これまで、過敏性腸症候群と大腸憩室がリンクしていることが報告されている。

 

さらに、大腸憩室症に対して、乳酸菌飲料などのプロバイオティクス効果について、有効とされている論文を検証した結果、有効であると結論できないという研究結果が報告されている。

 

（PubMedより）
 

J Gastrointestin Liver Dis. 2016 Mar;25(1):79-86. doi: 10.15403/jgld.2014.1121.251.srw.

Probiotics in the Treatment of Diverticular Disease. A Systematic Review.

Lahner E1, Bellisario C2, Hassan C3, Zullo A3, Esposito G1, Annibale B4.

Author information

·         1Dipartimento Medico-Chirurgico di Scienze Cliniche e Medicina Traslazionale, Sant'Andrea Hospital, School of Medicine, University Sapienza, Rome,Italy.

·         2Department of Cancer Screening, Centre for Epidemiology and Prevention in Oncology (CPO), University Hospital Città della Salute e della Scienza di Torino, Turin, Italy.

·         3Digestive Endoscopy Unit, Ospedale Nuovo Regina Margherita, Rome, Italy.

·         4Dipartimento Medico-Chirurgico di Scienze Cliniche e Medicina Traslazionale, Sant'Andrea Hospital, School of Medicine, University Sapienza, Rome, Italy. bruno.annibale@uniroma1.it.

Abstract

BACKGROUND AND AIMS:

Diverticular disease is a common gastrointestinal condition. Low-grade inflammation and altered intestinal microbiota have been identified as factors contributing to abdominal symptoms. Probiotics may lead to symptoms improvement by modifying the gut microbiota and are promising treatments for diverticular disease. The aim of this study was to systematically review the efficacy of probiotics in diverticular disease in terms of remission of abdominal symptoms and prevention of acute diverticulitis.

METHODS:

According to PRISMA, we identified studies on diverticular disease patients treated with probiotics (Pubmed, Embase, Cochrane). The quality of these studies was evaluated by the Jadad scale. Main outcomes measures were remission of abdominal symptoms and prevention of acute diverticulitis.

RESULTS:

11 studies (2 double-blind randomized placebo-controlled, 5 open randomized, 4 non-randomized open studies) were eligible. Overall, diverticular disease patients were 764 (55.1% females, age 58-75 years). Three studies included patients with symptomatic uncomplicated diverticular disease, 4 studies with symptomatic uncomplicated diverticular disease in remission, 4 studies with complicated or acute diverticulitis. Mainly (72.7%) single probiotic strains had been used, most frequently Lactobacilli. Follow-up ranged from 1 to 24 months. Interventions were variable: in 8 studies the probiotic was administered together with antibiotic or anti-inflammatory agents and compared with the efficacy of the drug alone; in 3 studies the probiotic was compared with a high-fibre diet or used together with phytoextracts. As an outcome measure, 4 studies evaluated the occurrence rate of acute diverticulitis, 6 studies the reduction of abdominal symptoms, and 6 studies the recurrence of abdominal symptoms. Meta-analysis on the efficacy of probiotics in diverticular disease could not be performed due to the poor quality of retrieved studies.

CONCLUSION:

This systematic review showed that high-quality data on the efficacy of probiotics in diverticular disease are scant: the available data do not permit conclusions. Further investigation is required to understand how probiotics can be employed in this condition.

 

 また、これまで、便秘と大腸憩室が関係しているとされてきたが、無関係であるという報告が発表された。

 

Int J Surg. 2015 Jul;19:42-5. doi: 10.1016/j.ijsu.2015.04.045. Epub 2015 May 15.

Constipation is not associated with diverticular disease - Analysis of 976 patients.

Braunschmid T1, Stift A1, Mittlböck M2, Lord A3, Weiser FA4, Riss S5.

Author information

·         1Medical University of Vienna, Department of Surgery, Austria.

·         2Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Austria.

·         3Southampton University Hospital, UK.

·         4Endoscopic Center, Anton-Baumgartner-Straße 44, 1230 Vienna, Austria.

·         5Medical University of Vienna, Department of Surgery, Austria. Electronic address: stefan.riss@meduniwien.ac.at.

Abstract

BACKGROUND:

In the light of controversial data in the literature, the present study was designed to evaluate potential associations between colonic diverticular disease, constipation and quality of life.

DESIGN:

We prospectively enrolled 976 consecutive patients, who participated in the nationwide colorectal cancer screening program in four medical centers between 2008 and 2009. All patients underwent full colonoscopy and completed a standardized questionnaire. The severity of constipation was assessed by the validated Wexner constipation score. Quality of Life (QOL) was evaluated by the SF-12 health score.

RESULTS:

The median age was 62 years (range 22-90) and the male to female ratio was 1:1. Colonic diverticular disease was found in 290 participants (30%). Age, body mass index and diabetes mellitus were significantly associated with the presence of diverticular disease (p < 0.0001, p = 0.0007 and p = 0.0178). The median constipation score in patients with diverticular disease was 3 (range 0-18), and comparable to patients without diverticula (p = 0.1073). The physical component summary of the SF-12 was significantly reduced in patients with diverticular disease (p = 0.0038).

CONCLUSION:

This large population based study revealed no association between colonic diverticular disease and constipation. Notably, the presence of diverticular disease significantly impacts quality of life.


 以上から、大腸憩室は、

便秘と関係なく、過敏性腸症候群と関係していて、

プロバイオティクスの効果は期待できないようである。