Abstract
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.
Highlights
Gastroesophageal reflux disease (GERD) is a common digestive disorder in the general population that primarily affects the esophagus and gastro-duodenum
Probiotics may be beneficial for patients receiving pomp inhibitors (PPIs) treatment, we focused on studies with non-medicated subjects [23]
Abstracts were screened for eligibility; 128 records were excluded, and 54 two interventions and oneInarticle reported12two probiotic arms One and one shared placebo full-text articles were[25], reviewed
Summary
Gastroesophageal reflux disease (GERD) is a common digestive disorder in the general population that primarily affects the esophagus and gastro-duodenum. GERD has a significant impact on quality of life (QoL) and healthcare costs. The World Gastroenterology Organization defines GERD as ‘troublesome symptoms sufficient to impair an individual’s quality of life, or injury or complications that result from the retrograde flow of gastric contents into the esophagus, oropharynx, and/or respiratory tract’ [1]. The Rome IV criteria include functional heartburn (FH) and reflux hypersensitivity (RH), which can overlap with. The Rome IV criteria describe infant regurgitation (IR) as follows: regurgitation 2 or more times per day for 3 or more weeks [3], spontaneous resolution with age, and no association with negative long-term consequences [4].
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