High-fibre diet and Lactobacillus paracasei B21060 in symptomatic uncomplicated diverticular disease

• Published in: World journal of gastroenterology : WJG 2012-11, Vol.18 (41), p.5918-5924
• Main Authors: Lahner, Edith, Esposito, Gianluca, Zullo, Angelo, Hassan, Cesare, Cannaviello, Claudio, Paolo, Maria Carla Di, Pallotta, Lorella, Garbagna, Nicoletta, Grossi, Enzo, Annibale, Bruno
• Format: Article
• Language: English
• Subjects: Abdominal Pain - etiology; Abdominal Pain - therapy; Adult; Aged; Aged, 80 and over; Brief; Combined Modality Therapy; Dietary Fiber - administration & dosage; Diverticulum, Colon - complications; Diverticulum, Colon - diagnosis; Diverticulum, Colon - therapy; Female; Humans; Italy; Lactobacillus - growth & development; Male; Middle Aged; Pain Measurement; Synbiotics; Time Factors; Treatment Outcome; VAS; 干酪乳杆菌; 并发症; 疾病症状; 胃肠病学; 随机分配; 饮食治疗; 高纤维
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i41.5918

AIM： To investigate in symptomatic uncomplicated di- verticular disease the efficacy of symbiotics associated with a high-fibre diet on abdominal symptoms. METHODS： This study was a multicentre, 6-too ran- domized, controlled, parallel-group intervention with a preceding 4-wk washout period. Consecutive out- patients with symptomatic uncomplicated diverticular disease, aged 40-80 years, evaluated in 4 Gastroenterology Units, were enrolled. Symptomatic uncomplicated diverticular disease patients were randomized to two treatment arms A or B. Treatment A （n = 24 patients） received 1 symbiotic sachet Flortec~ （Lactobacillus paracasei B21060） once daily plus high-fibre diet for 6 mo. Treatment B （n = 21 patients） received high-fibre diet alone for 6 rno. The primary endpoint was regres- sion of abdominal symptoms and change of symptom severity after 3 and 6 mo of treatment. RESULTS： In group A, the proportion of patients with abdominal pain 〈 24 h decreased from 100% at base- line to 35% and 25% after 3 and 6 mo, respectively （P 〈 0.001）. In group B the proportion of patients with this symptom decreased from 90.5% at baseline to 61.9% and 38.1% after 3 and 6 mo, respectively （P = 0.001）. Symptom improvement became statistically sig- nificant at 3 and 6 mo in group A and B, respectively. The proportion of patients with abdominal pain 〉24 h decreased from 60% to 20% then 5% after 3 and 6 too, respectively in group A （P 〈 0.001） and from 33.3% to 9.5% at both 3 and 6 mo in group B （P = 0.03）. In group A the proportion of patients with ab- dominal bloating significantly decreased from 95% to 60% after 3 mo, and remained stable （65%） at 6-mo follow-up （P = 0.005） while in group B, no significant changes in abdominal bloating was observed （P = 0.11）. After 6 mo of treatment, the mean visual analogic scale （VAS） values of both short-lasting abdominal pain （VAS, mean ± SD, group A： 4.6 ± 2.1 vs 2.2 ± 0.8, P = 0.02; group B： 4.6 ± 2.9 vs 2.0 ± 1.9, P = 0.03） and abdom- inal bloating （VAS, mean ± SD, group A： 5.3 ± 2.2 vs 3.0 ± 1.7, P = 0.005; group B： 5.3 ±3.2 vs 2.3 ± 1.9, P = 0.006） decreased in both groups, whilst the VAS values of prolonged abdominal pain decreased in the Flortec group, but remained unchanged in the high-fibre diet group （VAS, mean ± SD, group A： 6.5 ± 1.5 vs 4.5 ± 2.1, P = 0.052; group B： 4.5 ± 3.8 vs 5.5 ± 3.5）. CONCLUSION： A high-fibre diet is effective in relievingabdominal symptoms in symptomatic uncomplicated di- verticular disease. This treat