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Volume 20, Issue 1
  • ISSN: 1574-8871
  • E-ISSN: 1876-1038

Abstract

Background

Microbial imbalance is thought to play a role in the pathogenesis of Diverticular Disease (DD).

Objective

We aimed to assess the efficacy of a symbiotic mixture () in the treatment of moderate to severe DD, scored according to the Diverticular Inflammation and Complication Assessment (DICA) classification.

Methods

A retrospective study was conducted enrolling the following patients: at the first diagnosis of DD; in whom DD was diagnosed with colonoscopy and scored according to DICA classification; treated with two times/daily for 2 consecutive months; in whom the severity of the abdominal pain was scored with a 10-points visual-analogue scale (VAS) at baseline and the end of follow-up; in whom fecal calprotectin (FC) was assessed at baseline and the end of follow-up as µg/g.

Results

Twenty-four patients were identified (10 males, 14 females; 16 as DICA 2, and 8 as DICA 3). decreased the severity of abdominal pain both in DICA 2 ( =0.02) and DICA 3 patients ( =0.01), while FC decreased significantly in DICA 2 ( <0.02) but not in DICA 3 ( =0.123) patients. Acute diverticulitis occurred during the follow-up in two DICA 3 patients but none DICA 2 patients. Add-on therapy was required by eight DICA 2 (50%) and six DICA 3 patients (75%).

Conclusion

In newly diagnosed patients with DD, the symbiotic mixture can be a potential treatment for moderate (DICA 2) DD as a single treatment.

© 2025 Bentham Science Publishers
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2024-07-24
2025-04-24

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References

  1. GiorgettiG. BrandimarteG. FabiocchiF. RicciS. FlaminiP. SandriG. TrottaM.C. EliseiW. PennaA. LeccaP.G. PicchioM. TursiA. Interactions between innate immunity, microbiota, and probiotics.J. Immunol. Res.201520151710.1155/2015/50136126090492
     [Google Scholar]
  2. MiyauchiE. ShimokawaC. SteimleA. DesaiM.S. OhnoH. The impact of the gut microbiome on extra-intestinal autoimmune diseases.Nat. Rev. Immunol.202323192310.1038/s41577‑022‑00727‑y35534624
     [Google Scholar]
  3. AlemanR.S. MoncadaM. AryanaK.J. Leaky gut and the ingredients that help treat it: A review.Molecules202328261910.3390/molecules2802061936677677
     [Google Scholar]
  4. Al BanderZ. NitertM.D. MousaA. NaderpoorN. The gut microbiota and inflammation: An overview.Int. J. Environ. Res. Public Health20201720761810.3390/ijerph1720761833086688
     [Google Scholar]
  5. TursiA. ScarpignatoC. StrateL.L. LanasA. KruisW. LahatA. DaneseS. Colonic diverticular disease.Nat. Rev. Dis. Primers2020612010.1038/s41572‑020‑0153‑532218442
     [Google Scholar]
  6. KvasnovskyC.L. BjarnasonI. DonaldsonA.N. SherwoodR.A. PapagrigoriadisS. A randomized double-blind placebo-controlled trial of a multi-strain probiotic in treatment of symptomatic uncomplicated diverticular disease.Inflammopharmacology201725549950910.1007/s10787‑017‑0363‑y28528364
     [Google Scholar]
  7. TursiA. BrandimarteG. EliseiW. PicchioM. FortiG. PianeseG. RodinòS. D’AmicoT. SaccàN. PortincasaP. CapezzutoE. LattanzioR. SpadacciniA. FiorellaS. PolimeniF. PolimeniN. StoppinoV. StoppinoG. GiorgettiG.M. AielloF. DaneseS. Randomised clinical trial: Mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease - a double-blind, randomised, placebo-controlled study.Aliment. Pharmacol. Ther.201338774175110.1111/apt.1246323957734
     [Google Scholar]
  8. PetruzzielloC. MignecoA. CardoneS. CovinoM. SavianoA. FranceschiF. OjettiV. Supplementation with Lactobacillus reuteri ATCC PTA 4659 in patients affected by acute uncomplicated diverticulitis: A randomized double-blind placebo controlled trial.Int. J. Colorectal Dis.20193461087109410.1007/s00384‑019‑03295‑131011868
     [Google Scholar]
  9. OjettiV. SavianoA. BrigidaM. PetruzzielloC. CaronnaM. GayaniG. FranceschiF. Randomized control trial on the efficacy of Limosilactobacillus reuteri ATCC PTA 4659 in reducing inflammatory markers in acute uncomplicated diverticulitis.Eur. J. Gastroenterol. Hepatol.202234549650210.1097/MEG.000000000000234235045564
     [Google Scholar]
  10. TursiA. BrandimarteG. EliseiW. GiorgettiG.M. InchingoloC.D. DaneseS. AielloF. Assessment and grading of mucosal inflammation in colonic diverticular disease.J. Clin. Gastroenterol.200842669970310.1097/MCG.0b013e3180653ca218347509
     [Google Scholar]
  11. D’AmicoF. FioriniG. TursiA. SaracinoI.M. PavoniM. DaneseS. VairaD. Efficacy of a new nutraceutical formulation in patients with Symptomatic Uncomplicated Diverticular Disease (SUDD): A prospective observational study.J. Gastrointestin. Liver Dis.202028Suppl. 4495210.15403/jgld‑56031930222
     [Google Scholar]
  12. BrandimarteG. FrajeseG.V. BargiggiaS. CastellaniD. CoccoA. ColucciR. EvangelistaE. GravinaA.G. NapoletanoD. NardiE. MaistoT. MorabitoA. PianeseG. RomanoA. SaccoR. SediariL. SinnonaN. TifiL. D’AvinoA. EliseiW. TursiA. Performance of a multicompounds nutraceutical formulation in patients with symptomatic uncomplicated diverticular disease.Minerva Gastroenterol.202268221622210.23736/S2724‑5985.22.03132‑135262307
     [Google Scholar]
  13. KrokowiczL. StojcevZ. KaczmarekB.F. KociembaW. KaczmarekE. WalkowiakJ. KrokowiczP. DrewsM. BanasiewiczT. Microencapsulated sodium butyrate administered to patients with diverticulosis decreases incidence of diverticulitis—a prospective randomized study.Int. J. Colorectal Dis.201429338739310.1007/s00384‑013‑1807‑524343275
     [Google Scholar]
  14. PagniniC. Di PaoloM.C. UrgesiR. PallottaL. FanelloG. GrazianiM.G. Delle FaveG. Safety and potential role of Lactobacillus rhamnosus GG administration as monotherapy in ulcerative colitis patients with mild–moderate clinical activity.Microorganisms2023116138110.3390/microorganisms1106138137374884
     [Google Scholar]
  15. KianiA.K. BonettiG. DonatoK. BertelliM. Dietary supplements for intestinal inflammation.J. Prev. Med. Hyg.2022632Suppl. 3E214E22036479492
     [Google Scholar]
  16. TursiA. BrandimarteG. Di MarioF. AndreoliA. AnnunziataM.L. AstegianoM. BiancoM.A. BuriL. CammarotaG. CapezzutoE. ChiloviF. CianciM. ConigliaroR. Del FaveroG. Di CesareL. Di FonzoM. EliseiW. FaggianiR. FarroniF. FortiG. GermanàB. GiorgettiG.M. GiovannoneM. LeccaP.G. LoperfidoS. MarmoR. MorucciP. OcchigrossiG. PennaA. RossiA.F. SpadacciniA. ZampalettaC. ZilliM. ZulloA. ScarpignatoC. PicchioM. Development and validation of an endoscopic classification of diverticular disease of the colon: The DICA classification.Dig. Dis.2015331687610.1159/00036603925531499
     [Google Scholar]
  17. TursiA. BrandimarteG. Di MarioF. EliseiW. PicchioM. AllegrettaL. AnnunziataM.L. BafuttoM. BassottiG. BiancoM.A. ColucciR. ConigliaroR. DumitrascuD. EscalanteR. FerriniL. FortiG. FranceschiM. GrazianiM.G. LammertF. LatellaG. MaconiG. NardoneG. Camara de Castro OliveiraL. Chaves OliveiraE. PapaA. PapagrigoriadisS. PietrzakA. PontoneS. PoskusT. PranzoG. ReichertM.C. RodinòS. RegulaJ. ScaccianoceG. ScaldaferriF. VassalloR. ZampalettaC. ZulloA. PiovaniD. BonovasS. DaneseS. Prognostic performance of the ‘DICA’ endoscopic classification and the ‘CODA’ score in predicting clinical outcomes of diverticular disease: An international, multicentre, prospective cohort study.Gut20227171350135810.1136/gutjnl‑2021‑32557434702716
     [Google Scholar]
  18. TursiA. BrandimarteG. EliseiW. GiorgettiG.M. InchingoloC.D. AielloF. Faecal calprotectin in colonic diverticular disease: A case–control study.Int. J. Colorectal Dis.2009241495510.1007/s00384‑008‑0595‑918941760
     [Google Scholar]
  19. TursiA. PiovaniD. BrandimarteG. Di MarioF. EliseiW. PicchioM. AllegrettaL. AnnunziataM.L. BafuttoM. BassottiG. BiancoM.A. ColucciR. ConigliaroR. DumitrascuD.L. EscalanteR. FerriniL. FortiG. FranceschiM. GrazianiM.G. LammertF. LatellaG. MaconiG. CompareD. NardoneG. Camara De Castro OliveiraL. OliveiraE.C. PapaA. PapagrigoriadisS. PietrzakA. PontoneS. PoskusT. PranzoG. ReichertM.C. RodinòS. RegulaJ. ScaccianoceG. ScaldaferriF. VassalloR. ZampalettaC. ZulloA. SpazianiE. BonovasS. DaneseS. Diverticular inflammation and complication assessment classification, CODA score and fecal calprotectin in clinical assessment of patients with diverticular disease: A decision curve analysis.United European Gastroenterol. J.202311764265310.1002/ueg2.1236937550901
     [Google Scholar]
  20. TursiA. Diverticulosis today: Unfashionable and still under-researched.Therap. Adv. Gastroenterol.20169221322810.1177/1756283X1562122826929783
     [Google Scholar]
  21. TursiA. FranceschiM. EliseiW. PicchioM. MarioF.D. BrandimarteG. The natural history of symptomatic uncomplicated diverticular disease: A long-term follow-up study.Ann. Gastroenterol.202134220821333654361
     [Google Scholar]
  22. JonoT. KasaiY. KessokuT. OgataT. TanakaK. YoshiharaT. MisawaN. KatoS. HigurashiT. HosonoK. YonedaM. SeitaK. KatoT. SakaiE. KurihashiT. NakatogawaM. OyamadaS. FutagamiS. GweeK.A. NakajimaA. The prevalence and characteristics of symptomatic uncomplicated diverticular disease among asian patients with unexplained abdominal symptoms.J. Neurogastroenterol. Motil.2024301879610.5056/jnm2216238012092
     [Google Scholar]
  23. CameronR. WalkerM.M. ThuressonM. RoelstraeteB. SköldbergF. OlénO. TalleyN.J. LudvigssonJ.F. Mortality risk increased in colonic diverticular disease: A nationwide cohort study.Ann. Epidemiol.202276394910.1016/j.annepidem.2022.10.00636252891
     [Google Scholar]
  24. TursiA. PapaV. LopetusoL.R. SettanniC.R. GasbarriniA. PapaA. Microbiota composition in diverticular disease: Implications for therapy.Int. J. Mol. Sci.202223231479910.3390/ijms23231479936499127
     [Google Scholar]
  25. CapursoL. Thirty years of Lactobacillus Rhamnosus GG: A Review.J. Clin. Gastroenterol.201953Suppl. 1S1S4110.1097/MCG.000000000000117030741841
     [Google Scholar]
  26. LiY. YaoJ. HanC. YangJ. ChaudhryM. WangS. LiuH. YinY. Quercetin, inflammation and immunity.Nutrients20168316710.3390/nu803016726999194
     [Google Scholar]
  27. HartmannR.M. FillmannH.S. Morgan MartinsM.I. MeurerL. MarroniN.P. Boswellia serrata has beneficial anti-inflammatory and antioxidant properties in a model of experimental colitis.Phytother. Res.20142891392139810.1002/ptr.514224619538
     [Google Scholar]
  28. GaoJ. XuK. LiuH. LiuG. BaiM. PengC. LiT. YinY. Impact of the gut microbiota on intestinal immunity mediated by tryptophan metabolism.Front. Cell. Infect. Microbiol.201881310.3389/fcimb.2018.0001329468141
     [Google Scholar]
  29. YuR. YinY. CaoM. YeD. ZhangY. ZhouQ. MeiY. Fructo-oligosaccharides lower serum lipid levels and suppress high-fat/high-sugar diet-induced inflammation by elevating serum and gut levels of short-chain fatty acids.J. Int. Med. Res.202048410.1177/030006051989671431891285
     [Google Scholar]
  30. AvanA. Ghayour-MobarhanM. TabatabaeizadehS-A. TafazoliN. FernsG.A. Vitamin D, the gut microbiome and inflammatory bowel disease.J. Res. Med. Sci.20182317510.4103/jrms.JRMS_606_1730181757
     [Google Scholar]
  31. TursiA. EliseiW. PicchioM. Di MarioF. BrandimarteG. Serum levels of vitamin D are associated with the severity of the endoscopic appearance of diverticular disease of the colon according to DICA classification.J. Gastrointestin. Liver Dis.201625456556810.15403/jgld.2014.1121.254.vid27981318
     [Google Scholar]
  32. LaghiL. MastromarinoP. EliseiW. CapobiancoD. ZhuC.L. PicchioM. GiorgettiG. BrandimarteG. TursiA. Impact of treatments on fecal microbiota and fecal metabolome in symptomatic uncomplicated diverticular disease of the colon: A pilot study.J. Biol. Regul. Homeost. Agents20183251421143230574746
     [Google Scholar]
  33. TursiA. BrandimarteG. Di MarioF. AnnunziataM.L. BafuttoM. BiancoM.A. ColucciR. ConigliaroR. DaneseS. De BastianiR. EliseiW. EscalanteR. FaggianiR. FerriniL. FortiG. LatellaG. GrazianiM.G. OliveiraE.C. PapaA. PennaA. PortincasaP. SøreideK. SpadacciniA. UsaiP. BonovasS. ScarpignatoC. PicchioM. LeccaP.G. ZampalettaC. CassieriC. DamianiA. DesserudK.F. FiorellaS. LandiR. GoniE. LaiM.A. PigòF. RotondanoG. SchiaccianoceG. Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study.United European Gastroenterol. J.20164460461310.1177/205064061561763627536372
     [Google Scholar]
  34. TursiA. BrandimarteG. PapaA. GiglioA. EliseiW. GiorgettiG.M. FortiG. MoriniS. HassanC. PistoiaM.A. ModeoM.E. Rodino’S. D’AmicoT. SebkovaL. Sacca’N. Di GiulioE. LuzzaF. ImeneoM. LarussaT. Di RosaS. AnneseV. DaneseS. GasbarriniA. Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment: A double-blind, randomized, placebo-controlled study.Am. J. Gastroenterol.2010105102218222710.1038/ajg.2010.21820517305
     [Google Scholar]
  35. ZoccoM.A. Dal VermeL.Z. CremoniniF. PiscagliaA.C. NistaE.C. CandelliM. NoviM. RiganteD. CazzatoI.A. OjettiV. ArmuzziA. GasbarriniG. GasbarriniA. Efficacy of Lactobacillus GG in maintaining remission of ulcerative colitis.Aliment. Pharmacol. Ther.200623111567157410.1111/j.1365‑2036.2006.02927.x16696804
     [Google Scholar]
  36. TursiA. EliseiW. InchingoloC.D. NennaR. PicchioM. IerardiE. BrandimarteG. Chronic diverticulitis and Crohn’s disease share the same expression of basic fibroblastic growth factor, syndecan 1 and tumour necrosis factor-α.J. Clin. Pathol.201467984484610.1136/jclinpath‑2013‑20213724970903
     [Google Scholar]
  37. LimketkaiB.N. AkobengA.K. GordonM. AdepojuA.A. Probiotics for induction of remission in Crohn’s disease.Cochrane Database Syst. Rev.202077CD00663432678465
     [Google Scholar]
  38. WachholzP.A. NunesV.S. Polachini do ValleA. JacintoA.F. Villas-BoasP.J.F. Effectiveness of probiotics on the occurrence of infections in older people: Systematic review and meta-analysis.Age Ageing201847452753610.1093/ageing/afy00629415116
     [Google Scholar]
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Impact of a Symbiotic Mixture on Moderate-to-severe Diverticular Disease of the Colon
Rev. Recent Clin. Trials 20, 27 (2025); https://doi.org/10.2174/0115748871308652240712101604
/content/journals/rrct/10.2174/0115748871308652240712101604
/content/journals/rrct/10.2174/0115748871308652240712101604
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  • Article Type:     Research Article
Keyword(s): acute diverticulitis; clinical outcome; DICA classification; Diverticular disease; fecal calprotectin; symbiotic mixture

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