Multistrain probiotics alleviate gastrointestinal symptoms during bismuth quadruple therapy for Helicobacter pylori infection

source extracted confidence: high 2026-04-09
#humans #helicobacter-infections #probiotics #adult #male

Multistrain probiotics alleviate gastrointestinal symptoms during bismuth quadruple therapy for Helicobacter pylori infection

Liu et al., 2025 | World J Gastroenterol | Rct

Citation

Liu Wen-Jun, Zhao Yue-Ming, ... Lin Qian. Multistrain probiotics alleviate gastrointestinal symptoms during bismuth quadruple therapy for Helicobacter pylori infection. World J Gastroenterol. 2025-Nov-14;31(42):112577. doi:10.3748/wjg.v31.i42.112577

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.

Key Findings

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 in

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 89
Age Range 18-60 years
Condition See abstract

MeSH Terms

  • Humans
  • Helicobacter Infections
  • Probiotics
  • Adult
  • Male
  • Female
  • Helicobacter pylori
  • Middle Aged
  • Bismuth
  • Treatment Outcome
  • Drug Therapy, Combination
  • Young Adult
  • Anti-Bacterial Agents
  • Proton Pump Inhibitors
  • Adolescent
  • Double-Blind Method
  • Gastrointestinal Diseases
  • Diarrhea

Evidence Classification

  • Level: Rct
  • Publication Types: Journal Article, Randomized Controlled Trial
  • Vertical: probiotics-immune

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09