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Maintaining remission in patients with refractory or treatment-resistant pouchitis is problematic. In this partially manufacturer-supported study, researchers evaluated the effectiveness of a single daily high-dose probiotic preparation (VSL#3) for maintaining remission in 36 patients with refractory or relapsing pouchitis (≥2 episodes per year).
All patients were treated with metronidazole and ciprofloxacin for 4 weeks before study entry and then were randomized to receive VSL#3 (6 g) or placebo once daily in the evening for 12 months or until relapse. At 1 year, 85% of VSL#3 recipients versus 6% of placebo recipients were in remission (P<0.0001). Patients' inflammatory bowel disease quality-of-life scores remained high in the VSL#3 group b…