Microencapsulated sodium butyrate administered to patients with diverticulosis decreases incidence of diverticulitis—a prospective randomized study

Lukasz Krokowicz,Tomasz Banasiewicz,Zoran Stojcev,Elżbieta Kaczmarek,Bartosz Filip Kaczmarek,Michal Drews,Jaroslaw Walkowiak,Piotr Krokowicz,Wojciech Kociemba

doi:10.1007/s00384-013-1807-5

Abstract

BackgroundMicroencapsulated sodium butyrate (MSB) has been previously associated with anti-inflammatory and regenerative properties regarding large bowel mucosa. We aimed to examine a role of MSB in patients with diverticulosis, hypothesizing its potential for reduction of diverticulitis episodes and diverticulitis prevention.MethodsSeventy-three patients with diverticulosis (diagnosed in colonoscopy or/and barium enema or/and CT colography) were recruited for the study and randomized. The investigated group was administered MSB 300 mg daily; the control group was administered placebo. After 12 months, a total of 52 patients completed the study and were subject to analysis (30 subjects and 22 controls). During the study, the number of episodes of diverticulitis (symptomatic diagnosis with acute pain, fever, and leukocytosis), hospitalizations, and surgery performed for diverticulitis were recorded. Additionally, a question regarding subjective improvement of symptoms reflected changes in quality of life during the analysis.ResultsAfter 12 months, the study group noted a significantly decreased number of diverticulitis episodes in comparison to the control group. The subjective quality of life in the study group was higher than in the control group. There were no side effects of the MSB during the therapy.ConclusionsMSB reduces the frequency of diverticulitis episodes, is safe, and improves the quality of life. It can play a role in the prevention of diverticulitis.

Highlights

60 % of individuals over age of 60 living in industrialized countries will develop colonic diverticula [1]
The primary outcome was the number of episodes of diverticulitis experienced by the patients and diverticulitis diagnosed in imaging studies, number of patients hospitalized, and number of patients undergoing surgical intervention for diverticulitis
Subjective improvement in observed symptoms based on a single closed-end question: “Did you observe adequate relief of diverticulosis related to abdominal pain or discomfort within the past 12 months?” was reported to be higher in the treatment group (55.67 vs 22.73 %, p =0.0143)

Summary

Introduction

60 % of individuals over age of 60 living in industrialized countries will develop colonic diverticula [1]. Developing an effective method of prevention of symptomatic diverticulitis in patient with diverticulosis could lead to a significant reduction in both morbidity and mortality. We aimed to examine a role of MSB in patients with diverticulosis, hypothesizing its potential for reduction of diverticulitis episodes and diverticulitis prevention. The number of episodes of diverticulitis (symptomatic diagnosis with acute pain, fever, and leukocytosis), hospitalizations, and surgery performed for diverticulitis were recorded. Results After 12 months, the study group noted a significantly decreased number of diverticulitis episodes in comparison to the control group. Conclusions MSB reduces the frequency of diverticulitis episodes, is safe, and improves the quality of life. It can play a role in the prevention of diverticulitis

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