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Prebiotic carbohydrates: not sweet yet for Crohn's disease?
  1. Philippe Marteau1,2,3
  1. 1Université Denis Diderot, Paris 7, France
  2. 2Laboratoire de Biologie EA 3199, CNAM, Paris, France
  3. 3AP-HP, Hôpital Lariboisière, Paris, France
  1. Correspondence to Dr Philippe Marteau, Département Médico-chirurgical de Pathologie Digestive, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris cedex, France; philippe.marteau{at}

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The double-blind placebo controlled study performed by Benjamin et al1 published in Gut (see page 923) shows that the daily consumption of 15 g fructo-oligosaccharides (FOS) worsens the clinical signs of active Crohn's disease. The message for the clinician and the patient is clear: despite a strong rationale and hopes from open studies,2 there is presently no evidence of efficacy of prebiotics in Crohn's disease. The same conclusion applies for probiotics and synbiotics.3 However, one should avoid throwing the baby out with the bath water.

Descriptive studies of the microbiota and microenvironment in Crohn's disease have repeatedly shown dysbiosis, which is probably partly a consequence of the ecological modifications induced …

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  • Competing interests Consultancy for Biocodex, Danone, Nestlé.

  • Provenance and peer review Commissioned; internally peer reviewed.

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