Evidence supporting the use of: Lactobacillus casei
For the health condition: Diverticulitis

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Synopsis

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

Lactobacillus casei is a probiotic bacterium commonly found in the human gut and in fermented foods. Its use in diverticulitis is mainly based on its general benefits for gut health, such as modulating intestinal microbiota, enhancing the mucosal barrier, and reducing inflammation. Scientifically, there is some evidence suggesting that probiotics, including L. casei, might help in maintaining remission and preventing recurrence of diverticulitis, but the data is limited and not robust.

Several small clinical trials and observational studies have explored the use of probiotics for diverticular disease (a spectrum that includes diverticulosis and symptomatic uncomplicated diverticular disease), but specific studies focusing on acute diverticulitis are rare. For example, a randomized controlled trial published in Alimentary Pharmacology & Therapeutics (2006) tested a combination of probiotics (including L. casei) and found some improvement in symptoms and reduction in inflammation in patients with symptomatic uncomplicated diverticular disease, but not specifically in acute diverticulitis. The mechanism proposed is that L. casei may suppress pathogenic bacteria and modulate immune responses, potentially reducing inflammation and supporting gut barrier function.

However, major clinical guidelines do not currently recommend probiotics as a standard treatment for acute diverticulitis, largely due to insufficient high-quality evidence. Most support is extrapolated from studies on other forms of intestinal inflammation or from the general benefits of probiotics for gut health. Thus, while there is some scientific rationale and early supportive data, the evidence base is weak (rated 2/5), and more rigorous studies are needed.

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