The findings offer further evidence that probiotic bacteria can be effective therapeutic strategy. A recent meeting of probiotic specialists in Canada, organised by Institut Rosell-Lallemand, concluded that the mounting scientific evidence for the therapeutic use of probiotics suggests that these products should be incorporated into conventional medical practices.
In the new study, researchers gave the probiotic preparation VSL#3, marketed by US-based VSL Pharmaceuticals, to 36 patients with recurrent (occurrence at least twice in the previous year) or refractory (requiring continuous use of antibiotics) pouchitis, a post-surgical complication. The patients, who had had their colons removed, received the supplement daily for a year in the double-blind, placebo-controlled study.
VSL#3 is said to be different from other probiotic therapies in that it contains numerous strains of bacteria at high concentrations (450 billion).
It was found to be highly effective in maintaining antibiotic induced remission of pouchitis. Additionally, patients in the study who took VSL#3 reported improved quality of life compared with a marked deterioration in quality of life seen in the patients who received placebo.
Remission was induced in all patients by a four-week course of antibiotics. It was maintained at one year in 17 patients (85 per cent) taking VSL#3 and in only one (6 per cent) patient who received placebo.
"About 5 to 15 percent of patients experience recurrent or refractory pouchitis, which is associated with a severe decline in quality of life for patients," said lead investigator Toshiki Mimura, MD, PhD, Lecturer, School of Medicine, Teikyo University, Japan. "These individuals require continuous doses of antibiotics, which are not without side effects and place them at risk for developing an antibiotic-resistant infection. Some patients do not respond to any treatments and have little choice but to suffer with their symptoms."
The Inflammatory Bowel Disease Questionnaire (IBDQ) was used to assess quality of life examining bowel, systemic and emotional symptoms and social function of patients, with a score of 32 being worst and 224 being best. At the beginning of the study, IBDQ scores were high (190 in the VSL#3 group and 169 in the placebo patients). However, at 12 months or time of relapse, the VSL#3 group score was 205 versus 105 for placebo. Similarly, patient satisfaction scores remained high for the VSL#3 treated group, but deteriorated significantly for the placebo group.
The trial conducted at St. Mark's Hospital in the United Kingdom and a center in Bologna, Italy, is published in this month's issue of Gut.In May, researchers writing in the journal Gastroenterology, reported that VSL#3 is effective in the prevention of pouchitis.