克罗恩病

益生菌可以帮助您的克罗恩病吗？

研究表明他们可能会。因此，我们去找专家，看看您是否应该尝试一下。

经过Holly St. Lifer 卫生作家

2022年5月31日

Medical Reviewer

Mona Rezapour，医学博士

iStock/koto_feja

2022年5月31日

Medical Reviewer

Mona Rezapour，医学博士

Living with克罗恩的, you’ve likely honed a list of best practices—regular sleep! plenty of water! fewer processed foods!—that help keep your symptoms in check (along with any meds you’re taking). No one can blame you for proceeding with caution when introducing anything new into the mix of managing this inflammatory bowel disease (IBD), but you may have wondered about adding益生菌to your tried-and-true toolkit. These foods and supplements get a lot of buzz because they contain some of the same beneficial live microorganisms in your gut that make for a healthy environment in the gastrointestinal (GI) tract. We went to the experts to see whether they’re worth making part of your self-care.

Your Gut Microbiome and Crohn’s

克罗恩（Crohn）耀斑发展的可能方法之一是肠道微生物组的平衡出了问题。什么是微生物组？这是一系列活的微生物，包括好细菌和坏细菌。当坏处开始超过好处的时候，您更容易在消化道中发展问题，即使对于没有克罗恩的人来说也是如此。实际上，尽管克罗恩的确切原因是未知的，但克罗恩和结肠炎基金会与没有这种状况的人相比，具有IBD的人的肠道中这些微生物的多样性较小。那么，如何知道自己的微生物组的表现呢？不幸的是，“没有FDA批准的测试方法，”马萨诸塞州波士顿贝丝以色列执事医疗中心的胃肠病学家约瑟夫·费乌斯坦（Joseph D. Feuerstein）说。

The question is whether proactively ingesting probiotics can tip the scales in your favor so that you have more of the good bacteria—and whether this will help you to fend off flares. “Studieshave 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 suchstudy发现服用益生菌（称为SAccharomyces boulardii）与非企业群体相比，与肠道通透性降低了33％。

早期的研究also suggests probiotics might通过减少胃肠道的活动炎症来预防耀斑。Feuerstein博士说：“益生菌的减少肠道炎症的能力仍在研究中，但这是益生菌可能受益的另一个领域。”

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.

No One Single Probiotic Fits All

有很多原因为什么益生菌可以帮助一个人可能无法帮助另一个人。Feuerstein博士说：“根据遗传背景，居住的地方，环境暴露，旅行的地方以及他们吃的东西，每个人的克罗恩斯都有些不同。”“因此，请保持简单。只需选择一个您感到舒适的一个即可。”换句话说，益生菌以相似的方式起作用，无论其名称如何，因此在称重时不要挂在拉丁语上。

Also, simply because, say, acidophilus or a certain probiotic combination was used in a particular study, there is no guarantee the version on the shelf at your health food store or in your yogurt are necessarily the same strains or amounts studied. Nor should you assume one is more potent because it has multiple strains, requires a larger dose, must be refrigerated, is a brand name, or is more expensive.

一些经过充分研究的常见包括乳杆菌和bifidobacterium，但是请记住，您真的不会出错。费乌斯坦博士说：“这可能会有所帮助，但可能不会受到伤害。”

How to Test-Drive Probiotic Supplements

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performed at the Stanford School of Medicine in California, 36 healthy adults were randomly assigned to a 10-week diet that had them eating either fermented or high-fiber foods. 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.

沃伦说：“想想早餐的希腊酸奶冻糕，午餐的发酵莳萝泡菜或酸菜的一面，以及泡菜或其他发酵蔬菜作为晚餐。”也就是说，她提醒客户避免任何已知的食物触发因素。她说：“例如，如果您对乳制品敏感，那么酸奶，开菲尔和奶酪可能不是发酵食品选择的最佳选择。”“基于植物的酸奶是一个很好的替身，因为它们充满活跃的活跃文化。”

With any yogurt, avoid flavored versions. “Many of the yogurts these days are full of added sugar and sweeteners. We used plain, unsweetened yogurt,” says Christopher Gardner, Ph.D., the director of nutrition studies at theStanford Prevention Research Center和临床试验的共同研究者。

If a patient is struggling with excessive gas, then cabbage (sauerkraut) or kombucha should be avoided. Smoothies are popular among Warren’s IBD patients because they are blended and therefore easier to digest: Add (dairy or nondairy) yogurt or kefir, a scoop of probiotic powder, or a small amount of raw honey and/or microalgae. For a list of more foods with probiotics and how to integrate them into your daily diet, Warren suggests the炎症性肠病抗炎饮食（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。

然而，药丸不太可能受到胃酸的影响，使它们可以前往胃肠道的部分，在那里他们可以做得最佳。但是，如果您是难以吞咽药丸的人，那么您可能会更适合食物，粉末或液体。

Bottom Line: Probiotics Are Not Meds

Think of probiotics as an addition, not a replacement. If you are taking any medication such as生物制剂，Feuerstein博士说，抗炎症或中度至重度克罗恩的免疫系统抑制剂不会停止它们。另外，请记住益生菌由FDA作为食物而不是药物调节。这意味着，尽管药物需要一定的效力和功效才能获得批准，但益生菌却没有。

And probiotics should not replace a健康，多样化的饮食，particularly when you are in remission. “This is essential not only to ensure overall adequate nutrition, but to provide essential nutrients to your gut,” says Warren. “That also helps to improve the balance.”

Meet Our Writer

Holly St. Lifer

Holly is a journalist and editor with more than 20 years of experience covering health and social justice. Her work has appeared in自己,AARP The Magazine, goodhousekeeping.com,Psychology Today， 和Prevention， 之中更多的

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