Multistrain probiotics alleviate gastrointestinal symptoms during bismuth quadruple therapy for Helicobacter pylori infection
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: BACKGROUND Bismuth quadruple therapy (BQT) induces troublesome gastrointestinal side effects that reduce adherence and efficacy. AIM To evaluate multistrain probiotics efficacy for alleviating gastrointestinal symptoms during BQT for Helicobacter pylori (H. pylori) eradication. METHODS One hundred seventy-four adults (18-60 years) with confirmed H. pylori infections between July 2022 and December 2023 were randomised to receive BQT plus a multispecies probiotic (n = 89) or a maltodextrin placebo (n = 85) for 4 weeks. Gastrointestinal Symptom Rating Scale (GSRS) and Bristol Stool Classification Scale scores were collected at baseline, 2, 4 and 8 weeks; eradication was assessed 8 weeks post-treatment. Intention-to-treat analysis used multiple imputation and SPSS 26.0. RESULTS After 8 weeks, GSRS scores (all dimensions and total) decreased significantly compared with those at baseline. ITT analysis showed significantly greater reductions for the intervention vs the placebo in reflux by week 2, total/diarrhea scores by week 4, and total/dyspepsia scores by week 8. Probiotics provided no protective effect against gastrointestinal symptoms at week 2 but showed significant protection at weeks 4 and 8. Both groups reported decreased diarrhea/constipation-type stools and increased normal-type stools post-intervention. H. pylori eradication rates were slightly higher for the intervention group (88.8%) than for the placebo group (84.7%), but the difference was not significant (P = 0.430). CONCLUSION Multistrain probiotics significantly relieved BQT-associated gastrointestinal symptoms without affecting eradication success.
Authors: Wen-Jun Liu, Yue-Ming Zhao, Qing-Qing Xie, Min-Chan Wu, Yun-Feng Pan, Hao-Kun Yan, Xiao-Xi Shan, Wen-Ting Xu, Yang-Ling Liu, Cai-Xia Peng, Xiao-Mei Zhang, Qian Lin
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: McMaster University, University of Toyama, Seoul National University Bundang Hospital, Institut National de la Santé et de la Recherche Médicale, Keio University, Seoul National University, Chulalongkorn University, Universiti Malaya, Università degli Studi di Parma, Chinese University of Hong Kong, Hyogo College of Medicine, Hirosaki University, Hokkaido University, Università di Bologna, National Taiwan University, Universidade Federal de Minas Gerais, Kawasaki Medical School, Changi General Hospital
OpenAlex ID: W4416156264