*2.5.7 Colon cancer*

*Oral Health by Using Probiotic Products*

*2.5.5 Pouchitis*

disease [35].

pouchitis [38].

beneficial role [44].

*2.5.6 Lactose intolerance*

are involved in causing Crohn's disease include *Salmonella, Clostridium difficile, Campylobacter jejuni, Mycoplasma* and *Adenovirus*, There are various reports that influence the efficacy of various probiotics, e.g., *S. boulardii, L. GG, VSL3, E. coli*

The role of probiotics in therapeutic utilization of Crohn's disease is because of its competition with the groups of bacteria, maintaining the immune system and also destroying the various pathogenic microorganisms. Irritable bowel syndrome can additionally be prevented by using the probiotics which help in maintaining the

Pouchitis is third kind of Irritable bowel syndrome where there is inflammation of ileal pouch particularly after the procedures such as colectomy and the other include anastomosis of ileal pouch. Various Studies were done and it was observed that the blend of probiotic VSL3 plays a significant role in the reduction of this

The strains of powerful probiotic stimulate definite IL-10 and IL-4 mucosal cytokine. Also Probiotics may impact the cell to cell association of mucosa and integrity of the cells through upgrading activity of intestinal mucosa through the regulation of phosphorylation and cytoskeletal activity of tight junctional protein and furthermore through the production of enzymes having anti-oxidant nature. For example, catalase and superoxide dismutase hence remediating the symptoms of IBD [36]. Ileal pouch-anal anastomosis (IPAA) is the favored option to proctocolectomy with perpetual ileostomy in ulcerative colitis and the inherited disease in which adenomatous polyps are formed in the epithelial of large intestines. The most as often as possible noticed chronic problem of IPAA is potentially perpetual inflammation of the ileal supply which is either acute or chronic and is called pouchitis. Gionchetti et al. in a randomized, controlled treatment containing placebo preliminary in which VSL3 was regulated to 40 patients quickly after carefully surgical formation of ileal anal pouches, accomplished abeyance of 90% in the group treated with VSL3 versus 60% in the placebo treatment group following a year [37]. These examinations have confirmed the role of VSL3 in the administration of

According to the Rome II Crieteria irritable bowel syndrome is defined as syndrome that lasts for greater than 3 months with the implications of either diarrhea or constipation and also accompanied by the abdominal pain. Many studies on the role of probiotics in preventing Irritable bowel syndrome have been conducted [39–43]. Out of five surveys conducted three trials showed a decrease trend in the symptoms of Irritable Bowel Syndrome. As there is a beneficial role of the probiotics but the reduction in the symptoms of disease without the clinical manifestations has not yet confirmed. However, beneficial role of probiotics in terms of clinical improvement can be attained in reducing the symptoms related to the diarrhea. Many new studies are needed to be conducted on variety of bacterial strains to draw any conclusion regarding their

It is a type of disorder that comprises of intolerance to the digestion of carbohydrate lactose that is present mainly in dairy products having prevalence of around 7–20% in Caucasians, 90–100% in Asians and from around 50–85% in Africans [45]. Lactose intolerance can be solved by using the probiotics that alleviate

Nissel 1917, in combating the issues of CD in human beings [33].

defensive functions of the mucosa of intestines [34].

**10**

The intake of probiotics and prebiotics has several antagonistic effects on mutagens [48, 49]. The link between the colon cancer and diets that are high in fats and oils and low in fiber and some other western diets lead to the alteration in the bacterial enzymes in the feces. The process through which the probiotic bacteria such as lactobacilli reduce the onset of colon cancer may include various modifications on the metabolic pathways of the intestinal microflora, inhibiting and binding of the cancer causing agents, physicochemical alterations in binding to colon, formation of compounds cancer causing agents and several other mutagens. Improving the immune system and physiology of the host. There is a remarkable evidence on the basis of various animal models and controlled studies [50, 51]. However, there is not enough data or studies to confirm the role of probiotics for protection against the onset of colon cancer.

The process through which the probiotics exhibit tumor suppressing activity includes the modification in the immune functions that are related with the various immune responses, Regulating cell differentiation and apoptosis, inhibiting the formation of the enzymes produced from the pathogenic bacteria *E. coli* and *C. perferinges* that includes the ureases different reductases specifically nitroreductases and oxidoreductases, β-glucuronidase and choloylglycine hydrolase. Enzymes such as ureases and beta glucosidases are involved in the conversion of pro carcinogens to the active carcinogens. In a study probiotic namely *Propionibacterium freudenreichii* produced Short chain fatty acids in the culture media and caused the cell death of gastric and colon cancer cells in humans [52, 53].

#### *2.5.8 Constipation*

It is common problem among the older population. Several controlled studies showed that in constipation either the bowel movements are increased or there is decrease in the transit time through the gastro-intestinal tract, for this purpose probiotics are utilized in the treatment of constipation [54, 55]. The most frequently used laxative is lactulose which is also a probiotics is not affected by the disaccharidases of the humans and the microflora in the colon, *bifidobacterium* utilizes it as a substrate that breakdown it into the smaller subunits leading to the creation of the osmotic effect. However, larger controlled studies are needed in order to confirm the use of prebiotics and probiotics apart from lactulose [56, 57].

#### *2.5.9 Immunomodulation*

Probiotics are involved in the modulation of the immune responses, are antiinflammatory in nature and also have effect on humoral and cell regulated immunity. Probiotics are thought to involve in secretion of the factors that are responsible for regulating the immunity. For example the factors secreted from the probiotic strain *L. reuteri* limit the gene expression that is dependent on NF-Κb which results in the decrease in cell growth and greater protein kinases activated by nitrogen which leads to the induction of apoptosis [58].

Probiotics are present in greater quantity in fermented milks. During milk fermentation, *L. helveticus* is able to produce factors that are involved in enhancing the expression of calcineurin which is involved in the formation of mast and goblet cells in the gastrointestinal tract of mouse [59]. The intake of probiotic strain VSL3 is involved in down regulation of such immune responses by decreasing the secretion of IL-8, regardless of the presence of the bacterial pathogen *Salmonella dublin* [60].
