克罗恩的Disease

Can Probiotics Help Your Crohn’s Disease?

Research suggests they might. So we went to the experts to see whether you should give them a try.

byHolly St. Lifer Health Writer

2022年5月31日

医学评论者

Mona Rezapour, M.D.

istock/koto_feja

2022年5月31日

医学评论者

Mona Rezapour, M.D.

和...一起生活克罗恩的，您可能已经磨练了一系列最佳做法 - 重新睡眠！很多水！加工食品更少！ - 这有助于控制症状（以及您服用的任何药物）。在管理这种炎症性肠道疾病（IBD）的混合中，没有人会责备您谨慎行事，但是您可能想知道添加probiotics到您久经考验的工具包。这些食物和补充剂引起了很多嗡嗡声，因为它们在您的肠道中包含一些相同的有益的活微生物，从而使胃肠道（GI）的健康环境造成了健康的环境。我们去找专家，看看他们是否值得构成您的自我保健。

您的肠道微生物组和克罗恩

One of the possible ways that a Crohn’s flare develops is when the balance of your gut’s microbiomegoes awry. What’s a microbiome? It’s a collection of live microorganisms that includes both good and bad bacteria. It’s when the bad starts to outweigh the good that you become more prone to developing problems in the digestive tract—even for those without Crohn’s. In fact, although the exact causes of Crohn’s are unknown, according to the克罗恩的和Colitis Foundation，，，，people with an IBD have less diversity of these microorganisms in their gut compared to those who don’t have the condition. So how to know just how your own microbiome is doing? Unfortunately, “there is no FDA-approved way to test,” says Joseph D. Feuerstein, M.D., a gastroenterologist at Beth Israel Deaconess Medical Center in Boston, MA.

问题是主动摄取益生菌是否可以使鳞片能力以您有利，从而使您拥有更多的好细菌，这是否会帮助您消除耀斑。“学习have found that [probiotics] may help rebalance, improve, or recalibrate the gut flora in those with Crohn’s disease,” says Ryan Warren, R.D.N., a registered dietitian at the Jill Roberts Center for Inflammatory Bowel Disease at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City. One such学习found that taking a probiotic (called SAccharomyces boulardii) reduced intestinal permeability (key for maintaining remission in Crohn’s patients) by 33% compared to the non-probiotic group.

Earlyresearch还暗示益生菌可能prevent flares by reducing active inflammation in the GI tract. “Probiotics’ ability to reduce inflammation in the gut is still being studied, but this is another area where probiotics might have a benefit,” says Dr. Feuerstein.

But here’s the rub: While research shows probiotics might help reduce the risk of Crohn’s flares, studies vary on dosage details and there’s no clear winner as to which types are best or how many, how often, and in what form to use them to see results. So finding the precise probiotic that may work for you to ease symptoms can require experimentation. Here’s what you need to know.

没有一个益生菌适合所有人

There are many reasons why a probiotic that helps one person might not help another. “Everyone’s Crohn’s is a little bit different based on genetic background, where they live, environmental exposures, where they travel, and what they eat,” says Dr. Feuerstein.“So keep it simple. Just pick one you feel comfortable with.” In other words, probiotics function in similar ways, regardless of their names, so don’t get hung up on the Latin-speak when weighing which to try first.

另外，仅仅是因为在特定研究中使用了嗜酸菌或某种益生菌组合，因此不能保证您的保健食品商店或酸奶中的架子上的版本一定是相同的菌株或数量。您也不应该认为一个人更有效，因为它具有多种菌株，需要更大的剂量，必须冷藏，是品牌名称或更昂贵的。

Some common ones that have been well-studied includelactobacillus和双歧杆菌，，，，but remember, you can’t really go wrong. “It might help, it might not, but it can’t hurt,” says Dr. Feuerstein.

如何测试驱动益生菌补充剂

确定要服用哪种益生菌（无论是在胶囊，粉末，液体还是其他形式）上，瓶中的剂量方向。Feuerstein博士然后建议坚持使用六到八周。他说：“看看您是否注意到典型的克罗恩症状的频率有所不同，例如胃肠道刺激，腹泻和胃部不适。”“如果您没有看到任何好处，那并不一定意味着益生菌对您不起作用；您可以考虑尝试其他类型。”

但是不要掉下兔子洞。Feuerstein博士说：“如果尝试过几种不同类型的益生菌，那么我认为感到沮丧或加剧与克罗恩（Crohn）的任何潜在利益的无助者的成本。”“我告诉患者如果不工作，不要感到难过。我提醒他们数据仍然没有确定性。”

吃益生菌与药丸

如果您是一个喜欢饮食和饮用发酵食品和饮料作为健康生活方式的一部分的人，那么整个食物的适合益生菌的途径可能对您来说很有意义。发酵食品是通过将牛奶，蔬菜和其他原始成分与酵母和细菌等微生物结合起来制成的。然后，这些微生物繁殖，因此这些食物具有健康的健康益生菌。

在小型临床试验中在加利福尼亚的斯坦福大学医学院演出，有36名健康成年人被随机分配为10周的饮食，使他们吃了发酵食品或高纤维食品。The researchers found that eating fermented foods such as yogurt, kefir, fermented cottage cheese, kimchi, and other fermented vegetables, vegetable brine drinks, and kombucha tea led to a more diverse array of microbes and a marked decrease in 19 inflammatory compounds in people’s guts. The high-fiber foods did not show these results.

“Think about a Greek yogurt parfait for breakfast, a side of fermented dill pickles or sauerkraut with lunch, and kimchi or other fermented vegetables for dinner,” says Warren. That said, she reminds clients to avoid any known food triggers. “For instance, if you’re sensitive to dairy, then yogurt, kefir, and cheese might not be the best choices for fermented food options,” she says. “Plant-based yogurts are a good stand-in since they are just as packed with live active cultures.”

使用任何酸奶，避免使用调味版本。“如今，许多酸奶都充满了糖和甜味剂。我们使用了普通的，不加糖的酸奶。” Christopher Gardner博士说。斯坦福预防研究中心和co-researcher for the clinical trial.

如果患者正在用过度的气体挣扎，则应避免卷心菜（酸菜）或康普茶。冰沙在沃伦（Warren）的IBD患者中很受欢迎，因为它们混合在一起，因此易于消化：添加（乳制品或非乳制）酸奶或开菲尔，一勺益生菌粉，或少量的生蜂蜜和/或微藻。有关更多含有益生菌的食物以及如何将其融入您的日常饮食的清单，沃伦建议Inflammatory Bowel Disease Anti-Inflammatory Diet (IBD-AID)，在马萨诸塞大学医学院应用营养中心开发。

要考虑的缺点：要有效，益生菌需要到达小肠和小结肠，那里有很多细菌，并且经常发生微生物组失衡。Feuerstein博士说，由于胃是一个酸性的环境，因此食物（或液体和粉末）可能会降解并变得效力降低。

Pills, however, are less likely to be impacted by stomach acid, allowing them to travel to the parts of the GI tract where they can do the most good. But if you are someone who has difficulty swallowing pills, then you may be more comfortable with food, powders, or liquids.

底线：益生菌不是药物

将益生菌视为一种补充，而不是替代品。如果您正在服用任何药物生物制剂，anti-inflammatories, or immune system suppressors for moderate to severe Crohn’s, do not discontinue them, says Dr. Feuerstein. Also, remember probiotics are regulated by the FDA as food, not drugs. That means that whereas a drug requires a certain potency and efficacy to get approved, probiotics do not.

和益生菌不应取代healthy, varied diet,特别是当您缓解时。沃伦说：“这不仅要确保总体上足够的营养，而且要为您的肠道提供必需的营养。”“这也有助于提高平衡。”

认识我们的作家

Holly St. Lifer

霍莉（Holly）是一位记者和编辑，拥有超过20年的健康和社会正义经验。她的作品出现在SELF，，，，AARP杂志，goodhousekeping.com，Psychology Today，，，，和预防，，，，amongmore

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