Helicobacter pylori antimicrobial resistance and CYP2C19 genotypes in a paediatric cohort with initial eradication failure: A study from Henan, China (2019-2024).

Abstract Clinical Case Summary A 14-year-old boy presented to the Emergency Department of Mayo Hospital, Lahore, Pakistan, two hours after consuming "Dragon’s Breath" candy—a snack infused with liquid nitrogen. He complained of severe abdominal pain and distension. On examination, he was tachycardic and had a tense, tender abdomen with signs of generalized peritonitis. An abdominal X-ray revealed massive pneumoperitoneum. A provisional diagnosis of hollow viscus perforation was made. Emergency exploratory laparotomy revealed a large gush of air upon entering the peritoneal cavity and a 3×2 cm perforation along the lesser curvature of the stomach near the incisura angularis. Primary repair was performed using double-layer absorbable sutures, with drain placement in the lesser sac. The patient was shifted to HDU postoperatively. The drain was removed on postoperative day two, and recovery remained uneventful. He was discharged on the sixth postoperative day. Three days later, the patient returned with hematemesis and melena with a hemoglobin level of 8 g/dL with microcytic anemia. He was resuscitated and transfused. Upper GI endoscopy revealed mild erosive gastritis without evidence of active bleeding or perforation. Purpose of the Case This case highlights the dangerous complications associated with ingestion of liquid nitrogen, which is increasingly used in novelty snacks and entertainment. Gastric perforation is a life-threatening emergency requiring prompt surgical intervention. Key Learning Points Liquid nitrogen-infused products pose significant risks, especially to children and adolescents. Strict regulatory safety measures are necessary at national and international levels. Follow-up upper GI endoscopy is recommended to detect and manage delayed complications.

Background: Accessory spleen, or splenunculus, is a congenital anomaly resulting from failure of splenic anlage fusion during embryonic development. It is most commonly located near the splenic hilum or pancreatic tail and rarely occurs within the stomach wall. Gastric accessory spleen is a rare entity that may mimic submucosal neoplasms such as gastrointestinal stromal tumour, posing a diagnostic challenge. Case presentation: We report the case of a 37-year-old male presenting with a 3-month history of epigastric pain, dyspepsia, and nausea. Endoscopy revealed a 2.5–3 cm submucosal mass in the gastric fundus with intact mucosa, and erosive antral gastritis. Endoscopic ultrasound demonstrated a 22.6 × 17.2 × 23.3 mm hypoechoic, homogeneous lesion arising from the third layer of the gastric wall. Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) showed lymphoid aggregates with characteristic vascular structures lined by CD8-positive littoral cells and CD68/PGM1-positive macrophages. Immunohistochemistry excluded epithelial, neuroendocrine, and lymphoproliferative neoplasms, confirming the diagnosis of gastric accessory spleen. Discussion: This case is distinctive because the patient had no prior splenectomy or trauma and was diagnosed preoperatively using EUS-guided biopsy—avoiding unnecessary surgery. Gastric accessory spleen remains a rare but important differential diagnosis for submucosal gastric lesions. Recognition of its imaging and histopathologic features can prevent misdiagnosis and overtreatment. Conclusion: Gastric accessory spleen is a benign, rare condition that should be considered in patients presenting with gastric submucosal masses. Non-invasive diagnostic modalities such as EUS-FNB and immunohistochemistry are essential to achieve an accurate diagnosis and to avoid unnecessary surgical resection.

Background: Gastrointestinal (GI) disorders are frequently encountered in dogs but remain difficult to diagnose due to non-specific clinical signs. The study aimed to correlate the endoscopic findings with that of radiography and ultrasonography of upper and lower gastrointestinal tract (GIT) cases in dogs. Methods: Sixty adult dogs included in the study, comprised of 40 dogs diagnosed with upper or lower GI disorders and 20 normal dogs, served as controls for evaluating the normal GI tract. The clinical features of these disorders were assessed and diagnostic techniques such as radiography, ultrasonography and endoscopy were employed. Endoscopic procedures were performed under general anaesthesia using butorphanol (0.2 mg/kg IV), midazolam (0.2 mg/kg IV) and induction with tiletamine-zolazepam (2 mg/kg IV). Result: The study identified upper GI disorders such as erosive gastritis (7.5%), gastritis (10%), gastric ulcers (12.5%), foreign bodies (5%) and oesophageal affections (15%) including oesophagitis, oesophageal diverticulum and oesophageal nodule., while lower GI disorders included colitis (30%), rectal oedema (7.5%) and adenomas (12.5%). German shepherds aged 24-36 months were mostly affected, with males outnumbering females. Radiography effectively detected space-occupying lesions, while ultrasonography identified structural and textural changes. Endoscopy enabled direct visualization, biopsy collection, foreign body retrieval and provided superior diagnostic accuracy, even in cases with subtle mucosal alterations underscoring its relevance and utility in gastrointestinal diagnostics.

Background and objectives: Diagnosis of liver cirrhosis is made histologically, yet patients can present with clinical and laboratory features suggestive of end-stage liver disease and cirrhosis. The aim was to identify the causes, severity, and complications. Methods: A cross-sectional study was conducted from March-October 2023 in the Azadi Center of Gastroenterology and Hepatology in Duhok and included 205 cases. Demographic information was taken from the patients. Then patients were examined and sent to baseline and relevant investigations. A liver biopsy was done in selected patients. Results: The mean age of the patients was 52.4 ± 13.1. years. Males were (57.6%), and non-smokers were (68.3%). Furthermore, (64.4%) of the patients had Anorexia, (52.7%) had weight loss, (46.8%) had fever, and (43.4%) had abdominal pain. Upper endoscopic findings revealed varices in (48.8%), Portal Hypertensive Gastropathy (13.17%), Gastric Antral Vascular Ectasia (8.8%) and erosive gastritis in (3.41%). The metabolic dysfunction associated steatotic liver disease (31.22%), hepatitis B (15.61%), cryptogenic (11.22%), and hepatitis C (5.37%) were the most common types. Regarding the severity, chronic liver disease stage B was the most prevalent type (57.56%) and then type A was (21.46%). The mean scores of the Child-Pugh and the model of end stage liver disease-Sodium score were 8.05 and 18.19, respectively, which are statistically significant. Conclusion: Ascites and esophageal varices as a complication on presentation implies a delay in the presentation and diagnosis alongside under screening for liver cirrhosis. Metabolic dysfunction associated steatotic liver disease plays a major role as an underlying cause.

"The Effect of Tele-Nursing on Pain and Sleep in Patients With Gastritis".

Background: Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a major cause of gastric mucosal injury, ranging from gastritis to peptic ulcer disease. Gastroprotective agents such as proton pump inhibitors are widely prescribed to reduce these risks, yet their real-world effectiveness in preserving gastric mucosal integrity remains underexplored, particularly in South Asian populations. Objective: To evaluate gastric mucosal changes among chronic NSAID users receiving and not receiving gastroprotective therapy. Methods: A cross-sectional study was conducted in Lahore over five months, including 100 adult participants divided equally between NSAID users with gastroprotective therapy (n=50) and those without (n=50). Inclusion criteria required at least three months of continuous NSAID use. Patients underwent upper gastrointestinal endoscopy, and findings were classified using the Updated Sydney System. Data regarding Helicobacter pylori infection were also collected. Statistical analysis was performed using independent t-tests, chi-square tests, and logistic regression, with p<0.05 considered significant. Results: The mean age of participants was 49.8 ± 11.2 years in the gastroprotection group and 50.4 ± 10.9 years in the non-protection group. Normal gastric mucosa was observed in 40% of those with gastroprotection compared to 16% without. Erosive gastritis was identified in 18% versus 36%, and peptic ulcer in 10% versus 20% respectively. Severe mucosal lesions were significantly more common in the non-protected group (18%) compared to the gastroprotected group (6%). Logistic regression confirmed that absence of gastroprotective therapy was an independent predictor of mucosal injury after adjusting for confounders. Conclusion: Gastroprotective therapy substantially reduced the frequency and severity of gastric mucosal injury among chronic NSAID users. These findings support routine incorporation of preventive therapy to minimize NSAID-induced gastropathy.

The purpose of the study is to find out the effect of duodenogastral reflux (DGR) on the clinical manifestations of chronic erosive gastritis (HAG), the prevalence of Helicobacter infection among patients with the HAG and DGR association and the possibilities of eradication therapy. Materials and methods . Explored 59 patients with HAG, average age 34.6±8.13 years. Patients were divided into two groups: 28 people with exacerbation of the HAG and the presence of the DGR and 31 people who had a HAG without the DGR. Results and discussion . It was established that patients suffering from HAG in combination with the DGR revealed a brighter clinical symptoms with pronounced pain and dyspepsic syndromes. With HAG without DGR, there was often no clinical symptoms. For Hag with DGR, characters are frequent relapses of the disease with the lack of their seasonality. Erosive lesions of the stomach in patients with the DGR were more often multiple in nature and were mainly antral localization. The detection of helyicobacter infection in patients with HAG and DGR is significantly less than in patients without DGR, but this microorganism had a higher resistance to clarithromycin. Conclusions . The HAG and DGR association has certain clinical features, characterized by frequent exacerbations with the absence of seasonality, a lower frequency of detection of HP and higher resistance to clarithromycin.

Interleukin-10 (IL-10) is a key immunoregulatory cytokine that plays an important role in anti-inflammatory and immunosuppressive processes in the body. Objective:This study aims to investigate the association of single nucleotide polymorphism (SNP) c. -1082G>A of the IL10 gene promoter located in the 1q31-32 locus of the first human chromosome with inflammatory and ulcerative lesions of the stomach. Material and methods. The study included 96 unrelated patients of the Uzbek population with inflammatory and ulcerative diseases of the stomach, including: 18 patients with chronic atrophic gastritis, 13 with chronic erosive gastritis and 55 with gastric ulcer. Conclusion. It is assumed that the homozygous AA genotype (c. -1082G>A, rs1800896) of the IL10 gene may be associated with the development of inflammatory and ulcerative gastric lesions, which may be due to reduced production of the anti-inflammatory cytokine IL-10. Further studies with a larger sample are needed to confirm this hypothesis.

Background: Viral gastroenteritis, commonly known as the "stomach flu," is a highly contagious infection causing inflammation of the stomach and intestines. It is a major global health concern, leading to significant morbidity, healthcare burdens, and economic costs, with norovirus and rotavirus being the most prevalent pathogens. Aim: This article aims to provide a comprehensive overview of viral gastroenteritis by synthesizing its clinical manifestations, outlining evidence-based nursing care strategies, and exploring the role of health data analytics in improving prevention, outbreak management, and public health surveillance. Methods: The review synthesizes current clinical guidelines and best practices. It details the diagnostic approach, which is primarily based on clinical presentation and symptom assessment, with laboratory confirmation reserved for severe or outbreak scenarios. Nursing interventions are framed within a patient-centered model, focusing on thorough assessment, hydration management, and education. Results: The primary clinical manifestations include acute onset of watery diarrhea, vomiting, abdominal cramps, and nausea, which can lead to dehydration and electrolyte imbalances, particularly in vulnerable populations. Effective management is centered on vigorous oral or intravenous rehydration. Results highlight that meticulous nursing care—encompassing fluid balance monitoring, symptom control, and strict infection prevention protocols—is critical to patient recovery and containing transmission. Furthermore, leveraging health data enables real-time outbreak detection and informs targeted public health interventions. Conclusion: A multifaceted approach combining prompt clinical management, diligent nursing care, and robust health data systems is essential for reducing the impact of viral gastroenteritis.

Abstract Background and Aims Henoch-Schönlein purpura (HSP), primarily a pediatric vasculitis, can present with atypical manifestations in adults. We present a case initially misdiagnosed as inflammatory bowel disease that progressed to rapidly progressive glomerulonephritis, highlighting the variable presentation sequence, importance of early renal biopsy, and management challenges in resource-limited settings. Method Case report Results A 49-year-old male presented with edema and purpura. His symptoms began three weeks earlier with periumbilical pain and bloody diarrhea following alcohol consumption. Initial treatment led to improvement, but symptoms recurred two weeks before admission. Evaluation at that time showed normal stool examination and lipase levels. Endoscopic evaluation demonstrated severe erosive antral gastritis (CLO test was negative) and ileocolonic ulcerations with active bleeding. Pathology excluded malignancy and tuberculosis. The patient was diagnosed with IBD and discharged on mesalazine 2000 mg twice daily with a serum creatinine of 0.84 mg/dL. Four days after discharge, the patient was readmitted with bilateral lower extremity edema and purpura. Laboratory finding showed in Table 1. Autoimmune workup (ANA, anti-dsDNA, ANCA) was negative, complement levels were normal. Protein electrophoresis, and fixed immunoelectrophoresis were negative. Hemoglobin electrophoresis revealed HbE disease. Echocardiography was performed to exclude endocarditis. Treatment was modified from mesalazine to methylprednisolone, with concurrent albumin infusion and intravenous furosemide for acute kidney injury management. Despite maintaining adequate urine output (approximately 2000 mL daily), renal function did not improve, with creatinine levels persistently elevated (2.1–2.3 mg/dL) for a week. Subsequently, a kidney biopsy was performed. Given the clinical evidence of nephritis, pulse methylprednisolone therapy (250 mg daily) was initiated for five days. However, creatinine levels continued to rise, reaching 3.6 mg/dL. Preliminary biopsy results revealed cellular crescents in 7 of 18 glomeruli, with immunofluorescence results pending. Due to rapidly worsening renal function, therapeutic plasma exchange was initiated but discontinued after two sessions due to resource limitations. The treatment strategy was then modified to include three sessions of hemoperfusion using an HA 280 cartridge, combined with mycophenolate mofetil (1000 mg twice daily) and methylprednisolone (24 mg daily). The diagnosis of IgA vasculitis nephritis was established based on gastrointestinal symptoms, purpura, and biopsy findings (Figs 1 and 2). One week after hemoperfusion, the patient showed marked improvement with decreased creatinine (1.66 mg/dL), resolved edema, and no new purpuric lesions. Conclusion This case illustrates the diagnostic challenges of adult-onset HSP, particularly when gastrointestinal manifestations precede other symptoms. While our patient showed improvement with a combination of immunosuppression and hemoperfusion when standard plasma exchange was not available, this represents a single case experience. The case reinforces the importance of considering HSP in the differential diagnosis of adults presenting with gastrointestinal symptoms followed by renal involvement, and the value of early renal biopsy in guiding diagnosis and therapy.

Bismuth belongs to the group of heavy metals, but it has the lowest toxicity among them, including due to its weak solubility in aqueous and biological media. At the same time, bismuth compounds are promising for use in medicine due to their high biological activity. These substances are used in the treatment of various diseases, including cancer, because they have antiproliferative activity (induce apoptosis, inhibit proteasomes, modulate signaling pathways). For the treatment of Helicobacter pylori infection, drugs are used, mainly based on bismuth tricalcium dicitrate, which demonstrates high efficacy and a low incidence of resistance to the pathogen. Problematic aspects used in H. eradication pylori schemes are their empirical choice in the absence of a routine personalized approach to it, a low level of eradication control by the methods recommended for this purpose, the sensitivity of the pharmacodynamic effects of the scheme components to the pharmaceutical properties of each other, and the mentioned resistance of the pathogen to antibacterial drugs. Preparations based on bismuth tricalcium dicitrate, which have their own bactericidal activity independent of environmental conditions, several mechanisms of action that do not induce known pathways of resistance development, when used as part of various eradication regimens, increase their effectiveness without reducing tolerability. The main results of numerous clinical studies confirm these statements. An additional advantage of bismuth compounds included in medicinal preparations is their gastroprotective effect, which makes it possible to expand the range of indications due to gastric pathology, accompanied by the formation of erosive and ulcerative defects of its mucous membrane (erosive gastritis, peptic ulcer, etc.), as well as an antidiarrhoeal effect, which is of clinical importance in irritable bowel syndrome and functional diarrhea. The safety of using bismuth tricalcium dicitrate in low doses and during short courses has been confirmed by large meta-analyses; serious side effects are extremely rare and are not associated with neurotoxicity. The presented set of data indicates the prospects for further study and clinical use of bismuth in antitumor, antibacterial and gastroenterological practice.

(1) Background: Gastric cancer continues to pose a significant public health challenge, with its incidence influenced by various factors, including Helicobacter pylori (H. pylori) infection. In Lebanon, data on H. pylori prevalence and its associated risk factors remain limited. This study aimed to determine the prevalence of H. pylori infection among Lebanese outpatients presenting with gastrointestinal symptoms undergoing gastroscopy, to explore correlations between the infection and demographic and clinical variables, and to evaluate the prevalence of associated conditions such as gastritis, duodenitis, and intestinal metaplasia. (2) Methods: Using a retrospective design, data from 786 patients admitted at a hospital in Beirut over a three-year period were extracted from records. (3) Results: The prevalence of H. pylori infection was 29.6% despite 91.5% of patients showing signs of gastritis on endoscopy. The infection showed significant associations with erosive gastritis, non-erosive gastritis, mosaic gastritis, as well as with both erosive and non-erosive duodenitis. No significant relationships were observed between H. pylori and demographic factors, atrophic, or nodular gastritis. (4) Conclusions: These findings underscore the importance of targeted testing and early eradication of H. pylori to manage gastritis effectively and reduce the risk of progression to more serious gastric conditions in the Lebanese population.

Ulcer or gastritis is an inflammation of the stomach caused by increased stomach acid or mucosal irritation which is generally triggered by irregular diet, stress, smoking habits, and alcohol consumption. This activity aims to increase public understanding of the use of syrup-form pharmaceutical preparations in gastritis therapy. The webinar was held online through Zoom Meeting with a total of 32 participants, consisting of 24 women and 8 men who are students of the University of August 17, 1945 Jakarta, as well as the general public. Evaluation was carried out through pre-test and post-test using five multiple-choice questions that measured understanding of the advantages of syrup preparations, the function of active substances (antacids and sucralfates), the selection of preparations in dysphagia patients, the mechanism of action, and the components of the formulation. The results of the post-test showed an increase in participants' understanding, including 100% of participants answered correctly about the advantages of syrup preparations over tablets, 88% understood the function of antacids, 92% knew the mechanism of action of sucralfate, and 76% understood the selection of preparations in dysphagia patients. Thus, this activity has proven to be effective in increasing participants' knowledge about the use of syrup preparations for the treatment of gastritis. Emphasis is needed on the aspect of preparing preparation for dysphagia patients and an understanding of the components of the formulation.

Accurate detection of Helicobacter pylori infection is crucial for properly treating patients with dyspepsia. Several invasive and non-invasive diagnostic methods are being utilised. This study aimed to determine the prevalence of H. pylori in adult patients with dyspeptic conditions and how it related to endoscopic findings, histological features and the relationship to urea breath test (UBT) results. From 723, 100 adult dyspeptic outpatients who underwent UBT and endoscopy were investigated at the Department of Gastroenterology in Imam Al-Hujjah Hospital for gastroduodenal biopsy. A histopathological study was also used to identify H. pylori. The study included 68 females (37 H. pylori positive and 31 with H. pylori negative) and 32 males (13 with H. pylori and 19 without H. pylori) with a female-to-male ratio of 2.1:1. The most common endoscopic finding was nodularity in 28 patients (46%) H. pylori positive and 5 (10%) H. pylori negative, followed by gastritis, erosive gastritis, erythema, hiatus hernia and gastric ulcer. The most common histological feature was chronic gastritis in 52 cases (64%) in the positive bacterial cases and 20 (36%) in the negative group, with a statistically significant relationship. There was a significant difference between histopathological findings with both endoscopic examination and UBT results for H. pylori positive and negative patients. Endoscopic and histological studies with UBT showed a significant ability to detect H. pylori. Early detection and treatment are crucial for the H. pylori infection to avoid major complications.

Background: Non-variceal upper gastrointestinal bleeding (NVUGIB) remains a critical medical–surgical emergency associated with significant morbidity, mortality, and healthcare burden worldwide. Despite advances in diagnostic and therapeutic modalities, NVUGIB continues to pose complex clinical challenges, particularly in resource-limited settings. Methods: This retrospective observational study analyzed 364 consecutive adult patients diagnosed with NVUGIB and hospitalized at the First Surgical Clinic of the County Emergency Clinical Hospital Craiova between January 2009 and December 2014. Inclusion criteria required a confirmed diagnosis based on clinical presentation, laboratory findings, and upper gastrointestinal endoscopy (UGIE). Demographic variables, etiology, comorbidities, drug-induced triggers, laboratory parameters, onset-to-admission and onset-to-surgery intervals, endoscopic findings, therapeutic interventions (medical, endoscopic, surgical), rebleeding rates, and mortality were recorded and analyzed. Results were descriptively compared with historical data from the national and international literature. Due to the retrospective and aggregate nature of the data, survival analysis (Kaplan–Meier) was not applicable. Results: Peptic ulcers, erosive gastritis, Mallory–Weiss syndrome, and gastric neoplasms were the predominant etiologies. NSAID use, oral anticoagulation, and alcohol consumption emerged as major risk factors. Endoscopic hemostasis was achieved in the majority of cases; surgical intervention was required in 11.5% of patients, mainly for refractory or recurrent bleeding. The overall mortality rate was 10.9%, consistent with historical benchmarks. Comparative analysis revealed trends in etiology and management reflecting evolving clinical practice standards. Conclusions: NVUGIB remains a significant clinical challenge with persistent mortality and rebleeding risks. This cohort highlights the need for timely diagnosis, risk stratification, and an evidence-based therapeutic strategy integrating modern endoscopic and surgical options. An updated diagnostic and management algorithm is proposed to guide practical decision-making and optimize outcomes in similar tertiary care settings.

Infectious bronchitis virus (IBV) causes high morbidity and mortality worldwide, leading to significant economic losses. While the widespread vaccination with the H120 strain has effectively curbed the spread of IBV, we have discovered that the H120 strain can cause glandular stomach inflammation in chickens. Further research indicates that the S1 gene of the H120 strain determines its tropism for the glandular stomach. Studying the glandular tropism of the H120 strain is crucial for developing effective and safe IBV vaccines.

In 2020, the Food and Drug Administration approved an oral sulfate tablet (OST) containing sodium sulfate, magnesium sulfate, and potassium chloride as a colonoscopy preparation that is more palatable and convenient than polyethylene glycol (PEG) with comparable efficacy. There is a precautionary warning regarding potential risk of mucosal ulcerations in patients with inflammatory bowel disease (IBD), but post-marketing reports describing gastritis and gastric ulceration have been sporadically reported, and the occurrence of gastric erosive disease in non-IBD patients has not been extensively documented. This study aimed to assess the occurrence of erosive gastritis in adult patients who received OST bowel preparation compared to patients who received PEG prior to same-day esophagogastroduodenoscopy (EGD) and colonoscopy. A single-center, blinded, retrospective study was conducted of adults who underwent same-day EGD and colonoscopy. A total of 177 patients who received OST were matched with 219 patients who received PEG. Data collection involved a detailed review of the patients' demographics, procedural, and pathology reports. The OST group demonstrated a significantly higher incidence of both gastric ulcers (13.6% vs. 2.3%, P-value < 0.001) and erosions (16.9% vs. 5.0%, P-value < 0.001) compared to the PEG group. There was no statistically significant difference between the locations of erosions and ulcers between groups. The use of OST bowel preparation prior to colonoscopy is associated with increased incidence of erosive gastritis compared to PEG in patients undergoing EGD and colonoscopy on the same day at our center. Prospective, randomized studies are needed to definitively establish the risks associated with OST and to evaluate the mechanism by which it may increase the occurrence of mucosal injury.

Gastritis is a digestive disorder caused by inflammation of the stomach that often occurs among students. Unhealthy lifestyles such as irregular eating patterns and high stress are the main risk factors for gastritis. Nusa Cendana University is a relevant location to conduct this survey because of the large number of students and the habit of consuming regional specialties that have the potential to trigger gastritis. This study aims to analyze the relationship between stress levels and eating patterns with the incidence of gastritis in Nusa Cendana University students. This study used a rapid survey design with a cross-sectional approach. A sample of 210 students was selected using the cluster random sampling technique using the Csurvey application. The independent variables consisted of eating patterns and stress, while the dependent variable was the incidence of gastritis. Primary data were collected through questionnaires, and secondary data were obtained from the Kupang City Health Office and Nusa Cendana University. Data analysis used the chi-square test. The results of the study were that out of 210 respondents, the majority of students who had poor eating patterns and experienced stress tended to experience gastritis. The results of the chi-square test showed a significant relationship between eating patterns and stress with the incidence of gastritis, where the p-value = 0,000. So it can be concluded that poor diet and high stress levels can increase the risk of gastritis in students at Nusa Cendana University in 2025.

Gastroenteritis is a leading cause of global morbidity, characterized by inflammation of the stomach, small intestine, or large intestine, resulting in diarrhea, vomiting, and abdominal pain. Acute gastroenteritis (AGE) typically resolves within 14 days, but probiotics are increasingly used to restore gut microbiota balance and counteract pathogenic organisms. This study evaluates the safety and efficacy of a novel multistrain probiotic formulation in managing AGE and antibiotic-associated diarrhea (AAD). This observational, real-world study included 683 patients from 239 sites across India, assessing the effects of a multistrain probiotic formulation in AGE and AAD. The study adhered to ICH-GCP guidelines and the Declaration of Helsinki, with Ethics Committee approval. Clinical outcomes were assessed based on stool frequency, consistency, and Clinician's Global Impression of Improvement (CGI-I) scores after 7 days of treatment. Statistical analyses were conducted using SPSS version 29.0.1.0 to evaluate significant changes in these parameters. Among AGE patients (mean age: 45.91 ± 11.77 years; 68.92% male), 56.42% had no comorbidities. The most common symptoms were diarrhea (96.70%) and abdominal cramps (37.67%). Probiotics were prescribed to 93.92% of patients, with 93.23% achieving diarrhea resolution. Stool frequency significantly declined from 5.63 ± 1.43 to 1.65 ± 0.65 per day (68.94% reduction, p < 0.0001), and 95.31% of patients achieved normal stool consistency. CGI-I scores improved in 99.83% of cases. Among AAD patients (mean age: 43.32 ± 11.64 years; 60.75% male), diarrhea (97.20%) and vomiting (30.84%) were predominant symptoms. Probiotics were prescribed to 99.07% of patients, with an equal proportion achieving diarrhea resolution. Stool frequency significantly decreased by 67.94% (p < 0.0001), and Oral Rehydration Solution (ORS) use declined from 54.21% at baseline to zero by Day 7. No treatment-related adverse events were reported. The multistrain probiotic formulation significantly improved stool frequency and consistency in AGE and AAD patients within 7 days. Additionally, it effectively reduced ORS dependence and exhibited a strong safety profile, with no reported adverse events. These findings support the probiotic's potential as a safe and effective adjunct in managing AGE and AAD. This clinical study was registered at CTRI (Clinical Trial Registry of India) under the Registered number CTRI/2024/01/061546 on 17 Jan 2024.