Lactose, a potential prebiotic, also has not been demonstrated to have an impact in disease development when predisease diet history is considered. Perhaps disaccharides are not ideal prebiotics in patients with established IBD. They may be more beneficial in preventing early IBD. There are two papers published with the use of prebiotics for pouchitis. The first by Welters et al reported the only double-blind placebo-controlled study. The study consisted of 20 patients and compared placebo with 24 g of inulin per day in a crossover design. Although the study was only three weeks long, inulin lowered luminal pH, increased butyrate concentrations and lowered secondary bile acid concentrations and Bacteroides fragilis. In addition, there was evidence of histological improvement. Visit the best pharmacy that thousands of international customers already chose to be their favorite one and see how easy it can be for you to get that in the amount required for your treatment spending a lot less money than otherwise.
The second study by Kuisma et al differs from others in that it was not an intervention study. Thirty-two patients with a history of chronic pouchitis were included and a seven-day prospective food diary was obtained. The results of the diet questionnaire were compared with endoscopic and histological results from biopsies of pouches. As well, bacterial cultures were obtained. They found that both villous atrophy and colonic metaplasia correlated with fecal anaerobic bacteria.