Probiotics Study

Patients want their doctor’s take on beneficial bacteria

If you have ever wondered whether probiotics are right for you, you might be interested in a study now under way in Cleveland Clinic’s Department of Bioethics.

The three-year, $1.1 million research project is evaluating how patients see bioengineered probiotics as a therapy to combat digestive diseases such as Crohn’s disease and ulcerative colitis.

Probiotics are bacteria that are taken to improve health. Many are found naturally in the intestinal tract; they also are added to products such as yogurt and orange juice, and can be taken as a food supplement.

The researchers initially thought that study participants would be resistant to the idea of ingesting microorganisms, but that has not been the case. “There is tremendous interest among these patients in using probiotics,” says Richard Sharp, PhD, Director of Bioethics Research, who is co-directing the study with Ruth Farrell, MD.

The study, titled “Patient Understandings of Bioengineered Probiotics and Clinical Metagenomics,” has enrolled 136 patients in 22 focus groups across three study sites. Mary Beth Mercer is the Project Coordinator. Collaborators in the study, which is funded by the National Institutes of Health, are Mayo Clinic and Johns Hopkins University, along with Jean-Paul Achkar, MD, holder of the Kenneth Rainin Endowed Chair in IBD Research at Cleveland Clinic’s Digestive Disease Institute.

The participants – who are all patients with chronic gastrointestinal diseases – “see probiotics as potentially helping with the side effects of drugs that control GI disease,” Dr. Sharp says. Patients hear a lot of claims by manufacturers and wonder how much of that information is reliable and supported by good research. “What we’ve seen so far in our study is that patients have a lot of questions about probiotics. They want to talk to their doctors about whether probiotics may be right for them, but they don’t know how to broach the subject.”

The main reason for their hesitancy is that probiotics are food supplements rather than drugs. Study participants have expressed doubt as to whether this is an appropriate subject to bring up to their doctor. “Our research suggests that if doctors initiate this conversation, patients not only will welcome the information but will feel more connected to them as partners in managing their disease,” Dr. Sharp says.

“This study illustrates the type of work we do in bioethics, and how bioethics research can make a difference in patient care,” he says. The study will help physicians be more aware that patients are desperate for this information. “Ultimately, we hope our research will improve doctor-patient communication, which is the foundation of all respectful patient care.”

This story is updated from the original version, which appeared in Bioethics Reflections, a publication of the Cleveland Clinic Bioethics Department, in spring 2009.

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