Lactulose and antioxidant vitamins in the prevention of the recurrence of adenomatous polyps.

There is evidence in the literature which suggests that it is theoretically possible to prevent the occurrence and recurrence of adenomatous polyps of the large bowel. Although not all polyps become malignant, it is commonly believed that adenomas represent the natural precursor of colorectal cancer. Thus, the prevention of their recurrence might represent a practical step in the control of this common neoplasm. At present, patients who have undergone endoscopic polipectomy are usually left without any specific therapy. Since the postulated ttherapies-lactulose and vitamins- are safe and well tolerated , it seems appropriate to undertake randomized controlled studies to evaluate the possibility of primary prevention of large bowel neoplasms. The preliminary results of such a controlled investigation at our institutions are encouraging, suggesting a lower recurrence rate of polyps in patients given lactulose or antioxidant vitamins than in patients without therapy. Much more data and longer follow-up are needed, however, before any conclusions can be drawn.