PREBIOTICS DON'T HELP AFTER SURGERY FOR CROHN'S DISEASE: Research study

When Crohn's disease doesn't respond to medication, surgery may be needed in the area where the small and large intestine meet (the terminal ileum and the first part of the colon). After surgery, the disease can return to the intestines and cause inflammation in the same area or others. Current research is investigating the role that intestinal bacteria, often called the microbiome, could play in preventing the return of the disease.

A group of Canadian researchers wanted to look at the relationship between prebiotics and inflammation after the terminal ileum and nearby colon had been removed from mice (M Laffin and others, IBD Journal, January 2018).  Two days after surgery, some of the mice were given prebiotics for 28 days. The hope was that the prebiotics would encourage the growth of bifidobacterium and lactobacillus (bacteria found in healthy guts) and decrease the risk of inflammation. 

While the prebiotics did increase the amount of bifidobacteria and lactobacillus, the  inflammation actually worsened. Similar results were found in children with Crohn's disease (Crohnies) taking a common probiotic (Culturelle). The kids taking the placebo supplement ended up having better intestinal outcomes than those who were taking the probiotic.

It is still not understood why the presence of bacteria (even healthy ones) appear to be having negative effects on Crohn's disease. One theory is that bacteria in general can activate inflammation in the intestines. Could it be that in Crohn's the intestines are more sensitive to normal bacterial activity which increases the risk of bacteria induced inflammation? Until more research is done, it is too soon to know whether or not bacteria can help in Crohn's disease.