Lactobacillus reuteri and Diverticulitis: Evidence Overview

Lactobacillus reuteri is a probiotic strain that has been studied for its potential benefits in various gastrointestinal disorders, including diverticular disease. The rationale for its use in diverticulitis is based on its ability to modulate the gut microbiota, enhance the intestinal barrier, and exert anti-inflammatory effects. Several small clinical studies and reviews have explored probiotics' role—often as adjuncts to standard therapy—in reducing inflammation, preventing recurrence, and alleviating symptoms such as bloating and pain in patients with diverticular disease.

Specifically, L. reuteri has demonstrated anti-inflammatory properties in laboratory and animal models, and its use in human trials has shown benefit in other gastrointestinal conditions, such as irritable bowel syndrome. However, evidence directly linking L. reuteri supplementation to improved outcomes in acute diverticulitis is limited. Some studies suggest that probiotics, in general, may help reduce symptoms or prevent recurrence when used in chronic or uncomplicated diverticular disease, but these studies are often small, heterogeneous, and include mixed probiotic strains.

Major gastroenterology guidelines do not yet endorse probiotics, including L. reuteri, as a standard treatment for diverticulitis due to insufficient high-quality, large-scale clinical trials. As such, while there is a scientific rationale and some preliminary evidence for using L. reuteri, the overall quality and quantity of supporting data remain modest.