title: Probiotic and prebiotic use in patients with inflammatory bowel disease: a case-control study.
abstract: BACKGROUND
  The use of complementary and alternative medicine in inflammatory bowel disease (IBD) has been extensively studied. However, the use of probiotics and prebiotics is poorly documented, despite evidence of efficacy of particular probiotic strains in specific forms of IBD.
  
  
  METHODS
  A case-control study comprising interviewer-administered questionnaires was conducted in IBD patients and healthy controls. Data regarding use and knowledge of probiotics and prebiotics, demographic, and clinical information were collected.
  
  
  RESULTS
  In total, 334 participants (234 IBD, 100 controls) were interviewed. Significantly more IBD patients than controls had ever used probiotics to manage their health (Crohn's disease [CD] 43%, ulcerative colitis [UC] 51%, controls 21%, P < 0.001). Prebiotic use was negligible. On logistic regression analysis, having UC (odds ratio [OR] 4.30, 95% confidence interval [CI] 2.27-8.12) or CD (OR 3.05, 95% CI 1.66-5.60) were the strongest predictors of probiotic use. Within IBD patients the strongest predictor of probiotic use was current steroid use (OR 2.4, 95% CI 1.11-5.18). IBD patients had greater probiotic knowledge scores than controls (P = 0.003), although 20% of IBD probiotic users could not provide a definition of a probiotic. Less than half of IBD probiotic users discussed probiotic use with healthcare professionals, with commercial advertising being the primary source of information.
  
  
  CONCLUSIONS
  Patients with IBD use probiotics to manage their health but frequently choose strains without evidence of efficacy in IBD. Patients rely on nonclinical sources of information and often do not disclose probiotic use to healthcare professionals. Conventional healthcare providers should inquire about probiotic use among their patients and offer evidence-based advice.
authors.affiliation: Nutritional Sciences Division, Kings College London, London, UK. charlotte.hedin@kcl.ac.uk
authors.forename: Charlotte R H
authors.initials: CR
authors.lastname: Hedin
authors.forename: Miriam
authors.initials: M
authors.lastname: Mullard
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sharratt
authors.forename: Clare
authors.initials: C
authors.lastname: Jansen
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Sanderson
authors.forename: Penelope
authors.initials: P
authors.lastname: Shirlaw
authors.forename: Leslie C
authors.initials: LC
authors.lastname: Howe
authors.forename: Serpil
authors.initials: S
authors.lastname: Djemal
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Stagg
authors.forename: James O
authors.initials: JO
authors.lastname: Lindsay
authors.forename: Kevin
authors.initials: K
authors.lastname: Whelan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000382:microbiology / Q000628:therapy*; D003424:Crohn Disease / Q000382:microbiology / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056692:Prebiotics; D019936:Probiotics / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D056692:Prebiotics