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Mesalazine and/or Lactobacillus casei in maintaining long-term remission of symptomatic uncomplicated diverticular disease of the colon.
Hepatogastroenterology 2008, 55(84):916-20.

BACKGROUND/AIMS:
Four different therapeutic schedules with mesalazine and/or probiotics were assessed in preventing recurrence of symptomatic diverticular disease (DD) of the colon.

METHODOLOGY:
A prospective, dose-finding study was conducted on 75 patients, enrolled in an open fashion: mesalazine 800mg/daily (group M1) or mesalazine 1.6gr 10 days/month (group M2); mesalazine 800mg/daily + Lactobacillus casei DG 16 billion/day for 10 day/ month (group LM1) or mesalazine 1.6gr + Lactobacillus casei DG 16 billion/day for 10 day/ month (group LM2); Lactobacillus casei DG 16 billion/day for 10 day/month (group L).

RESULTS:
Seventy one patients completed the study (94.66%).
Sixty six patients (88%) were symptom-free after the 24th month of treatment: 11 of group M1 (on intention-to-treat (ITT): 84% [CI 95%: 55.5-98.8]), 8 of group M2 (on ITT: 80% [CI 95%: 44.39-97.48]), 15 of group LM1 (on ITT: 93.75% [CI 95%: 69.77-99.84]), 12 of group LM2 (on ITT: 92.30% [CI 95%: 63.97-99.81]), 20 in group L (on ITT: 86.95% [CI 95%: 66.41-97.22]) (p-ns).
Four patients (5.33%) suspended the treatment during the follow-up: all experienced recurrence of symptoms (100%), and 2 of them developed diverticulitis (50%).

CONCLUSIONS:
Mesalazine and/or Lactobacillus casei seem to be effective in maintaining remission of DD for long-time. Moreover, we found recurrence of the disease and complications in all patients suspending treatments.

Authors
Tursi A, Brandimarte G, Giorgetti GM, Elisei W

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