Crohn’s disease is considered an autoimmune disease with no known cause and no known cure. The damage to the digestive tract, particularly the intestines, is the result of an immune system gone awry. For reasons that are unclear, components of the immune system act in a dysfunctional manner and attack the patient’s own gut tissues, causing severe inflammation and damage.
Enteral nutrition—supplying nutrient-rich formula directly into the stomach or intestines through a tube—is often used to bring about remission, especially in small children. Powerful anti-inflammatory drugs and even surgery to remove or repair damaged areas of the digestive tract are also standard practices for dealing with the ravages of the disease.
This is the state of medicine regarding Crohn’s disease in the early 21st century: we don’t really understand what’s going wrong or why, and the only “solutions” available, such as probiotics, mitigate the damage at best. But that picture may change one day soon as our understanding of the biology of the gut advances and we come closer to knowing more about the complex interplay among some key players in this drama: the billions of microbes living in the gut.
Bacteria Are Not All Bad
Bacteria tend to get a bad rap. When we think of bacteria, we’re most likely to think of infection. Certainly, bacteria can be the villain. No one would argue that Yersinia pestis—the bacterium responsible for bubonic plague—is lovable, for instance. And Methicillin-resistant Staphylococcus aureus (MRSA) is rightfully feared and despised for the terrible damage it can do. But not all bacteria are bad.
In fact, many species have evolved alongside humans in a close relationship that greatly benefits both. This is especially true of the human digestive system. Although we’ve long known that these bacteria exist, it’s fair to say that scientists are only beginning to fully appreciate the complexity and richness of these partnerships among healthy humans and their hoards of microscopic passengers.
What we’re beginning to comprehend has implications for Crohn’s patients. Normal gut bacteria, called the intestinal microflora, play an integral role in both immunity and digestion. And different areas of the digestive tract are colonized by distinct types of bacteria. In a healthy gut, there’s a delicate balance among these different species and immune function is normal.
But what happens when something disturbs this delicate balance? Modern antibiotics, for instance, are known not only to kill off the infection they’re prescribed to treat, but to dramatically disturb normal gut bacteria as well. By killing off “friendly” bacteria, the stage is set for other, less friendly microbes to set up shop. The implications for inflammatory bowel diseases, including Crohn’s, are profound.
According to an emerging theory, infection with a microbe that normally infects dairy cows may be linked to Crohn’s disease in humans. While this theory is far from proven, it underscores the importance of a healthy gut microflora, and what can happen when the delicate balance is disturbed.
Probiotics: Nature’s Health Food
And that’s where probiotic yogurt comes in. Probiotics and prebiotics are defined as substances that encourage the growth and establishment of friendly bacteria and fungi that provide health benefits to the body.
Humans discovered thousands of years ago that milk could be converted into a highly digestible and beneficial food called yogurt through a type of fermentation. Yogurt largely avoids the pitfalls of lactose for people who happen to be lactose intolerant, by providing most of the nutritional benefits of milk—calcium, for instance—without much lactose. The friendly bacteria that ferment the milk digest most of the lactose in the process.
What’s more, these bacteria happily take up residence in the gut, crowding out less beneficial bacteria and helping the gut lining the immune system stay healthy. At least six separate mechanisms have been proposed to explain these benefits, and scientists are actively investigating them all.
Investigating the Benefits of Probiotics
In general, it appears certain that consuming yogurt, especially with active cultures, is beneficial for most people. The data on using probiotics to treat Crohn’s patients are somewhat less clear, but overall it appears that yogurt is well-tolerated, provides needed calcium and calories, and may actually improve the patient’s condition.
In one small study, Japanese researchers reported that seven out of 10 patients responded favorably to high-dose prebiotic/probiotic therapy. Six had a complete response and one had a partial response. Some were able to decrease or discontinue their intake of anti-inflammatory drugs to control their symptoms. Only three out of the 10 patients failed to respond to the probiotics.
Other studies have reported more mixed findings, but none have reported any serious adverse events associated with yogurt or probiotics consumption. The bottom line is this: Yogurt is a healthful food that supplies much-needed calcium and calories. It may even help keep the gut lining healthier and could possibly help provide relief from further symptoms. Consult with your doctor or nutritionist, and give it a try.