Belei Oana, Olariu Laura, Dobrescu Andreea, Marcovici Tamara, Marginean Otilia
First Pediatric Clinic, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania.
Genetics Department, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania.
J Neurogastroenterol Motil. 2018 Jan 30;24(1):51-57. doi: 10.5056/jnm17059.
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 ( DSM 17938) associated, compared to controls.
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).
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, < 0.001). Bacterial overgrowth was detected in 5% of controls (6/120). Probiotics group had a lower prevalence of dysbiosis, similar to controls ( = 0.740).
Probiotics administration decreased the rate of dysbiosis among children treated with PPI.
背景/目的：胃食管反流病（GERD）是儿童中常见的疾病，通常用质子泵抑制剂（PPI）进行治疗。长期使用PPI会抑制胃酸屏障，从而改变肠道菌群，并可能导致腹泻。本研究旨在评估通过葡萄糖氢呼气试验评估的小肠细菌过度生长在接受12周PPI治疗（无论是否联合益生菌（DSM 17938））的儿童中的患病率，并与对照组进行比较。
对128名连续的GERD患儿（1至18岁）和一个对照组（120名健康儿童）在PPI治疗前和PPI治疗12周后进行葡萄糖氢呼气试验。GERD患儿被随机分为两组：安慰剂组（64名接受PPI和安慰剂治疗12周）和益生菌组（64名接受PPI和益生菌治疗12周）。
治疗12周后，安慰剂组56.2%的儿童（36/64）检测到菌群失调，而益生菌组为6.2%（4/64，P<0.001）。对照组中5%（6/120）检测到细菌过度生长。益生菌组的菌群失调患病率较低，与对照组相似（P = 0.740）。
给予益生菌可降低接受PPI治疗儿童的菌群失调发生率。
