Probiotics for Diarrhea: Are 'Bug-Drugs' the Answer?

David A. Johnson, MD


September 20, 2013

In This Article

Probiotics for Relapsing Diverticulitis

A new study[5] looked at the advantages of probiotics. This study, from Italy, looked at the prevention of diverticulitis in 210 patients. All patients had diagnosis of diverticulitis within 4 weeks of being randomly assigned. This was a placebo-controlled, randomized, 4-way trial with mesalamine 1.6 g daily for 10 days, Lactobacillus (in this case, L casei DG) at a dose of 24 billion cells/day, and the appropriate placebo for both. There were 4 groups: a group that received both active products (mesalazine plus Lactobacillus), a group that received both placebos but no active products, and 2 groups that each received 1 active product and 1 placebo. The endpoint was relapse of diverticulitis within 12 months. In the group that received both active products, there was no relapse of acute diverticulitis. In the group that took either combination of placebo with Lactobacillus or mesalamine, the relapse rate was about 14%. In the patients who took no active therapy, the relapse rate was 40.6%.

What does this mean? It is something that would be very interesting to talk about with your diverticulitis patients. A zero percent relapse rate in a placebo-controlled trial is hard to dismiss, so we may need to revisit this probiotic combination in some of our patients with relapsing diverticulitis, and revisit the whole idea of probiotics as we start to apply them to different diseases.


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