Effects of Probiotics and Prebiotics in Inflammatory Bowel Disease

Inflammatory bowel diseases (IBD) including most important forms; Crohn’s disease (CD) and ulcerative colitis (UC); are chronic diseases affecting the gastrointestinal tract with unclear etiology and pathology. The role of gut microbiota has recently been considered as major a factor, since altered microbiome or "dysbiosis" is a key player in the protracted course of inflammation in IBD. However, despite of new treatment program IBD is still in difficult managing disorders. Although, biologics have revolutionized the treatment of IBD recently and probiotics and prebiotics have provided some clues in developing a new class of therapeutic agents for the treatment/ prevention of IBD.  Probiotics are living microorganisms with good tolerability and minimal risk, which confer a health benefit for the host when administered in adequate amounts. Their effect is closely related to maintaining the natural function of the intestinal flora. Probiotics and prebiotics could be used in prevention and therapy of many disorders of gastrointestinal tract including inflammatory bowel diseases. VSL#3 for example, is a mixture of various strains of lactic acid bacteria and bifidobacteria at a concentration of 450 billion microorganisms per sachet and has been proven effective in several IBD trials. Here we review advances in our understanding of microbial involvement in IBD pathogenesis over the past years and offer insight into how this will shape our therapeutic management of the disease in the coming years.