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Failure of Synbiotic 2000 to Prevent Postoperative Recurrence of Crohn’s Disease

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Abstract

Complications of Crohn’s disease (CD) lead to surgery in about 70–90% of patients. The majority of patients suffer from relapse of the disease. Colonic bacteria are essential to the development of CD. Therefore, a rationale exists in trying to prevent relapse by manipulation of gut microflora. This is feasible by treatment with probiotics or antibiotics. Synbiotic 2000 is a cocktail containing 4 probiotic species and 4 prebiotics. It is rational to pursue that it could be effective in preventing postoperative disease. We sought to check weather treatment with Synbiotic 2000 could prevent postoperative recurrence in patients with CD. This was a prospective multicenter, randomized study. Patients were randomized to active treatment or placebo in a 2:1 ratio. Follow-up consisted of endoscopic, clinical, and laboratory parameters. Thirty patients were enrolled. No differences were found between the 2 treatment groups regarding gender, age at diagnosis, age at surgery, weight, smoking status, type of disease, length of the resected segment, or medical treatment prior to surgery. No difference in either endoscopic or clinical relapse rate was found between patients treated with once daily dose of Synbiotic 2000 or placebo. In our small study, Synbiotic 2000 had no effect on postoperative recurrence of patients with CD. Larger studies in patients with the inflammatory type of CD undergoing surgery, using higher doses of probiotics cocktail might prove effective.

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Acknowledgments

Stig Bengmark and Rami Eliakim share senior authorship.

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Authors and Affiliations

  1. Gastroenterology Department, Rambam Health Care Campus, PO Box 9602, Haifa, 31096, Israel

    Irit Chermesh, Alain Suissa, Dalia Katz & Rami Eliakim

  2. Department of Community Medicine and Epidemiology, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel

    Ada Tamir

  3. Gastroenterology Department, Western Galilee Hospital, Nahariya, Israel

    Ron Reshef

  4. Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Yehuda Chowers

  5. Department of Medicine, Laniado Hospital, Netanya, Israel

    Moshe Gelber

  6. Department of Gastroenterology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

    Zamir Halpern

  7. Institute of Hepatology, University College London Medical School, London, United Kingdom

    Stig Bengmark

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  1. Irit Chermesh
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  2. Ada Tamir
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  3. Ron Reshef
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  4. Yehuda Chowers
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  5. Alain Suissa
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  6. Dalia Katz
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  7. Moshe Gelber
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  8. Zamir Halpern
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  9. Stig Bengmark
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  10. Rami Eliakim
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Correspondence to Irit Chermesh.

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Chermesh, I., Tamir, A., Reshef, R. et al. Failure of Synbiotic 2000 to Prevent Postoperative Recurrence of Crohn’s Disease. Dig Dis Sci 52, 385–389 (2007). https://doi.org/10.1007/s10620-006-9549-7

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  • DOI: https://doi.org/10.1007/s10620-006-9549-7

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