We read with interest the article by Furrie and colleagues (Gut 2005;54:242–9). While we believe this approach represents a very interesting advance in our understanding of aspects of the mucosal response to synbiotic therapy in ulcerative colitis (UC), we would like to raise some questions about the design of the study, which relate in particular to the conclusion that the synbiotic cocktail produces some improvement in disease activity in UC.

Five patients were taking steroids, and six patients were taking immunosuppressants in each of the active treatment and placebo groups (see table 2). …