DuPont Nutrition & Biosciences, Global Health & Nutrition Science, Danisco Sweeteners Oy, Sokeritehtaantie 20, FI-02460 Kantvik, Finland.
Nutrients. 2020 Jan 2;12(1):132. doi: 10.3390/nu12010132.
Probiotic is little known for its benefits on upper gastrointestinal health. The objective of this systematic review was to examine the efficacy of probiotics in alleviating the frequency and severity of symptoms in gastroesophageal reflux disease (GERD) in the general adult population. The PubMed and Web of Science databases were searched for prospective studies on GERD, heartburn, regurgitation, and dyspepsia, without any limitation on sample size. The Jadad scale was used to evaluate the quality of randomized controlled trials. In total, 13 prospective studies that were published in 12 articles were included in the analysis and scored per the Jadad scale as high- (five studies), medium- (two), and low- (six) quality. One article reported on two probiotic groups; thus, 14 comparisons were included in the selected studies, of which 11 (79%) reported positive benefits of probiotics on symptoms of GERD. Five out of 11 positive outcomes (45%) noted benefits on reflux symptoms: three noted reduced regurgitation; improvements in reflux or heartburn were seen in one study; five (45%) saw improvements in dyspepsia symptoms; and nine (81%) saw improvements in other upper gastrointestinal symptoms, such as nausea (three studies), abdominal pain (five), and gas-related symptoms (four), such as belching, gurgling, and burping. In conclusion, probiotic use can be beneficial for GERD symptoms, such as regurgitation and heartburn. However, proper placebo-controlled, randomized, and double-blinded clinical trials with a sufficient number of participants are warranted to confirm its efficacy in alleviating these symptoms. Further, interventions with longer durations and an intermediate analysis of endpoints should be considered to determine the proper therapeutic window.
益生菌对胃肠道上部健康的益处鲜为人知。本系统评价的目的是研究益生菌对一般成年人群胃食管反流病（GERD）症状的频率和严重程度的缓解作用。检索了 PubMed 和 Web of Science 数据库中关于 GERD、烧心、反流和消化不良的前瞻性研究，对样本量没有任何限制。Jadad 量表用于评估随机对照试验的质量。共有 13 项前瞻性研究被纳入分析，其中 5 项研究的 Jadad 量表评分较高，2 项评分中等，6 项评分较低。有 1 篇文章报道了 2 个益生菌组，因此，在选定的研究中有 14 个比较被纳入分析，其中 11 个（79%）报道了益生菌对 GERD 症状的积极益处。在 11 个阳性结果中，有 5 个（45%）观察到反流症状有改善：3 个观察到反流减少；1 个研究中观察到反流或烧心改善；5 个（45%）观察到消化不良症状改善；9 个（81%）观察到其他上胃肠道症状改善，如恶心（3 个研究）、腹痛（5 个）和与气体相关的症状（4 个），如打嗝、肠鸣和嗳气。总之，益生菌的使用可能对 GERD 症状有益，如反流和烧心。然而，需要进行适当的安慰剂对照、随机和双盲临床试验，并有足够数量的参与者，以确认其缓解这些症状的疗效。此外，还应考虑干预持续时间更长和终点的中期分析，以确定适当的治疗窗。
