Probiotics and severe acute pancreatitis.
Acute pancreatitis (AP) is an acute inflammatory process ranging from mild forms to severe disease with high rates of mortality. In this disease, enteral nutrition helps in maintaining the integrity of the gut barrier, with consequent decreased bacterial translocation, a key factor in limiting the complications in severe AP. Modulation of the intestinal flora through the administration of probiotics (PBs) has thus an intriguing rationale as possible treatment option. Their role in this setting has been investigated both in animal models and clinical trials in the last few years; however, their use has never been recommended or even cited by existing guidelines. We analyzed the literature in search of the existing data from human and animal models studies evaluating the effect of PB administration in AP to highlight existing evidence. An interesting scenario emerges from the the papers that have been evaluated. The adjunct of PBs in the treatment of AP may show some advantage in terms of the reduction of infectious complications. Nevertheless, more data on efficacy and safety from a larger and stringently designed study are eagerly waited.
Capurso
Gabriele
G
Digestive and Liver Disease Unit, II Medical School, University La Sapienza, Rome, Italy.
Marignani
Massimo
M
Piciucchi
Matteo
M
Merola
Elettra
E
Delle Fave
Gianfranco
G
D000208:Acute Disease; D000818:Animals; D004195:Disease Models, Animal; D006801:Humans; D010195:Pancreatitis / Q000150:complications / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome