Beneficial effect of probiotics supplements in reflux esophagitis treated with esomeprazole: A randomized controlled trial
| Autor: | Hong-Yan Wang, Han Zhang, Qing-Hua Sun, Xin Zhang, Shi-Dong Sun |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Proton pump inhibitors Enterococcus faecium Clinical Trials Study Placebo Severity of Illness Index Gastroenterology Body Mass Index Esomeprazole Young Adult Recurrence Surveys and Questionnaires Internal medicine Digestive disorder Small intestinal bacterial overgrowth medicine Humans Relapse Reflux esophagitis Esophagitis Peptic Aged Proportional Hazards Models medicine.diagnostic_test business.industry Probiotics Therapeutic effect Endoscopy General Medicine Middle Aged medicine.disease Symptomatic relief Gastrointestinal Microbiome Treatment Outcome Dietary Supplements Female business Hydrogen breath test Bacillus subtilis medicine.drug |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 1007-9327 |
| Popis: | BACKGROUND Reflux esophagitis (RE) is a common digestive disorder, and its frequent recurrences cause significant physical pain and are financially burdensome to patients. However, studies on the natural history of treated RE are few. Although proton pump inhibitors (PPIs) as the first-line treatment provide notable symptomatic relief, disordered gut microbiota has been observed among PPI users. Probiotics are commonly administered to patients to regulate the disordered intestinal flora. AIM To evaluate the therapeutic effects in RE patients treated with a combination of esomeprazole and probiotics [Bacillus subtilis (B. subtilis) and Enterococcus faecium (E. faecium)]. METHODS One hundred and thirty-four RE patients were randomized into two groups of 67 subjects each. The probiotics group was administered with esomeprazole 20 mg b.i.d. and live combined B. subtilis and E. faecium enteric-coated capsules 500 mg t.i.d. for eight weeks; the placebo group was administered with esomeprazole 20 mg b.i.d. and placebo for eight weeks. Subsequently, 12-wk follow-up was carried out on patients who achieved both endoscopic and clinical cure. Endoscopy, reflux diagnostic questionnaire (RDQ), gastrointestinal symptom rating scale (GSRS), and lactulose hydrogen breath test were performed to evaluate the therapeutic effects. A difference of P < 0.05 was considered statistically significant. RESULTS Sixty-six patients in the probiotics group and 64 patients in the placebo group completed the 8-wk treatment. The healing rate and RDQ score had no significant difference between the two groups (P > 0.05). However, the GSRS diarrhea syndrome score was decreased significantly in the probiotics group (P = 0.002), and the small intestinal bacterial overgrowth negative rate in the probiotics group was significantly higher than that in the placebo group (P = 0.002). Of 114 endoscopically and clinically cured patients, 96 completed the follow-up. The log-rank test showed that the time to relapse was shorter in the placebo group than in the probiotics group (P = 0.041). Furthermore, the therapy had a significant influence on relapse time, and the risk of relapse in the probiotics group was lower than that in the placebo group at any time point during the 12-wk follow-up (hazard ratio = 0.52, P = 0.033). CONCLUSION Esomeprazole combined with probiotics (B. subtilis and E. faecium) have a beneficial effect on RE treatment and patient management. |
| Databáze: | OpenAIRE |
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