Abstract
Colonic diverticular disease is an extremely common condition in which several pathogenic factors are implicated, including dysbiosis. Thus, probiotics may represent an important therapy for restoring a healthy colonic microenvironment. Different probiotics have been studied to date, showing anti-inflammatory effects with the capability to enhance anti-inflammatory defenses by maintaining an adequate bacterial colonization in the gastrointestinal tract and by inhibiting colonic bacterial overgrowth and metabolism of pathogens. Based on these studies, the use of probiotics alone or in association with anti-inflammatory drugs, such as mesalazine or balsalazide, seems to be effective in inducing and maintaining remission in patients with symptomatic uncomplicated diverticular disease and in favoring the control of the inflammatory burden during an acute attack of uncomplicated diverticulitis. However, further studies such as randomized, controlled placebo studies including a larger number of patients are now needed to unequivocally demonstrate the actual role of probiotics in different manifestations of diverticular disease.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tursi A, Scarpignato C, Strate LL, et al. Colonic diverticular disease. Nat Rev Dis Primers. 2020;6:20.
Ticinesi A, Nouvenne A, Corrente V, et al. Diverticular disease: a gut microbiota perspective. J Gastrointestin Liver Dis. 2019;3:327–37.
Piccioni A, Franza L, et al. Gut microbiota and acute diverticulitis: role of probiotics in Management of this Delicate Pathophysiological Balance. J Pers Med. 2021;11:298.
Lahner E, Annibale B. Probiotics and diverticular disease evidence based? J Clin Gastroenterol. 2016;50:S159–60.
Ojetti V, Petruzziello C, Sinatti D, et al. The efficacy of Lactibiane IKI (BifidobacteriumLactis LA 304, lactobacillus Salivarius LA 302, lactobacillus acidophilus LA 201) in reducing abdominal symptoms and inflammatory biomarkers in acute uncomplicated. Diverticulitis J Clin Gastroenterol. 2016;50:S110.
Petruzziello C, Migneco A, Cardone S, et al. Supplementation with lactobacillus reuteri ATCC PTA 4659 in patients affected by acute uncomplicated diverticulitis: a randomized double-blind placebo-controlled trial. Int J Color Dis. 2019;34:1087.
Lahner E, Bellisario C, Hassan C, et al. Probiotics in the treatment of diverticular disease. A systematic review. J Gastrointestin Liver Dis. 2016;25:79–86.
Carabotti M, Annibale B. Treatment of diverticular disease: an update on latest evidence and clinical implications. Drugs in Context. 2018;7:212526.
Ojetti V, Petruzziello C, Cardone S, et al. The use of probiotics in different phases of diverticular disease. Rev Recent Clin Trials. 2018;13:89–96.
Giaccari S, Tronci S, Falconieri M, et al. Long-term treatment with rifaximin and lactobacilli in post-diverticulitic stenoses of the colon. Riv Eur Sci Med Farmacol. 1993;15:29–34.
Fric P, Zavoral M. The effect of non-pathogenic Escherichia coli in symptomatic uncomplicated diverticular disease of the colon. Eur J Gastroenterol Hepatol. 2003;15:313–5.
Tursi A, Brandimarte G, Giorgetti GM, et al. Beclomethasone dipropionate plus VSL#3 for the treatment of mild to moderate diverticular colitis: an open, pilot study. J Clin Gastroenterol. 2005;39:644–5.
Tursi A, Giorgetti GM, Brandimarte G, et al. Beclomethasone dipropionate for the treatment of mild-to-moderate Crohn’s disease: an open-label, budesonide-controlled, randomized study. Med Sci Monit. 2006;12:PI29–32.
Tursi A, Brandimarte G, Giorgetti GM, et al. Balsalazide and/or high-potency probiotic mixture (VSL#3) in maintaining remission after attack of acute, uncomplicated diverticulitis of the colon. Int J Colorectal Dis. 2007;22:1103–8.
Tursi A, Brandimarte G, Giorgetti GM, et al. Mesalazine and/or Lactobacillus casei in maintaining long-term remission of symptomatic uncomplicated diverticular disease of the colon. Hepatogastroenterology. 2008;55(84):916–20.
Lamiki P, Tsuchiya J, Pathak S, et al. Probiotics in diverticular disease of the colon: an open label study. J Gastrointestin Liver Dis. 2010;19:31–6.
Annibale B, Maconi G, Lahner E, et al. Efficacy of Lactobacillus paracasei sub. paracasei F19 on abdominal symptoms in patients with symptomatic uncomplicated diverticular disease: a pilot study. Minerva Gastroenterol Dietol. 2011;57:13–22.
Lahner E, Esposito G, Zullo A, et al. High-fibre diet and Lactobacillus paracasei B21060 in symptomatic uncomplicated diverticular disease. World J Gastroenterol. 2012;18:5918–24.
Stollman N, Magowan S, Shanahan F, et al. A randomized controlled study of mesalamine after acute diverticulitis: results of the DIVA trial. J Clin Gastroenterol. 2013;47(7):621–9.
Tursi A, Brandimarte G, Elisei W, et al. Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease--a double-blind, randomised, placebo-controlled study. Aliment Pharmacol Ther. 2013;38:741–51.
Kvasnovsky CL, Bjarnason I, Donaldson AN, et al. A randomized double-blind placebo-controlled trial of a multi-strain probiotic in treatment of symptomatic uncomplicated diverticular disease. Inflammopharmacology. 2017.
Petruzziello C, Marannino M, Migneco A, et al. The efficacy of a mix of three probiotic strains in reducing abdominal pain and inflammatory biomarkers in acute uncomplicated diverticulitis.Eur Rev Med Pharmacol Sci. 2019;23:9126–33.
Peery AF, Shaukat A, Strate LL. AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review. Gastroenterology. 2021;160:906-911.
Didari T, Mozaffari S, Nikfar S, et al. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015;21:3072–84.
Foligne, Nutten, Grangette, et al. Correlation between in vitro and in vivo immunomodulatory properties of lactic acid bacteria. World J Gastroenterol. 2007;13:236–43.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Savarino, E., Ojetti, V., Saviano, A. (2022). Probiotics. In: Tursi, A., Bafutto, M., Brandimarte, G., Chaves de Oliveira, E. (eds) Colonic Diverticular Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-93761-4_20
Download citation
DOI: https://doi.org/10.1007/978-3-030-93761-4_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-93760-7
Online ISBN: 978-3-030-93761-4
eBook Packages: MedicineMedicine (R0)