Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial.

Abstract

BACKGROUND & AIMS:

We have recently documented the efficacy of a highly concentrated probiotic preparation (VSL#3) in the prevention of flare-up in patients with chronic pouchitis. The aim of this study was to compare probiotic therapy with VSL#3 versus placebo in the ability to prevent the onset of acute pouchitis during the first year after ileal pouch-anal anastomosis.

METHODS:

Forty consecutive patients who underwent ileal pouch-anal anastomosis for ulcerative colitis were randomized to receive either VSL#3 (1 packet containing 900 billion bacteria/day) (n = 20) or an identical placebo (n = 20) immediately after ileostomy closure for 1 year. The patients were assessed clinically, endoscopically, and histologically after 1, 3, 6, 9, and 12 months. Health-related quality of life was assessed using the Inflammatory Bowel Disease Questionnaire.

RESULTS:

Two of the 20 patients (10%) treated with VSL#3 had an episode of acute pouchitis compared with 8 of the 20 patients (40%) treated with placebo (log-rank test, z = 2.273; P < 0.05). Treatment with VSL#3 determined a significant improvement in Inflammatory Bowel Disease Questionnaire score, whereas this was not the case with placebo.

CONCLUSIONS:

Treatment with VSL#3 is effective in the prevention of the onset of acute pouchitis and improves quality of life of patients with ileal pouch-anal anastomosis.

• Authors: Paolo Gionchetti, Fernando Rizzello, Ulf Helwig, Alessandro Venturi, Karen Manon Lammers, Patrizia Brigidi, Beatrice Vitali, Gilberto Poggioli, Mario Miglioli, Massimo Campieri
• Journal: Gastroenterology (Gastroenterology) Vol. 124 Issue 5 Pg. 1202-9 (May 2003) ISSN: 0016-5085 [Print] United States
• PMID: 12730861 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Chronic Disease
• Colitis, Ulcerative (surgery)
• Defecation
• Double-Blind Method
• Enterobacteriaceae
• Female
• Humans
• Intestines (microbiology)
• Male
• Middle Aged
• Patient Selection
• Postoperative Complications (drug therapy, prevention & control)
• Pouchitis (drug therapy, prevention & control)
• Probiotics (administration & dosage, adverse effects)
• Quality of Life
• Treatment Outcome