Synbiotic Supplementation in Patients with Symptomatic Uncomplicated Diverticular Disease (SUDD): A Single-Centre, Double-Blind, Randomised, Placebo-Controlled Trial

Abstract Symptomatic uncomplicated diverticular disease (SUDD) is characterized by recurrent lower gastrointestinal (GI) symptoms in patients with colonic diverticula. Different treatments have been suggested but supporting evidence is limited. We aimed to assess the effectiveness of a synbiotic formulation combined with a high-fibre diet (HFD) for improving GI symptoms in patients with SUDD, compared with a HFD plus placebo. We conducted a single-centre, randomized, double-blind, placebo-controlled trial. Patients diagnosed with SUDD were included. After run-in, all participants completed structured questionnaires, received dietary counselling, and were randomly assigned to either: (I) Placebo plus HFD (Arm A), or (II) Enterolactis duo (Lacticaseibacillus paracasei DG plus inulin), plus HFD (Arm B) for 12 weeks. During treatment, participants filled in a weekly diary of GI symptoms and bowel habits. Patients were followed up 4 weeks after treatment. Overall, thirty-four patients (55.9% female; mean age 64±8.6 years) were randomly assigned to Arms A and B (n=17 each). At baseline, there were no significant differences between the two groups. After treatment, GI symptoms significantly improved in both groups, with no differences between them. There were no significant changes in quality-of-life scores compared to baseline. Follow-up at 4 weeks showed no significant changes in GI symptoms in either group. The synbiotic supplementation evaluated in this study was not superior to placebo in alleviating symptoms of patients with SUDD.

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