Introduction The emergency treatment for acute diverticulitis is straightforward, but many patients develop post-diverticulitis chronic symptoms which resemble that of Irritable Bowel Syndrome (IBS). We assessed the possible effect of Symprove, a multi strain probiotic, on these symptoms in a randomised double-blind placebo-controlled trial.
Methods This was a single-centre, randomised, double-blind, placebo-controlled trial of the efficacy of the probiotic Symprove in adult patients with post-diverticulitis IBS like symptoms. 143 patients were randomly assigned to receive 1 mL/kg/day of the probiotic (N = 72) or placebo (N = 71) for 3 months. The primary endpoint was a change in abdominal pain. Secondary endpoints included nine abdominal symptoms and changes in faecal calprotectin.
Results 120 patients completed the trial. Pain score with the probiotic decreased from 9.5±7.7 to 5.9±6.7, which did not differ significantly (P = 0.12) with that of placebo (7.5±7.0 to 6.1±6.4).
The probiotic improved constipation, diarrhoea, mucorrhoea, back pain and vaginal discharge significantly (p < 0.04) above that of placebo, but not abdominal pain, PR bleeding, dysuria or bloating. Symprove prevented an increase in intestinal inflammation in male patients (p = 0.05)
Conclusion The probiotic Symprove did not improve abdominal pain scores significantly, but significantly improved some other post-diverticulitis symptoms and prevented an escalation in intestinal inflammatory activity in male patients.
Disclosure of Interest C. Kvasnovsky: None Declared, A. Donaldson: None Declared, R. Sherwood: None Declared, I. Bjarnason Grant/research support from: Received financial support for a SpR for a PhD student (Charlotte), S. Papagrigordiasis Grant/research support from: Recipent of a grant from Symprove for a PhD studentship (Charlotte)
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