Abstract
This study aimed to investigate the intestinal microbiota in duodenal ulcer (DU) patients, effects of proton pump inhibitors,clarithromycin and amoxicillin, PCA) for Helicobacter pylori (H. pylori) and Bacillus subtilis and Enterococcus faecium (BSEF) on intestinal microbiota. DU patients were randomly assigned to receive either PCA (group TT) or PCA plus BSEF(group TP). The fecal microbiome was conducted using high throughput 16S rDNA gene and internal transcribed spacer sequencings. The diversity and abundance of intestinal bacteria in the DU were significantly lower than health check control (HC) group. In the TT group, the abundance and diversity of both intestinal bacteria and fungi decreased after PCA treatment, compared with those before treatment, whereas in the TP group no obvious changes were observed. In the TT group at all the time points, both the intestinal bacteria and fungi were different from those in the HC group. However, in the TP group, at 10w the bacterial flora abundance was close to that in the HC group. The results indicate that anti- H. pylori treatment induced significant decrease in the diversity of intestinal microbiota, while the combined therapy supplemented with BSEF could protect and restore the intestinal microbiota.
Highlights
Guidelines about H. pylori eradication have stated that H. pylori infection should be eradicated in duodenal ulcer (DU) patients by the standard triple therapy[1]
The effect on intestinal fungi caused by anti- H. pylori therapy, as well as a combined therapy with probiotic treatment in DU patients remains unclear
We hypothesized that (1) the intestinal microbiota in DU is different from that in healthy people; (2) H. pylori standard treatment disrupts intestinal microbiota; and (3) combined Bacillus subtilis and Enterococcus faecium(BSEF) treatment may improve the rate of H. pylori eradication, reduce side effects, and protect intestinal microbiota
Summary
Guidelines about H. pylori eradication have stated that H. pylori infection should be eradicated in duodenal ulcer (DU) patients by the standard triple therapy[1]. Of the DU patients who received standard anti-H. pylori treatment, 10% to 30% develop antibiotic-associated diarrhea (AAD) and stool changes[2]. The reasons may relate to intestinal microbiota disorders caused by the use of anti-bacterial drugs[3,4]. The intestinal microbiota in DU patients is unknown. The effect on intestinal fungi caused by anti- H. pylori therapy, as well as a combined therapy with probiotic treatment in DU patients remains unclear. We hypothesized that (1) the intestinal microbiota in DU is different from that in healthy people; (2) H. pylori standard treatment disrupts intestinal microbiota; and (3) combined Bacillus subtilis and Enterococcus faecium(BSEF) treatment may improve the rate of H. pylori eradication, reduce side effects, and protect intestinal microbiota
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