Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial
Abstract
Background & aims We have recently documented the efficacy of a highly concentrated probiotic preparation (VSL#3) in the prevention of flare-up in patients with chronic pouchitis. The aim of this study was to compare probiotic therapy with VSL#3 versus placebo in the ability to prevent the onset of acute pouchitis during the first year after ileal pouch-anal anastomosis.Methods Forty consecutive patients who underwent ileal pouch-anal anastomosis for ulcerative colitis were randomized to receive either VSL#3 (1 packet containing 900 billion bacteria/day) (n = 20) or an identical placebo (n = 20) immediately after ileostomy closure for 1 year. The patients were assessed clinically, endoscopically, and histologically after 1, 3, 6, 9, and 12 months. Health-related quality of life was assessed using the Inflammatory Bowel Disease Questionnaire.Results Two of the 20 patients (10%) treated with VSL#3 had an episode of acute pouchitis compared with 8 of the 20 patients (40%) treated with placebo (log-rank test, z = 2.273; P < 0.05). Treatment with VSL#3 determined a significant improvement in Inflammatory Bowel Disease Questionnaire score, whereas this was not the case with placebo.Conclusions Treatment with VSL#3 is effective in the prevention of the onset of acute pouchitis and improves quality of life of patients with ileal pouch-anal anastomosis.
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VSL#3 reduced the risk of disease onset and maintained an antibiotic-induced disease remission in pouchitis.
“VSL#3 reduced the risk of disease onset and maintained an antibiotic-induced disease remission in pouchitis.81”
From The gut microbiota and host health: a new clinical frontier (2016) · cites this paper as [81]
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Quigley, E. M. M. (2005) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2005.05.008 · Cited by 20 · see citing works
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- Authors
- Gionchetti, P., Rizzello, F., Helwig, U., Venturi, A., Lammers, K. M., Brigidi, P., Vitali, B., Poggioli, G., Miglioli, M., & Campieri, M.
- Affiliations
- University of Bologna (IT)
- Corresponding author
- Gionchetti, Paolo
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2003-05
- Volume
- 124
- Issue
- 5
- Pages
- 1202-1209
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2153551892
- Cited by
- 1,147
- References
- 41
- Citations by year
- 2026: 13 · 2025: 17 · 2024: 19 · 2023: 19 · 2022: 22 · 2021: 31 · 2020: 35 · 2019: 37 · 2018: 37 · 2017: 43 · 2016: 34 · 2015: 50 · 2014: 65 · 2013: 49 · 2012: 39
- FWCI
- 47.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- pouchitis, VSL#3, probiotics, ileal pouch-anal anastomosis, ulcerative colitis, ileostomy closure, health-related quality of life, inflammatory bowel disease
- MeSH terms
- Acute Disease, Adolescent, Adult, Aged, Chronic Disease, Colitis, Ulcerative, Defecation, Double-Blind Method, Enterobacteriaceae, Female, Humans, Intestines, Male, Middle Aged, Postoperative Complications, Quality of Life, Treatment Outcome, Patient Selection, Pouchitis, Probiotics
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