Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial
P Gionchetti, F Rizzello, U Helwig, A Venturi… - Gastroenterology, 2003 - Elsevier
Gastroenterology, 2003•Elsevier
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 …
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 …
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.
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