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Ulcerative colitis
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===Bacterial recolonization=== In a number of randomized clinical trials, [[probiotics]] have demonstrated the potential to be helpful in the treatment of ulcerative colitis. Specific types of probiotics such as [[Escherichia coli Nissle 1917|''Escherichia coli'' Nissle]] have been shown to induce remission in some people for up to a year.<ref name=Fedorak>{{cite journal | vauthors = Fedorak RN | title = Probiotics in the management of ulcerative colitis | journal = Gastroenterology & Hepatology | volume = 6 | issue = 11 | pages = 688–690 | date = November 2010 | pmid = 21437015 | pmc = 3033537 }}</ref> A [[Cochrane (organisation)|Cochrane]] review of [[controlled trials]] using various probiotics found low-certainty evidence that probiotic supplements may increase the probability of clinical remission.<ref name=":5">{{cite journal |last1=Kaur |first1=Lakhbir |last2=Gordon |first2=Morris |last3=Baines |first3=Patricia Anne |last4=Iheozor-Ejiofor |first4=Zipporah |last5=Sinopoulou |first5=Vasiliki |last6=Akobeng |first6=Anthony K |date=4 March 2020 |editor-last=Cochrane IBD Group |title=Probiotics for induction of remission in ulcerative colitis |journal=Cochrane Database of Systematic Reviews |volume=3 |issue=3 |pages=CD005573 |language=en |doi=10.1002/14651858.CD005573.pub3 |pmc=7059959 |pmid=32128795}}</ref> People receiving probiotics were 73% more likely to experience disease remission and over 2x as likely to report improvement in symptoms compared to those receiving a placebo, with no clear difference in minor or serious adverse effects.<ref name=":5" /> Although there was no clear evidence of greater remission when probiotic supplements were compared with [[Mesalazine|5‐aminosalicylic acid]] treatment as a [[monotherapy]], the likelihood of remission was 22% higher if probiotics were used in combination with 5-aminosalicylic acid therapy.<ref name=":5" /> It is unclear whether probiotics help to prevent future relapse in people with stable disease activity, either as a monotherapy or [[combination therapy]].<ref>{{cite journal |last1=Iheozor-Ejiofor |first1=Zipporah |last2=Kaur |first2=Lakhbir |last3=Gordon |first3=Morris |last4=Baines |first4=Patricia Anne |last5=Sinopoulou |first5=Vasiliki |last6=Akobeng |first6=Anthony K |date=4 March 2020 |editor-last=Cochrane IBD Group |title=Probiotics for maintenance of remission in ulcerative colitis |journal=Cochrane Database of Systematic Reviews |volume=3 |issue=3 |pages=CD007443 |language=en |doi=10.1002/14651858.CD007443.pub3 |pmc=7059960 |pmid=32128794}}</ref> [[Fecal microbiota transplant]] involves the infusion of human probiotics through fecal enemas. Ulcerative colitis typically requires a more prolonged bacteriotherapy treatment than ''Clostridioides difficile'' infection does to be successful, possibly due to the time needed to heal the ulcerated epithelium. The response of ulcerative colitis is potentially very favorable with one study reporting 67.7% of people experiencing complete remission.<ref name="pmid24257037">{{cite journal | vauthors = Borody TJ, Brandt LJ, Paramsothy S | title = Therapeutic faecal microbiota transplantation: current status and future developments | journal = Current Opinion in Gastroenterology | volume = 30 | issue = 1 | pages = 97–105 | date = January 2014 | pmid = 24257037 | pmc = 3868025 | doi = 10.1097/MOG.0000000000000027 }}</ref> Other studies found a benefit from using fecal microbiota transplantation.<ref>{{cite journal | vauthors = Narula N, Kassam Z, Yuan Y, Colombel JF, Ponsioen C, Reinisch W, Moayyedi P | title = Systematic Review and Meta-analysis: Fecal Microbiota Transplantation for Treatment of Active Ulcerative Colitis | journal = Inflammatory Bowel Diseases | volume = 23 | issue = 10 | pages = 1702–1709 | date = October 2017 | pmid = 28906291 | doi = 10.1097/MIB.0000000000001228 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Shi Y, Dong Y, Huang W, Zhu D, Mao H, Su P | title = Fecal Microbiota Transplantation for Ulcerative Colitis: A Systematic Review and Meta-Analysis | journal = PLOS ONE | volume = 11 | issue = 6 | pages = e0157259 | date = 2016 | pmid = 27295210 | pmc = 4905678 | doi = 10.1371/journal.pone.0157259 | doi-access = free | bibcode = 2016PLoSO..1157259S }}</ref><ref>{{cite journal | vauthors = Costello SP, Hughes PA, Waters O, Bryant RV, Vincent AD, Blatchford P, Katsikeros R, Makanyanga J, Campaniello MA, Mavrangelos C, Rosewarne CP, Bickley C, Peters C, Schoeman MN, Conlon MA, Roberts-Thomson IC, Andrews JM | title = Effect of Fecal Microbiota Transplantation on 8-Week Remission in Patients With Ulcerative Colitis: A Randomized Clinical Trial | journal = JAMA | volume = 321 | issue = 2 | pages = 156–164 | date = January 2019 | pmid = 30644982 | pmc = 6439766 | doi = 10.1001/jama.2018.20046 }}</ref>
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