title: Assessment of Mucosal Inflammation and Circulation in Response to Probiotics in Patients Operated with Ileal Pouch Anal Anastomosis for Ulcerative Colitis.
abstract: BACKGROUND
  Pouchitis is a common and troublesome condition, and a disturbed microbiological flora and mucosal blood flow in the pouch have been suggested as possible causes. Laser Doppler flowmetry (LDF) has been used successfully to measure gastric and colonic mucosal perfusion in humans. The aim of this study was to evaluate the effect of intervention with probiotics on ileal pouch inflammation and perfusion in the pouch, assessed by endoscopy, histology, fecal calprotectin and LDF.
  
  
  METHODS
  A fermented milk product (Cultura; 500 ml) containing live lactobacilli (La-5) and bifidobacteria (Bb-12) was given daily for 4 weeks to 10 patients operated with ileal-pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). Mucosal perfusion was measured with LDF and the degree of inflammation was examined at predefined levels of the distal bowel by endoscopy and histology. Stool samples were cultured for lactobacilli and bifidobacteria and calprotectin were measured before and after intervention.
  
  
  RESULTS
  The LDF measurements were reproducible in the pelvic pouch at each of the predefined levels, but did not change after intervention. The mucosal perfusion was reduced in the distal compared to the proximal part of the pouch. Calprotectin levels did not change significantly after intervention. The median endoscopic score for inflammation was significantly reduced by 50% after intervention, whereas the histological score did not change significantly.
  
  
  CONCLUSIONS
  The results suggest that probiotics primarily act superficially, with change of gross appearance of the mucosa at endoscopy, but without significant effect on histological picture, mucosal perfusion or faecal calprotectin, during a relatively short period of 4 weeks.
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: K O
authors.initials: KO
authors.lastname: Laake
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: P D
authors.initials: PD
authors.lastname: Line
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: L
authors.initials: L
authors.lastname: Aabakken
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: T
authors.initials: T
authors.lastname: Løtveit
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: A
authors.initials: A
authors.lastname: Bakka
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: J
authors.initials: J
authors.lastname: Eide
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: A
authors.initials: A
authors.lastname: Røsetti
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: K
authors.initials: K
authors.lastname: Grzyb
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: A
authors.initials: A
authors.lastname: Bjørneklett
authors.affiliation: a Research Institute of Internal Medicine , Dept. of Medicine, Dept. of Surgery, Dept. of Pathology , Rikshospitalet University Hospital , Oslo , Norway ; Dept. of Surgery, Central Hospital Akershus, Dept. of Medicine, Dept. of Pathology , Aker University Hospital , Oslo , Norway.
authors.forename: M H
authors.initials: MH
authors.lastname: Vatn
keywords: Bifidobacteriae; endoscopic laser doppler flowmetry; ileal pouch; inflammation; lactobacilli; mucosal blood perfusion