Background: Symptomatic uncomplicated diverticular disease (SUDD) is a common condition in older adults, primarily managed through symptom control. Emerging evidence highlights the role of gut microbiota in symptom modulation and disease progression. Butyrate supplementation offers anti-inflammatory benefits and supports gut barrier integrity; when combined with specific probiotic strains, it may further promote microbiota balance. Objectives: To evaluate the clinical and microbiological effects of an oral formulation combining microencapsulated sodium butyrate with probiotic strains from four probiotic strains (Lacticaseibacillus rhamnosus, Lactiplantibacillus plantarum, Limosilactobacillus reuteri, and Bifidobacterium longum subsp. infantis) in patients with SUDD. Methods: This prospective, preliminary observation enrolled 23 patients. To control for high interindividual variability in microbiota composition, each participant served as their own control. The intervention lasted 12 weeks and included five scheduled visits, incorporating a 3-week washout period. Symptom severity and quality of life were assessed using validated questionnaires. Faecal microbiota composition was evaluated using 16S rRNA sequencing and strain-specific colonisation was monitored with qPCR. Results: Significant improvements were observed in seven out of nine reported symptoms, including reductions in abdominal pain, bloating, and discomfort. Overall symptom burden decreased, especially symptoms related to gas and stool consistency. Quality of life scores improved notably. qPCR confirmed colonisation by the administered probiotic strains. Microbiome analysis demonstrated individualized but meaningful improvements in microbial profiles. Conclusions: The combined use of microencapsulated sodium butyrate and selected probiotic strains led to measurable clinical improvements and the positive modulation of gut microbiota in patients with SUDD. This formulation was well tolerated and may represent a promising adjunct or standalone approach in the dietary management of SUDD.
Borycka-Kiciak et al. (Thu,) studied this question.