A double-blind placebo-controlled randomized trial on probiotics in small bowel bacterial overgrowth in children...

Area of Science:

• Pediatric Gastroenterology
• Microbiology
• Pharmacology

Background:

• Proton pump inhibitors (PPIs) like omeprazole are widely used in children.
• PPIs can alter the gastrointestinal environment, potentially leading to bacterial overgrowth.
• Small bowel bacterial overgrowth (SBBO) is a condition characterized by excessive bacteria in the small intestine.

Purpose of the Study:

• To determine the incidence of SBBO in children treated with omeprazole.
• To investigate whether probiotic supplementation can prevent omeprazole-induced SBBO.

Main Methods:

• A double-blinded, placebo-controlled trial involving 70 children treated with omeprazole for four weeks.
• Participants received either a probiotic combination (Lactobacillus rhamnosus R0011 and Lactobacillus acidophilus R0052) or a placebo daily.
• SBBO diagnosis was based on symptoms and a positive glucose breath test.

Main Results:

• After one month of omeprazole treatment, 30% of children had a positive glucose breath test suggestive of SBBO.
• Of those with a positive breath test, 62% were symptomatic.
• There was no statistically significant difference in the incidence of positive breath tests between the probiotic group (33%) and the placebo group (26.5%).

Conclusions:

• Omeprazole treatment is associated with a notable incidence of SBBO in children, indicated by abnormal glucose breath tests.
• The tested probiotic formulation did not demonstrate a significant effect in reducing the risk of developing SBBO during omeprazole therapy.
• The potential for SBBO as a side effect of PPIs in pediatric patients warrants increased clinical consideration.