Table1,1, which will be adapted according to syntax-related requirements of other electronic databases.
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Single Medicine Treatment Of Ulcerative Colitis
In addition, there have been studies on the treatment of ulcerative colitis, such as Scutellariae radixCoptidis rhizoma drug pair, which also played an important role in interpreting the mechanism of TCM treatment of ulcerative colitis. As a common combination of Scutellariae radixCoptidis rhizoma drug pair in the treatment of ulcerative colitis, it was found that it has 43 active ingredients and 134 cross targets, including AKT1, JUN, TNF, VEGFA, and EGFR. The results showed that this drug may play a role in treating diseases through the reaction to toxic substances, positive regulation of cell death, reaction to injury, and reactive oxygen metabolism, involving the P53 signaling pathway, PI3K-Akt signaling pathway, IL-17 signaling pathway, and cancer pathway. The molecular docking results showed that there was a good affinity between the main active ingredients and the core target genes .
Traditional Chinese Medicine Uses Special Herbal Formulas For Healing Ulcerative Colitis
Ulcerative colitis, known as kui-jie in Chinese, is considered incurable by conventional western medicine. However, Traditional Chinese Medicine views this chronic disease as curable over time, with the proper use of herbal medicines and dietary therapy.
The onset of ulcerative colitis is often on the left side of the abdomen, and then gradually extends to the entire colon. The cause of the disease is not always immediately clear, but TCM doctors consider damp-heat toxicity in the large intestine as the primary irritant that leads to Ulcerative Colitis symptoms. Ulcerative colitis is no ordinary inflammatory disease.
The main clinical symptoms of ulcerative colitis are: pain diarrhea increased stool frequency alternating between dry and thin blood in the stool pus similar symptoms to dysentery and varying severity of symptoms. These pains tend to be localized in the left lower quadrant of the body.
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Background: Ulcerative Colitis And Crohn’s Disease
Ulcerative colitis and Crohn’s Disease are chronic inflammatory diseases of the intestines that may have similar causes. Crohn’s disease produces the main ulcerative sites in the ileum, especially in young people, while ulcerative colitis is mainly confined to the rectal area. Both diseases may cause abdominal pain and diarrhea, but Crohn’s is more often characterized by spasms and loss of appetite, while ulcerative colitis is more often characterized by bloody diarrhea. Ulcerative colitis occurs about ten times more frequently than Crohn’s, and is, for that reason, more often the subject of clinical study. The causes are not firmly established, but may include chronic infection, allergy responses, autoimmune disease, and genetic predisposition the condition worsening with emotional stress and poor dietary habits.
Western medical treatments usually focus on steroidal drugs to reduce the inflammation. In severe cases, intestinal portions that are unremittingly inflamed may be surgically removed. It has been noted that nicotine controls ulcerative colitis , and it has been suggested, though not proven, that the new and safer nicotine delivery systems, such as nicotine patch or nicotine chewing gum, may help manage the disease.
Epidemiology Of Complementary And Alternative Medicine Use In Patients With Inflammatory Bowel Disease
The estimated prevalence of CAM use in patients with IBD is high, ranging between 21% and 60%.,,, Reasons for CAM use include a desire for holistic approaches to supplement conventional therapy, the perception that herbal remedies are more natural, less toxic, or harmless a lack of response to or undesirable side effects of conventional therapy, and the desire for more control of the disease and symptoms to improve quality of life ., Predictors of CAM use include psychiatric comorbidities dissatisfaction with the patient-doctor relationship side effects from conventional therapies use of CAM among friends or family vegetarianism longer disease duration high corticosteroid usage female sex and higher income, education, and socioeconomic status.,, There is also geographic variation with regard to CAM use., In the United States, CAM is more frequently used in the Mountain, Pacific, and Midwest regions compared to other parts of the country.
Most CAM therapies fall into one of the following main categories: herbal/botanical or dietary supplements and mind-body practices, including hypnosis, yoga/exercise, mindfulness, and stress reduction. The most commonly used CAM therapies include probiotics, herbs , vitamins, and fish oil., Other therapies include the use of traditional Chinese practices such as acupuncture and moxibustion.
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