Introduction In routine colonoscopy, diverticulosis is the most commonly found feature, but only a minority of these cases show symptoms of diverticular disease. From June 2014 to December 2014, we enrolled prospectively 178 patients affected by symptomatic uncomplicated diverticular disease (Male/Female = 0.47, mean age 71.7 ± 11.5 y, range 41 to 95 y) from 15 General Pratictioners patient files. All patients were symptomatic; in all cases, diagnosis was been confirmed by a colonoscopy performed at least 1 year before. Patients with acute diverticulitis were excluded. On the basis of the predominant symptoms (abdominal complaints or constipation), patients were addressed to 4 different therapeutic approaches using mesalamine, rifaximine, probiotics (in a consortium of different species of Lactobacillus and Bifidobacterium), and fibers (Plantago Ovata Husk). All treatments lasted 3 months. Results: Sixty-three patients were enrolled in group A (rifaximine), 43 in group A1 (rifaximine + fibers + probiotics), 23 in group B (mesalamine), and 31 in group B1 (mesalamine + fibers). Analysis of variance suggested a statistically significant difference (P < 0.003) among groups at the end of the observation period, with Groups A1 and B1 showing a higher number of bowel movement per week. Global linear measurement confirmed the role of treatment as a significant factor (F = 2.858; P = 0.039) associated with body mass index (F = 6.972; P < 0.009). Conclusions: In accordance with the baseline clinical presentation, the supplementation of fiber and/or probiotics is associated with a statistically significant improvement in the clinical pattern of symptoms in patients with diverticular disease in a primary-care/family physician setting.

A primary-care interventional model on the diverticular disease: Searching for the optimal therapeutic schedule / Campanini, Angelo; De Conto, Umberto; Cavasin, Francesco; Bastiani, Fernanda; Camarotto, Antonio; Gardini, Luigi; Geremia, Alessandra; Marastoni, Cristina; Missorini, Carlo; Quarantelli, Elena; Sassi, Umberto; Scarabello, Francesco; Bo, Nadia Dal; Ricco, Matteo; Grillo, Simone; Landi, Stefano; Di Mario, Francesco. - In: JOURNAL OF CLINICAL GASTROENTEROLOGY. - ISSN 0192-0790. - 50:(2016), pp. S93-S96. [10.1097/MCG.0000000000000670]

A primary-care interventional model on the diverticular disease: Searching for the optimal therapeutic schedule

CAMPANINI, Angelo;Di Mario, Francesco
2016

Abstract

Introduction In routine colonoscopy, diverticulosis is the most commonly found feature, but only a minority of these cases show symptoms of diverticular disease. From June 2014 to December 2014, we enrolled prospectively 178 patients affected by symptomatic uncomplicated diverticular disease (Male/Female = 0.47, mean age 71.7 ± 11.5 y, range 41 to 95 y) from 15 General Pratictioners patient files. All patients were symptomatic; in all cases, diagnosis was been confirmed by a colonoscopy performed at least 1 year before. Patients with acute diverticulitis were excluded. On the basis of the predominant symptoms (abdominal complaints or constipation), patients were addressed to 4 different therapeutic approaches using mesalamine, rifaximine, probiotics (in a consortium of different species of Lactobacillus and Bifidobacterium), and fibers (Plantago Ovata Husk). All treatments lasted 3 months. Results: Sixty-three patients were enrolled in group A (rifaximine), 43 in group A1 (rifaximine + fibers + probiotics), 23 in group B (mesalamine), and 31 in group B1 (mesalamine + fibers). Analysis of variance suggested a statistically significant difference (P < 0.003) among groups at the end of the observation period, with Groups A1 and B1 showing a higher number of bowel movement per week. Global linear measurement confirmed the role of treatment as a significant factor (F = 2.858; P = 0.039) associated with body mass index (F = 6.972; P < 0.009). Conclusions: In accordance with the baseline clinical presentation, the supplementation of fiber and/or probiotics is associated with a statistically significant improvement in the clinical pattern of symptoms in patients with diverticular disease in a primary-care/family physician setting.
A primary-care interventional model on the diverticular disease: Searching for the optimal therapeutic schedule / Campanini, Angelo; De Conto, Umberto; Cavasin, Francesco; Bastiani, Fernanda; Camarotto, Antonio; Gardini, Luigi; Geremia, Alessandra; Marastoni, Cristina; Missorini, Carlo; Quarantelli, Elena; Sassi, Umberto; Scarabello, Francesco; Bo, Nadia Dal; Ricco, Matteo; Grillo, Simone; Landi, Stefano; Di Mario, Francesco. - In: JOURNAL OF CLINICAL GASTROENTEROLOGY. - ISSN 0192-0790. - 50:(2016), pp. S93-S96. [10.1097/MCG.0000000000000670]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2839838
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