Journal article Open Access

Impact of a Daily Probiotic (Lactobacillus casei Shirota) for 12 Months on the Frequency of Diverticulitis Episodes: Feasibility Study in Primary Care.

John Nichols*; Barbara Engel; Linda V. Thomas; Paul Grob; Michelle Dobrota Gibbs; Peter Williams; Tamara Fenton; Simon de Lusignan


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    <subfield code="a">Keywords: Dietary fibre; Diverticulitis; Gastrointestinal symptoms; Lactobacillus casei Shirota; Primary care; Probiotic</subfield>
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    <subfield code="u">Department of Nutritional Sciences, Faculty of Health and Medical Sciences, Duke of Kent Building, University of Surrey, Guildford, Surrey GU2 7TE</subfield>
    <subfield code="a">Barbara Engel</subfield>
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    <subfield code="u">Queen's Avenue, Dorchester, DT1 2EP, formerly at Yakult UK Limited, Odyssey Business Park, West End Road, South Ruislip HA4 6QQ, UK</subfield>
    <subfield code="a">Linda V. Thomas</subfield>
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    <subfield code="u">Department of Clinical Medicine and Ageing, University of Surrey, Guildford, Surrey GU2 7XH, UK.</subfield>
    <subfield code="a">Paul Grob</subfield>
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    <subfield code="u">Expert Nutrition Works, Whimple, Exeter, EX5 2PP</subfield>
    <subfield code="a">Michelle Dobrota Gibbs</subfield>
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    <subfield code="u">Department of Mathematics, University of Surrey, Guildford, Surrey GU2 7XH, UK.</subfield>
    <subfield code="a">Peter Williams</subfield>
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    <subfield code="u">Nutrition and Dietetic Service (Cambridge and Peterborough NHS Foundation Trust), First Floor, Sackville House, Sackville Way, Cambourne, Cambridgeshire, CB23 6HL</subfield>
    <subfield code="a">Tamara Fenton</subfield>
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    <subfield code="u">Department of Clinical Medicine and Ageing, University of Surrey, Guildford, Surrey GU2 7XH, UK.</subfield>
    <subfield code="a">Simon de Lusignan</subfield>
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    <subfield code="a">Impact of a Daily Probiotic (Lactobacillus casei Shirota) for 12 Months on the Frequency of Diverticulitis Episodes: Feasibility Study in Primary Care.</subfield>
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    <subfield code="a">&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt;Some small secondary care studies have shown benefits from taking probiotics in diverticular disease. We investigated the feasibility of conducting a year-long probiotic study in primary care.&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt;Patients (n=21) with a past history of uncomplicated acute diverticulitis but not currently taking antibiotics were recruited from four general practices. Subjects were asked to take the daily probiotic drink Yakult&amp;Ograve;. Probiotic effects were assessed by comparing clinically diagnosed diverticulitis attacks in the 6 months prior to probiotic intervention with the 0-6 and 6-12 month periods after probiotic intervention commenced. Effects on gastrointestinal symptoms were assessed by validated questionnaires at baseline, 6 and 12 months. Diet diaries were also completed.&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Two thirds (14/21) of subjects who demonstrated good adherence in taking the daily probiotic improved symptomatically (p=0.025). Clinical presentations with diverticulitis were down 50% during the study period compared with the 12 months period before (7 vs 14 cases; p=0.021). The mean change in gastrointestinal symptom score improved significantly (p &amp;lt;0.001). Diverticulitis episodes did not correlate with body mass index (BMI), diabetic status or dietary fibre.&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Taking the daily probiotic was associated with a lower rate of clinical presentation with diverticulitis episodes and improvement in gastrointestinal symptoms. Sufficient information is presented to design a definitive trial. However, we recommend inclusion of a method to validate the diagnosis of diverticulitis. It is feasible to recruit and run a study that requires participants to take a daily probiotic drink for a year in a primary care setting.&lt;/p&gt;

&lt;p&gt;LACTOPRoD was registered at ClinicalTrials.gov:&amp;nbsp;NCT01609751 in 2012.&lt;/p&gt;</subfield>
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