Probiotics in PSC

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Eur. J. Gastroenterol. Hepatol. 20: 688-692 (2008)

Probiotics in primary sclerosing cholangitis: a randomized placebo-

controlled crossover pilot study.

Vleggaar FP, Monkelbaan JF, van Erpecum KJ

Department of Gastroenterology, University Medical Center Utrecht,

Utrecht, The Netherlands. f.vleggaa@...

BACKGROUND: Beneficial effects of probiotics have been reported in

liver disease. Inflammatory bowel disease concurs in 90% of primary

sclerosing cholangitis (PSC) patients, suggesting that substances

originating from the inflamed gut may damage the biliary tree.

OBJECTIVE: To assess potential beneficial effects of probiotics on

serum liver tests, pruritus and fatigue in PSC. METHODS: Fourteen

patients (13 male/one female, mean age 45 years), with concurrent

inflammatory bowel disease were randomized to treatment with

probiotics (Ecologic 641, containing four Lactobacillus and two

Bifidobacillus strains; Winclove Bio Industries, Amsterdam, The

Netherlands) or placebo during 3 months in a double-blind fashion.

After a 1-month washout period, crossover was made. RESULTS: No

changes in pruritus, fatigue and stool frequency were noted during

placebo or probiotics. No significant differences were observed

between treatment with probiotics and placebo in bilirubin (at end of

probiotic vs. placebo period: -13 vs. -15% change from baseline;

P=0.89), alkaline phosphatase (-9 vs. -9%; P=0.99), gamma glutamyl

transpeptidase (-11 vs. -5%; P=0.60), aspartate aminotransferase (-16

vs. -15%; P=0.99), alanine aminotransferase (-27 vs. -26%; P=0.97),

prothrombin, albumin or bile salts. CONCLUSION: Our data do not

support beneficial effects of probiotics on symptoms, liver

biochemistry or liver function in PSC. PMID: 18679073.