6 Things to Expect When Switching to Probiotics for Crohn's

The article is written by Master, Doctor Mai Vien Phuong - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

According to the Crohn's and Colitis Foundation of America, Crohn's disease affects more than half a million Americans. If your Crohn's treatment isn't working as expected, your doctor may recommend that you try a probiotic medication. These are drugs made from living cells that target the inflammatory response. They are often used for moderate to severe Crohn's disease that has not responded well to conventional therapies.
Like most drugs, probiotics have benefits and risks. They can reduce your inflammation and help stop the progression of Crohn's disease. However, they can also put you at risk for infections and certain cancers.
Some doctors recommend avoiding the risks associated with probiotics by saving that treatment until other therapies don't work. Other doctors favor a "top-down" approach, meaning you should try probiotics earlier to prevent damage to your gut before it develops.
Your doctor will help you weigh the risks and benefits so you can make an informed decision about whether to start probiotic treatment. And you should be aware of what can happen when you start Crohn's with probiotics.

Your probiotic must be taken by injection or intravenously because the acid in your stomach will destroy the complex, delicate structure of this medicine.
Probiotics are injected under the skin . This means that the medicine is deposited in the fatty layer between your skin and muscles, where it is slowly absorbed. You may be taught to give the injection yourself or have a healthcare professional do it.
Intravenous doses are given by infusion in the clinical setting. This method can take several hours. Dress comfortably, bring snacks and entertainment (such as books), and arrange a ride home after the injection.

After taking probiotics, you may experience pain at the injection site or changes such as:
Itching. Red. Bruise. Swelling. Pain. Fever. Chills. Headache .

Probiotics come with risks such as:
Infection. Your ability to fight infections is reduced. Cancer. There is a small increase in your chances of developing lymphoma. Liver function changes. Your liver may be adversely affected. Tell your doctor right away if you develop jaundice. Arthritis . You may have joint pain. Lupus-like reaction (LLR). You may have a rash, fever, muscle aches, and joint pain. The likelihood of these risks occurring depends on the severity of the disease.

If you stop taking probiotic medications, they will likely decrease in effectiveness when you take them again. This is because your body can build up antibodies that make the medicine less effective. This is one of the reasons doctors recommend continuing to take probiotics even if your Crohn's disease is in remission. Another reason is that probiotic drugs are effective in maintaining remission by protecting you from reacting to flare-ups.
There are certain situations where your doctor will advise you to take a break from taking your medication, such as before surgery.

Live vaccines such as measles, mumps, rubella (MMR) should not be given when you start using probiotics because of the risk of infection they cause. Therefore, you should be vaccinated against these diseases before starting probiotic injections.

Relatively new probiotics. Therefore, the long-term effects on infants exposed to probiotics during pregnancy have not been studied. Experts believe that this risk is low and conclude that the possibility of birth defects when using biologicals during pregnancy is close to that of pregnant women who do not use biological products.
You and your doctor will need to discuss the risks of using probiotics during pregnancy compared with the possible risks to your baby. You may need to temporarily stop taking it during pregnancy depending on the type of probiotic you are taking.

Probiotic drugs work by targeting and blocking the inflammatory response that can cause a Crohn's flare-up. However, these drugs come with side effects including a decreased ability to fight infections. Even so, you should continue to take your probiotic medication even if you are in remission, unless otherwise directed by your doctor.