J Neurogastroenterol Motil.  2018 Jan;24(1):51-57. 10.5056/jnm17059.

Is It Useful to Administer Probiotics Together With Proton Pump Inhibitors in Children With Gastroesophageal Reflux?

• Belei O
• Olariu L
• Dobrescu A
• Marcovici
• Marginean

• KMID: 2417272
• DOI: http://doi.org/10.5056/jnm17059

Abstract

BACKGROUND/AIMS
Gastroesophageal reflux disease (GERD) is a frequent condition diagnosed in children and treated with proton pump inhibitors (PPI). Long-term PPI administration can alter intestinal bacterial population by suppressing the gastric acid barrier and may cause diarrhea. The aim of this study is to evaluate the prevalence of small intestinal bacterial overgrowth assessed by glucose hydrogen breath test among children that received 12 weeks of PPI with or without probiotics (Lactobacillus reuteri DSM 17938) associated, compared to controls.
METHODS
Glucose hydrogen breath test was performed before PPI treatment and after 12 weeks of PPI treatment to 128 consecutive children with GERD (1-18 years old) and a control group (120 healthy children). The children with GERD were randomized into 2 groups: placebo group (64 who received PPI and placebo for 12 weeks) and probiotics group (64 who received PPI and probiotics for 12 weeks).
RESULTS
After 12 weeks of treatment, dysbiosis was detected among 56.2% of children from placebo group (36/64), compared to 6.2% of children from the probiotics group (4/64, P < 0.001). Bacterial overgrowth was detected in 5% of controls (6/120). Probiotics group had a lower prevalence of dysbiosis, similar to controls (P = 0.740).
CONCLUSION
Probiotics administration decreased the rate of dysbiosis among children treated with PPI.

Keyword

Breath tests; Child; Dysbiosis; Probiotics; Proton pump inhibitors

MeSH Terms

Breath Tests
Child*
Diarrhea
Dysbiosis
Gastric Acid
Gastroesophageal Reflux*
Glucose
Humans
Hydrogen
Prevalence
Probiotics*
Proton Pump Inhibitors*
Proton Pumps*
Protons*
Glucose
Hydrogen
Proton Pump Inhibitors
Proton Pumps
Protons