Study Trial design No. of patients Randomisation Outcomes assessed

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Table 4 | Controlled trials in using probiotics for symptomatic diverticular disease Study Trial design No. of patients Randomisation Outcomes assessed Length of follow-up Results Annibal et al. Prospective, randomised, open- label 50 Group A, high-fibre diet alone; Group B, twice daily 1 sachet of probiotic Lactobacillus paracasei sub. paracasei F19 for 14c days/month + high- fibre diet); Group C twice daily 2 sachets of probiotic Lactobacillus paracasei sub. Paracasei F19 for 4 days/month+ high-fibre diet Decrease in VAS score after treatment in SUDD 6 months Bloating decreased significantly in Groups B and C (groupB: 4.6 + 2.6 vs. 2.3 + 2.0, P < 0.05, group C: 3.9 + 2.9 vs. 1.8 + 2.1, P < 0.05). Dughera et al. 83 Polybacterial lysate suspension of Escherichia coli + Proteus Vulgaris for 2 weeks every month plus fibre 15 g/day vs. fibre 15 g/day alone Prevention of diverticulitis recurrence 3 months Polybacterial lysate plus fibre had significant superiority to fibre alone at 1 and 3 months in controlling symptoms and preventing diverticulitis recurrence (P < 0.05 and P < 0.01 respectively) Lahner et al. 30 Methylcellulose 2 tablets/day vs. placebo 2 tablets/day Symptom score decreased significantly in the methylcellulose group (from 19 + 6 to 13 + 4, P < 0.01) but not in the placebo group (from 21 + 7 to 17 + 9, P = n.s.) Tursi et al. Double-blind, randomised, placebo-controlled 210 Mesalazine 800 mg twice a day and Mesalazine 800 mg twice a day + Lactobacillus casei 750 mg a day vs. Lactobacillus casei 750 mg a day vs. Placebo 12 months Remission was maintained in 93.33% in combined treatment group, 85.45% in probiotic group and 54% of placebo group (P = 0.0001)Acute diverticulitis occurred in 0% in combined treatment group, 1.82% in probiotic group and 12% in the placebo group (P = 0.003) Balsalazide 2.25 g daily for 10 days every month plus probiotic mixture VSL#3 450 billions/day for 15 days every month (Group A) vs. VSL#3 alone 450 billions/day for 15 days every month (Group B) 6.66% of group A and 13.33% of group B pts had recurrence of the disease (P = n.s.) VAS, Visual Analogic Scale; DD, diverticular disease; SUDD, symptomatic uncomplicated diverticular disease.