Long-Term Use of ProbioticsLactobacillusandBifidobacteriumHas a Prophylactic Effect on the Occurrence and Severity of Pouchitis: A Randomized Prospective Study

Banasiewicz Tomasz,Walkowiak Jarosław,Burdyński Robert,Stojcev Zoran,Marciniak Ryszard,Grochowalski Marcin,Gronek Piotr,Drews Michał,Krokowicz Lukasz,Paszkowski Jacek,Pyda Przemysław,Krokowicz Piotr

doi:10.1155/2014/208064

Abstract

Aim. The aim of the study was to assess the impact of the long-term use of the composite probiotics in patients after restorative proctocolectomy. Method. Forty-three patients (20 females and 23 males, aged 21 to 68 years) after restorative proctocolectomy were included in the study. After randomization patients were divided into placebo group and treatment group with oral intake of probiotic containing Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Bifidobacterium bifidus. Patients were investigated during initial visit and during final visit after 9 months. All patients were subjected to standard clinical and endoscopic examination with microscopic study of the specimens. Concentrations of calprotectin and pyruvate kinase isoenzyme M2-PK were determined in all cases. Results. The average severity of pouchitis and the number of patients with pouchitis significantly decrease after 9 months of the probiotic taking. The concentrations of calprotectin and pyruvate kinase isoenzyme M2-PK significantly decreased after the therapy. Conclusions. Nine months of the probiotic treatment (Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Bifidobacterium bifidus) reduced the number of patients with pouchitis, decreased the PDAI score, and also decreased the fecal pyruvate kinase and calprotectin. The long-term probiotics use is safe and well accepted and can be an effective method of the pouchitis prevention.

Highlights

The Western human diet contains several thousand times less bacteria than preindustrialized diets, mainly due to improved hygiene and nutrition and the use of processed and sterile foods which contain artificial sweeteners and preservatives, rather than fresh fruits and vegetables [1]
The aim of the study was to assess the impact of the longterm use of the composite probiotic (Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Bifidobacterium bifidus) in patients after restorative proctocolectomy
Forty-three patients (20 females and 23 males, aged 21 to 68 years) after restorative proctocolectomy, operated on for ulcerative colitis (UC) and familial adenomatous polyposis (FAP) and admitted to outpatient clinic according to prescheduled followup and without acute signs of the pouchitis or other GI tract severe disorders, were included in the study

Summary

Introduction

The Western human diet contains several thousand times less bacteria than preindustrialized diets, mainly due to improved hygiene and nutrition and the use of processed and sterile foods which contain artificial sweeteners and preservatives, rather than fresh fruits and vegetables [1]. Decreased concentration of the gut microbiome or dysbiosis may be implicated in gastrointestinal disorders including diarrheal diseases, ulcerative colitis, inflammatory bowel diseases, and life style diseases [2]. The use of probiotics in the treatment of the different GI tract diseases seems to be still more popular. Pouchitis— inflammation of the intestinal mucosa of the small intestine— is a common complication of restorative proctocolectomy. The data suggest positive role of the probiotics, especially in prevention of recurrence [3]. The randomized controlled trials using probiotics in patients with different inflammatory

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