Mutaflor: Probiotic Containing Escherichia Coli Nissle 1917

Mutaflor: Probiotic Containing Escherichia coli Nissle 1917

Mutaflor is the only probiotic supplement on the market containing the friendly bacterium Escherichia coli Nissle 1917. This is a non-pathogenic helpful bacterium, which is NOT to be confused with the disease-causing Escherichia Coli 0157.

The strain contained in this product, Escherichia coli Nissle 1917, is named after the German doctor Professor Alfred Nissle, who first isolated the bacterium in 1917 during the First World War.

Ingredients

In the United States and Canada, Mutaflor is available in capsule form. The capsules contain:

  • E. coli strain Nissle 1917 (2.5–25 x 109 viable cells (CFU))

  • Talc

  • Methacrylic acid-methyl methacrylate copolymer (1:1)

  • Macrogol

  • Dibuytl phthalate

  • Glycerol

  • Titanium dioxide

  • Iron (III) hydroxide oxide monohydrate

  • Gelatin

  • Beeswax (yellow)

  • Carnauba wax

  • Shellac

  • Purified water

The capsules are free from gluten, milk proteins and lactose so are suitable for those with allergies or intolerances to these substances. The product does contain gelatin though so is not suitable for vegetarians.

It is also available as a high strength capsule and as a suspension for children in Germany.


Clinical Evidence Supporting Mutaflor

Since it was first isolated, the bacterium contained in Mutaflor has been studied extensively and has been shown in scientific research to help numerous conditions

As well as being able to colonize the gut, biologically fit and active against disease-causing agents known as pathogens1, Escherichia coli Nissle 1917 has been shown in scientific studies to be of benefit for both inflammatory bowel as well as functional bowel disease:

Inflammatory Bowel Disease

  • Pouchitis: Induction and maintenance of remission2.
  • Ulcerative Colitis: Studies concluded that the use of Mutaflor with mezalasine was effective as a treatment for ulcerative colitis in maintaining remission3,4,5.

  • Crohn’s Disease: Fewer relapses in Crohn’s Disease patients taking Mutaflor versus control group (33.3% versus 63.6%)6.

  • Pseudomembranous colitis (also known as antibiotic-associated diarrhea and often caused by the bacterium Clostridium Difficile or C. Diff): Helpful when combined with intestinal lavage, otherwise known as colonic hydrotherapy or colonic irrigation7.

Functional Bowel Disorders

  • Diverticular Disease: Pilot study concluded that treatment with Mutaflor was helpful in reducing symptoms in diverticulitis8.

  • Diarrhea: Mutaflor normalized acute diarrhea more quickly than a placebo9.
  • Chronic Constipation: Research concluded Mutaflor was as effective as the laxative lactulose10 and it also increased the number of bowel movements in chronic idiopathic constipation11.

  • Irritable Bowel Syndrome: Significant improvement in stool frequency was observed as well as a marked improvement in other symptoms such as abnormal urge, flatulence and abdominal fullness12.

Advantages

Scientific studies suggest that this probiotic bacterium may be beneficial for a good number of conditions. The capsules are covered in a hard enteric coating to ensure that the friendly bacteria contained inside survive the stomach acid unharmed and are alive and viable when they reach the bowel, where they set to work.

The product can also be taken with or without food and is suitable for use as a long term therapy. According to the manufacturer of the product, Ardeypharm, the product can be taken with certain antibiotics WITHOUT loss of effectiveness. These antibiotics are those that are directed against gram-positive bacteria and include:

  • Clindamycin

  • Erythromycin

  • Metronidazole

  • Penicillin G

  • Quinupristin/Dalfopristin

  • Rifampin

  • Teicoplanin

  • Vancomycin

  • Cefsulodin

Antibiotics that are directed against gram-negative bacteria will, however, render the product less effective.

Whilst the product should be kept cool by means of refrigeration, it can be kept at room temperature for short periods of up to 72 hours without any loss of potency. This makes it suitable for taking on short trips away.

Disadvantages

Mutaflor is a Probiotic Containing Escherichia coli Nissle 1917

Compared to many other probiotic products, Mutaflor has a short shelf life of between three and six months when kept under refrigeration. Please don’t buy in bulk - you will waste your money.

The product also contains a good many additional ingredients such as fillers and preservatives, which may make it difficult to tolerate for the more sensitive patients. The hard enteric capsule also makes it almost impossible to open up the capsule to try just a small amount of the product to begin with. Very sensitive individuals may thus find that the dose of beneficial bacteria contained in a whole capsule may provoke side effects such as gas, changes in stool frequency and nausea in the initial stages of therapy.

In terms of cost Mutaflor is quite expensive especially when compared fairly (i.e. in terms of bacterial numbers) to the price of high potency probiotic products such as VSL3 and Custom Probiotics. Have a look at our cost comparison page for more details.

Our Evaluation

Mutaflor probiotic supplements contain the beneficial bacteria Escherichia coli Nissle 1917

We believe that Mutaflor products contain a helpful bacterium, which may be beneficial to many people. The product does, however, contain only one type of beneficial bacteria and also contains a good many additional ingredients. As a result we have scored the product as 3/5 – essentially a good product but with some limitations that may make it unsuitable for sensitive patients.

Where Can I Buy Mutaflor?

In the USA Mutaflor is available from Amazon.com.

In Canada, the product is available from the US distributor Medical Futures.

If you reside in Europe, you can purchase Mutaflor from those German Internet drugstores, which ship within Europe.

Whilst Mutaflor should be stored under refrigeration, a short interruption of refrigeration for shipping should not affect the potency of the product. Be sure though to select a drugstore that uses ice packs for transportation and avoid ordering at the height of summer. Try also to place your order at the beginning of the week so that your Mutaflor does not end up in a warehouse over the weekend.


References

1.Mutaflor: The Probiotic Drug for Life: Inflammatory Bowel Disease and Chronic Functional Bowel Diseases, Ardeypharm GmBH, Germany

2.Kuzela L et al; Induction and Maintenance of Remission with Nonpathogenic Escherichia Coli in Patients with Pouchitis; Am J Gastroenterol; 2001;96:3218-3219

3.Kruis W et al.; Maintaining Remission of Ulcerative Colitis with the Probiotic Escherichia Coli Nissle 1917 is as Effective as with Standard Mesalazine; Gut; 2004, 53:1617-1623

4.Kruis W et al; Double-Blind Comparison of an Oral Escherichia Coli Preparation and Mesalazine in Maintaining Remission of Ulcerative Colitis, Aliment Pharmacol Ther; 1997; 11: 853-858

5.Rembacken, B. J; Non-Pathogenic Escherichia Coli versus Mesalazine for the Treatment of Ulcerative Colitis: a Randomised Trial; Lancet; 1999; 354: 635-639

6.Malchow HA; Crohn’s Disease and Escherichia coli.; J Clin Gastroenterol; 1997; 25: 653-658

7.Goerg, K. J., et al.; A New Approach in Pseudomembranous Colitis: Probiotic Escherichia coli Nissle 1917 After Intestinal Lavage; Eur J Gastroenterol Hepatol; 2008; 20(2): 155-156

8.Fric, P., et al.; The Effect of Non-Pathogenic Escherichia Coli in Symptomatic Uncomplicated Diverticular Disease of the Colon; Eur J Gastroenterol Hepatol ; 2003; 15: 313-315

9.Henker, J.et al; Probiotic Escherichia Coli Nissle 1917 versus Placebo for Treating Diarrhea of Greater than 4 Days Duration in Infants and Toddlers; Pediatr Infect Dis J 2008; 27(6): 494-49

10.Bruckschen E et al; Chronic Constipation. Comparison of Microbiological and Lactulose Treatment; [German]; MMW 1994, 16: 241-245

11.Möllenbrink, M., et al; Treatment of Chronic Constipation with Physiologic Escherichia Coli Bacteria. Results of a Clinical Study of the Effectiveness and Tolerance of Microbiological Therapy with the E. Coli Nissle 1917 strain (Mutaflor)[German]; Med Klin; 1994, 89: 587-593

12.Plaßmann, D., et al; Treatment of Irritable Bowel Syndrome with Escherichia Coli Strain Nissle 1917 (EcN): a Retrospective Survey; Med Klin 2007; 102 (11): 888-892


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