Combined therapy: rifaximin-α and arabinogalactan with lactoferrin combination effectively prevents recurrences of symptomatic uncomplicated diverticular disease (SUDD)

Backgroun: Diverticulosis is the most common finding in the GI tract. Nearly half of the people with diverticula experience symptomatic uncomplicated diverticular disease (SUDD). Aim: The primary endpoints of our study were to assess the effectiveness of combined therapy with rifaximin-alpha and arabinogalactan-lactoferrin in symptom reduction and normalization of bowel movements. The secondary endpoints were an assessment of efficacy in SUDD recurrence prevention and patients' compliance to the combined therapy. Material and methods: A retrospective observational survey study was performed in 2019 among physicians experienced in diverticular disease (DD) treatment in Poland. Patients with previous episodes of recurrences treated with combined therapy (cyclic rifaximin-alpha at least 400 mg b.i.d/7 days/every month and continuous arabinogalactan-lactoferrin supplementation 1 sachet daily) were assessed after 3 and 6 months regarding symptoms' resolution in the three-point scale. The patients' SUDD history, diagnostic methods, treatment, and results, as well as patients' compliance were evaluated. Result: 281 patients met inclusion criteria, and were further evaluated (67.6% women, median age 65 years). After 6 months of combined-treatment, there was statistically significant reduction in the total severity score (sum from 8.5 [max 15 points] to 1.28; p <0.0001); and improvement in each symptom score (median from 1.7 [max 3 points] to 0.26; p< 0,001). Stool frequency statistically normalized in every group. As many as 31.7% had complete symptom resolution. Patients' compliance with the therapy was very good and good in 92.9% of cases. Conclusions and discussion: Combined therapy with cyclic rifaximin-alpha and continuous arabinogalactan combination with lactoferrin is effective in SUDD treatment in terms of symptom resolution, bowel movement normalization, prevention of recurrences with very good patient's compliance.