A randomized double-blind placebo-controlled trial of a multi-strain probiotic in treatment of symptomatic uncomplicated diverticular disease

• Published in: Inflammopharmacology 2017-10, Vol.25 (5), p.499-509
• Main Authors: Kvasnovsky, Charlotte L., Bjarnason, Ingvar, Donaldson, Ana Nora, Sherwood, Roy A., Papagrigoriadis, Savvas
• Format: Article
• Language: English
• Subjects: Allergology; Biomedical and Life Sciences; Biomedicine; Dermatology; Gastroenterology; Immunology; Original Article; Pharmacology/Toxicology; Rheumatology
• ISSN: 0925-4692; 1568-5608
• DOI: 10.1007/s10787-017-0363-y

Background Diverticular disease is a significant burden on healthcare systems that is managed, surgically or medically, mainly as an emergency or acute condition. There are no standardized treatment recommendations for symptomatic uncomplicated disease. We hypothesized that a probiotic would reduce abdominal pain in such patients. Methods We conducted a single-center, double-blind, placebo-controlled trial of probiotic treatment (Symprove) in adult patients with moderate-to-severe chronic, non-acute symptomatic diverticular disease. 143 patients were randomized to receive 1 mL/kg/day of probiotic liquid ( N  = 72) or placebo ( N  = 71) daily for 3 months. The primary endpoint was abdominal pain severity. Secondary endpoints consisted of the change in the frequency of eight abdominal symptoms and the level of intestinal inflammation (fecal calprotectin). Results 120 patients completed the trial. Abdominal pain score, the primary end point, decreased in both groups, but no significant difference between the groups was found ( P  = 0.11). In relation to placebo, the probiotic significantly decreased the frequency of four of the eight secondary endpoints: constipation, diarrhea, mucorrhea, and back pain ( P