In a paper in the September issue of Gut, researchers from the Division of Gastroenterology at the Azienda Ospedaliera S Camillo-Forlanini in Rome, Italy, have investigated the use of probiotic administration in the treatment of Crohn's disease.
Previous experimental studies have suggested a possible role for luminal bacteria in Crohn's disease, and so Dr C. Prantera and colleagues hypothesized that probiotics might be an alternative to antibiotics.
Dr Prantera and his fellow researchers therefore conducted a randomized, placebo-controlled study to determine if Lactobacillus GG, given by mouth for 1 year, could prevent Crohn's recurrent lesions after surgery, or could reduce the severity of such lesions.
Patients operated on for Crohn's disease, in whom all of the diseased gut had been removed, were randomly allocated to receive 12 billion colony-forming units of Lactobacillus or identical placebo for 1 year.
| Endoscopic recurrence;|
- patients receiving Lactobacillus, 60%
- patients receiving placebo, 35%
| Gut |
Ileocolonoscopy was performed at the end of the trial or at the onset of symptoms.
Endoscopic recurrence was defined as grade 2 or higher, according to Rutgeerts scoring system.
A total of 8 of the 45 patients were excluded from the trial for reasons of non-compliance (n = 3) or due to protocol violations (n = 5).
Clinical recurrence was ascertained in 3 (16.6%) patients who received Lactobacillus and in 2 (10.5%) who received placebo.
Of the 15 patients in clinical remission and on Lactobacillus, 9 (60%) had endoscopic recurrence. This compared with 6 of 17 (35%) on placebo.
The researchers found no significant differences in the severity of the lesions between the 2 groups.
They conclude that Lactobacillus GG seems neither to prevent endoscopic recurrence at 1 year, nor reduce the severity of recurrent lesions.