Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Lactobacillus, a genus of probiotic bacteria, has some scientific rationale for its use in patients with diverticular disease, particularly in the prevention of symptomatic recurrences and management of symptoms, rather than in acute diverticulitis. Several small clinical trials and systematic reviews have examined the role of probiotics, including Lactobacillus strains, in diverticular disease. Some studies suggest that probiotics may help modulate gut flora, reduce inflammation, and alleviate symptoms such as bloating and abdominal discomfort in patients with uncomplicated diverticular disease. However, the evidence is limited by small sample sizes, heterogeneity in probiotic strains and dosages, and varying study endpoints.

There is currently insufficient high-quality evidence to support the use of Lactobacillus probiotics as a standalone treatment for acute diverticulitis. Most clinical guidelines do not recommend probiotics as a primary therapy for the acute phase but acknowledge that they may have a role in chronic management or prevention of recurrence. A 2022 Cochrane review and several meta-analyses note that while probiotics appear safe, their benefit for diverticular disease outcomes remains uncertain, and more robust, large-scale randomized controlled trials are needed.

In summary, the use of Lactobacillus in diverticular disease is supported by preliminary scientific data, but the quality of evidence is low, and its clinical efficacy remains unproven for acute diverticulitis. Its use is best considered as adjunctive in select patients, not as a standard therapy.

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