title: The Effect of Probiotic Plus Prebiotic Supplementation on the Tolerance and Efficacy ofHelicobacter PyloriEradication Quadruple Therapy: a Randomized Prospective Double Blind Controlled Trial.
abstract: BACKGROUND Standard anti-Helicobacter pylori(H. pylori) treatment fails in the eradication of the organism in almost 10-35% of the patients and has different side effects. Recent studies have proposed that probiotic supplementations with or without prebiotic may improve the eradication rate and diminish the side effects, although it is still a controversial issue. We aimed to investigate the effect of probiotic with prebiotic supplementation on the eradication rate and side effects of antiH. pyloriquadruple therapy. METHODS 76 patients with a positive biopsy specimen forH. pyloriwere enrolled. They were randomized to receive quadruple therapy of bismuth, clarithromycin, amoxicillin, and omeprazole for 14 days and also the synbiotic or the placebo. We asked them to answer study questionnaires at the beginning and during the treatment. Finally, urea breath test was done 8 weeks after the treatment. RESULTS The eradication rate was significantly better in the synbiotic group by intention-to-treat analysis (p<0.05). Treatment side effects such as diarrhea, nausea, vomiting, epigastric pain, flatulence, constipation, and taste abnormality were similar in both groups but anorexia was significantly better in the synbiotic group (p <0.05). CONCLUSION The eradication rate was significantly better in the synbiotic group by intention-to-treat analysis (p<0.05). Treatment side effects such as diarrhea, nausea, vomiting, epigastric pain, flatulence, but could improve the eradication by augmenting the treatment tolerance and compliance.
authors.affiliation: Member of Gastrointestinal and Liver Diseases Research Center(GLDRC) and Gastroenterology Department, Guilan University of Medical Sciences, Rasht, Iran gjhsdfgjfdh.
authors.forename: Afshin
authors.initials: A
authors.lastname: Shafaghi
authors.affiliation: Infectious Disease Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Aydin
authors.initials: A
authors.lastname: Pourkazemi
authors.affiliation: Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Khosravani
authors.affiliation: Gastroenterology Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Saba
authors.initials: S
authors.lastname: Fakhrie Asl
authors.affiliation: Student Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Amir Maafi
authors.affiliation: Student Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Atrkar Roshan
authors.affiliation: Member of Caspian Tamin Pharmaceutical Company, Rasht, Iran.
authors.forename: Jafar
authors.initials: J
authors.lastname: Abaspour Rahimabad
keywords: H. pylori eradication; Prebiotic; Probiotic; Quadruple therapy; RCT; Synbiotic