Department of Child Health, University of Indonesia, Dopok, Indonesia.
J Pediatr (Rio J). 2013 Jul-Aug;89(4):381-7. doi: 10.1016/j.jped.2012.12.005. Epub 2013 Jun 21.
To evaluate the incidence of small bowel bacterial overgrowth (SBBO) in children treated with omeprazole, and to test whether probiotics influence the incidence.
A double-blinded, placebo-controlled trial was performed in 70 children treated orally during four weeks with 20mg omeprazole per day. Lactobacillus rhamnosus R0011 (1.9×10(9) cfu) and Lactobacillus acidophilus R0052 (0.1×10(9) cfu) were simultaneously given daily to 36 subjects (probiotic group), while 34 subjects received placebo (placebo group). The diagnosis of SBBO was based on the development of suggestive symptoms, in combination with a positive glucose breath test.
After one month of proton pump inhibitor (PPI) treatment, 30% (21/70) had a positive breath test suggesting SBBO; of these 62% were symptomatic. Five children developed SBBO-like symptoms, but had a negative breath test; and 44 (63%) were symptom free and had a negative breath test. There was no difference in the incidence of positive breath tests in the probiotic versus the placebo group (33% vs 26.5%; p=0.13).
Since symptoms suggesting SBBO developed in 26% of PPI-treated children, and since the glucose breath test was abnormal in 72% of these, this side-effect should be more frequently considered. The probiotic tested did not decrease the risk to develop SBBO.
评估接受奥美拉唑治疗的儿童中小肠细菌过度生长（SBBO）的发生率，并检验益生菌是否会影响其发生率。
对 70 名儿童进行了一项双盲、安慰剂对照试验，这些儿童在四周内每天口服 20mg 奥美拉唑。同时给予 36 名受试者（益生菌组）每日鼠李糖乳杆菌 R0011（1.9×10(9)cfu）和嗜酸乳杆菌 R0052（0.1×10(9)cfu），而 34 名受试者接受安慰剂（安慰剂组）。SBBO 的诊断基于出现提示性症状，并结合葡萄糖呼气试验阳性。
在接受质子泵抑制剂（PPI）治疗一个月后，30%（21/70）的患者葡萄糖呼气试验阳性提示 SBBO；其中 62%有症状。有 5 名儿童出现类似 SBBO 的症状，但葡萄糖呼气试验阴性；44 名（63%）无症状且葡萄糖呼气试验阴性。益生菌组和安慰剂组的阳性呼气试验发生率无差异（33% vs 26.5%；p=0.13）。
由于接受 PPI 治疗的儿童中有 26%出现提示 SBBO 的症状，并且这些症状中有 72%的葡萄糖呼气试验异常，因此应更频繁地考虑这种副作用。所测试的益生菌并未降低发生 SBBO 的风险。
