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The effect of probiotics on gut flora, level of endotoxin and Child–Pugh score in cirrhotic patients: results of a double-blind randomized study

Lata, Jana; Novotný, Ivoa; Příbramská, Veronikaa; Juránková, Janab; Frič, Přemyslc; Kroupa, Radeka; Stibůrek, Oldřicha

European Journal of Gastroenterology & Hepatology: December 2007 - Volume 19 - Issue 12 - p 1111-1113
doi: 10.1097/MEG.0b013e3282efa40e
Original Articles: Cirrhosis; Hepatitis B

Objective To determine the effect of Escherichia coli Nissle (Mutaflor, Ardeypharm GmbH, Herdecke, Germany) on the intestinal colonization, level of endotoxin and liver functions in patients with liver cirrhosis.

Methods Thirty-nine patients with liver cirrhosis diagnosed by means of biopsy and clinical examinations were randomly allocated to treatment with E. coli Nissle or placebo for 42 days. Standard clinical examination, biochemical and hematological examinations, level of endotoxin and microbiological examination of the stool were performed before and after the treatment.

Results In comparing the treatment of E. coli Nissle and placebo, significant improvement of the intestinal colonization (P<0.001) in the E. coli Nissle group was described. We found a trend of significant lowering of the endotoxemia (P=0.07) and improvement of liver functions evaluated by Child–Pugh score (P=0.06).

Conclusion E. coli Nissle seems to be effective in the restoration of normal colonic colonization and can probably lower endotoxemia in cirrhotic patients.

Departments of aInternal Medicine and Gastroenterology

bMicrobiology, University Hospital, Brno

cInternal Medicine, Military Hospital Prague, Prague, Czech Republic

Correspondence to Professor Jan Lata, MD, PhD, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic

Tel: +420 532233465; fax: +420 535532221; e-mail:

Received 17 February 2007 Accepted 19 June 2007

© 2007 Lippincott Williams & Wilkins, Inc.