THE ROLE OF PREBIOTICS AND PROBIOTICS IN ULCERATIVE COLITIS: A PLACEBO-CONTROLLED RCT

Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by mucosal inflammation of the colon. Emerging evidence suggests that modulation of the gut microbiota through prebiotics and probiotics may offer therapeutic benefits in UC management. This randomized, double-blind, placebo-controlled trial aimed to evaluate the efficacy of combined prebiotic and probiotic supplementation in inducing and maintaining remission in patients with mild to moderate UC. A total of 120 patients were randomized to receive either a synbiotic formulation containing inulin-type fructans and a multi-strain probiotic blend or a placebo, alongside standard mesalazine therapy, over 12 weeks. Clinical remission, assessed by the Mayo score, was achieved in 65% of the synbiotic group compared to 35% in the placebo group (p=0.002). Furthermore, significant reductions in fecal calprotectin levels and endoscopic scores were observed in the intervention group (p<0.01). No serious adverse events were reported. These findings indicate that adjunctive synbiotic therapy can enhance clinical outcomes in UC patients, potentially through modulation of gut microbiota and attenuation of mucosal inflammation. Further large-scale studies are warranted to confirm these results and elucidate underlying mechanisms.