Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 26: What Is The Role Of Probiotics In My Patients With Inflammatory Bowel Disease? (continued)

Fergus Shanahan, MD

I do not routinely use probiotics in patients with either Crohn’s disease (CD) or ulcerative colitis (UC). To put this statement in context, I don’t adopt any therapeutic routine for such patients. These conditions are far too complex, too heterogeneous, for fixed therapeutic strategies, algorithms, or routines. Long before it became fashionable to proclaim the concept of personalized medicine, the optimal management of chronic inflammatory bowel disease (IBD) required commitment to long-term follow-up, detailed knowledge of each clinical context, and a flexible approach to what…