title: Failure of Synbiotic 2000 to prevent postoperative recurrence of Crohn's disease.
abstract: Complications of Crohn's disease (CD) lead to surgery in about 70-90% of patients. The majority of patients suffer from relapse of the disease. Colonic bacteria are essential to the development of CD. Therefore, a rationale exists in trying to prevent relapse by manipulation of gut microflora. This is feasible by treatment with probiotics or antibiotics. Synbiotic 2000 is a cocktail containing 4 probiotic species and 4 prebiotics. It is rational to pursue that it could be effective in preventing postoperative disease. We sought to check weather treatment with Synbiotic 2000 could prevent postoperative recurrence in patients with CD. This was a prospective multicenter, randomized study. Patients were randomized to active treatment or placebo in a 2:1 ratio. Follow-up consisted of endoscopic, clinical, and laboratory parameters. Thirty patients were enrolled. No differences were found between the 2 treatment groups regarding gender, age at diagnosis, age at surgery, weight, smoking status, type of disease, length of the resected segment, or medical treatment prior to surgery. No difference in either endoscopic or clinical relapse rate was found between patients treated with once daily dose of Synbiotic 2000 or placebo. In our small study, Synbiotic 2000 had no effect on postoperative recurrence of patients with CD. Larger studies in patients with the inflammatory type of CD undergoing surgery, using higher doses of probiotics cocktail might prove effective.
authors.affiliation: Gastroenterology Department, Rambam Health Care Campus, Haifa, Israel. I_chermesh@rambam.health.gov.il
authors.forename: Irit
authors.initials: I
authors.lastname: Chermesh
authors.forename: Ada
authors.initials: A
authors.lastname: Tamir
authors.forename: Ron
authors.initials: R
authors.lastname: Reshef
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Chowers
authors.forename: Alain
authors.initials: A
authors.lastname: Suissa
authors.forename: Dalia
authors.initials: D
authors.lastname: Katz
authors.forename: Moshe
authors.initials: M
authors.lastname: Gelber
authors.forename: Zamir
authors.initials: Z
authors.lastname: Halpern
authors.forename: Stig
authors.initials: S
authors.lastname: Bengmark
authors.forename: Rami
authors.initials: R
authors.lastname: Eliakim
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy* / Q000601:surgery*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D055502:Secondary Prevention; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D004338:Drug Combinations