Probiotics in Diverticular Disease of the Colon: an Open  Label Study

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Pepu Lamiki¹, Junji Tsuchiya¹, Surajit Pathak², Ruichi Okura¹, Umberto Solimene³, Shalini Jain⁴, Shichiro Kawakita¹, Francesco Marotta⁵

1) TMC Hospital, Shizuoka, Japan;
2) Cytogenetics & Molecular Biology Lab, University of Kalyani, India;
3) WHO-cnt for Bioclimatology, Biotechnology & Traditional Medicine, University of Milano, Italy;
4) Department of Food Science and Human Nutrition, University of Illinois, USA;
5) Hepato-GI Department, S. Giuseppe Hospital, Milano, Italy

Abstract

Aim: To investigate the effectiveness and safety of a symbiotic mixture in preventing recurrence of constipation-related abdominal pain in patients with uncomplicated diverticular disease of the colon.

Methods: Forty-six consecutive patients (10 men, 36 women, mean age 62.5 years, range 49 to 77 years), previously affected by symptomatic uncomplicated diverticular disease of the colon, were enrolled in a 6-month follow-up study in a prospective, randomized, open-label study. The following symptoms were assessed at entry and through follow-up by using a quantitative scale: constipation, diarrhoea and abdominal pain. After recruitment, the patients were assigned to the following treatment: SCM-III symbiotic mixture, 10ml three times a day. The colonization of ingested Lactobacillus acidophilus 145 and Bifidobacterium spp. 420 was assessed by specie-specific PCR. Forty-five patients completed the study (97%).

Results: Thirty-one patients (68%) were still symptom free after the 6th month of treatment. Treatment with SCM-III was regarded as "effective" or "very effective" in more than 78% of the patients altogether (p<0.01 vs baseline values). The microbiological study showed that, as compared to baseline values, SCM-III enabled a significant increase of the lactobacilli and bifidobacteria counting and a trend decrease of clostridia. Genomic analysis confirmed the survivability of the ingested strain as long as treatment was given.

Conclusions: The present symbiotic mixture seems to be effective in preventing recurrence of symptomatic uncomplicated diverticular disease of the colon, especially in those patients with constipation-predominant features.

Key words
Symbiotics - recurrence - constipation-predominant - diverticular disease - probiotics.