Comparative analysis of the efficacy of probiotics combined with 5-amino salicylic acid in the treatment of ulcerative colitis
Wang Song     Zou Chuanxin(Corresponding author )

Jingzhou Hospital Affiliated to Yangtze University，Jingzhou city Hubei Province，434020；

Abstract: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. While 5-aminosalicylic acid (5-ASA) serves as the first-line treatment, its efficacy remains suboptimal in some patients. This study conducted a systematic review of the clinical efficacy of probiotic combination therapy with 5-ASA in treating acute-onset UC. By comparing the differences between combined therapy and single-ASA treatment in clinical symptom improvement, endoscopic mucosal healing, decreased inflammatory markers, clinical remission rates, and safety profiles, the results demonstrated that the combined therapy group significantly outperformed the single-drug control group across all evaluation metrics, indicating that probiotics can effectively enhance the therapeutic effects of 5-ASA. Comparative analysis of different probiotic preparations revealed that strain specificity was the key factor influencing efficacy, with certain combination preparations and specific strains (e.g., Lactobacillus rhamnosus GG) exhibiting superior synergistic effects. Mechanistically, probiotics exert synergistic effects with 5-ASA through multiple pathways including gut microbiota regulation, intestinal barrier repair, and anti-inflammatory responses. Safety evaluations showed good tolerability of the combined regimen without significant adverse reactions.

Key words: ulcerative colitis; probiotics; 5-amino salicylic acid

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