Lactobacillus Paracasei CNCM I 1572 is Better than Placebo in Preventing Acute Diverticulitis Occurrence (Revised Manuscript 661a120f-b910-4133-ab7e-4bd3e1713c96)

Data analysing the impact of probiotics in preventing the occurrence of acute diverticulitis (AD) in patients having symptomatic uncomplicated diverticular disease (SUDD) of the colon are still scarce. We assessed the effectiveness of Lactobacillus paracasei CNCM I 1572 in preventing the first episode of AD in patients with SUDD. A post-hoc analysis of a 12-month, multicentre, double-blind, placebo-controlled study was conducted. One hundred and five patients were randomly enrolled in a double-blind fashion into Group L (Lactobacillus paracasei CNCM I 1572, 24 billion CFU/day) and Group P (placebo). Patients received treatment for 10 days per month for 12 months. The occurrence of AD was defined according to radiological criteria from abdominal computerised tomography. AD occurred in 7 of the analysed patients during follow-up: 6 patients were in group P and one patient in group L (p = 0.036). AD was uncomplicated in 6 out of 7 patients, while one patient receiving placebo underwent surgery due to free perforation. During the follow-up, mild adverse events (7.27% in group L and 9.0% in group P, p = 0.90) were recorded and did not necessitate treatment discontinuation. Lactobacillus paracasei CNCM I 1572 appears to be more effective than placebo in preventing the first episode of AD in SUDD patients. It could therefore be a real chance for the prevention of this diverticular disease complication. We need more data from prospective placebo-controlled trials enrolling a large population of patients to confirm this finding.