ABSTRACT
PURPOSE: Pouchitis is the major long-term complication after ileal-pouch anal anastomosis for ulcerative colitis. Broad-spectrum antibiotics are the mainstay of treatment in this condition. Recently, we have shown the efficacy of a highly concentrated probiotic preparation (VSL#3, 900 billions/sachet lyophilized viable bacteria) in preventing relapses of chronic pouchitis and in preventing pouchitis onset. This study was designed to evaluate the efficacy of high-dose VSL#3 in the treatment of mildly active pouchitis. METHODS: Twenty-three consecutive patients with mild pouchitis, defined as a score of between 7 and 12 in the Pouchitis Disease Activity Index, which includes clinical, endoscopic, and histological criteria, were treated with VSL#3, 2 sachets b.i.d. (3,600 billion bacteria/day) for four weeks. Symptomatic, endoscopic, and histologic evaluations were undertaken before and after treatment according to Pouchitis Disease Activity Index. Remission was defined as a combination of a Pouchitis Disease Activity Index clinical score of Subject(s)
Bacteroides
, Pouchitis/drug therapy
, Probiotics/administration & dosage
, Adult
, Bacteroides/genetics
, Bacteroides/isolation & purification
, Colonoscopy
, DNA, Bacterial/analysis
, Defecation/physiology
, Dose-Response Relationship, Drug
, Feces/microbiology
, Female
, Humans
, Male
, Polymerase Chain Reaction
, Pouchitis/pathology
, Pouchitis/physiopathology
, Remission Induction/methods
, Severity of Illness Index
, Treatment Outcome