Clinical Evaluation And Intervention
Phase 1: A random number table was used to divide the 134 RE patients into two groups of 67 subjects each. Esomeprazole is the first choice of PPI, having strong and lasting acid suppression effect. Medilac-s are live combined B. subtilis and E. faecium enteric-coated capsules. These two kinds of bacteria are regular members of the intestinal flora of healthy people. Taking this product can directly supplement normal physiological living bacteria, inhibit the excessive reproduction of harmful bacteria in the intestinal tract, and adjust the intestinal flora, which is applied widely in the clinic. The dosage of the medicine was determined by the published drug instructions. The placebo was provided by the Pharmacy Department from the PKUCare Luzhong Hospital. The dosage form, appearance, size, and color of the placebo were completely identical with the drug. The drugs conform to Chinas Good Manufacture Practice of Medical Products. Patients in the placebo group took 20 mg of esomeprazole orally twice a day and placebo thrice a day for eight weeks. Patients in the probiotics group took 20 mg of esomeprazole orally twice a day and 500 mg of live combined B. subtilis and E. faecium enteric-coated capsules thrice a day for 8 wk. The treatment was single blinded. Patients did not know their assigned groups. Observation for medication compliance was performed twice a week through phone, by asking the parents about compliance. Poor compliance was defined as missed doses for 3 d.
What Is The Difference Between Gastritis And Acid Reflux
These two conditions get mixed up quite often as they present with very similar symptoms. Gastritis is an unpleasant inflammatory condition associated with high levels of stomach acid, but instead of inflammation of the oesophagus, its inflammation of the stomach lining. Gastritis can have similar root causes and risk factors as acid reflux, including overconsumption of certain foods and drinks, overuse of certain pain medications or a bacterial infection like H. pylori. We will cover the best probiotics for gastritis in the next section.
Role For Probiotics In Gerd
As gastroesophageal reflux disease soars globally, alternatives to traditional therapies are welcomed. An excellent review described below looked at the ability of probiotics to alleviate symptoms in GERD.
GERD, a little background
Gastroesophageal reflux disease commonly known as GERD affects an estimated one billion people worldwide with large variations between regions and countries.
The World Gastroenterology Organization defines GERD as troublesome symptoms sufficient to impair an individuals quality of life, or injury or complications that result from the retrograde flow of gastric contents into the esophagus, oropharynx, and/or respiratory tract.
In addition to these undesirable health effects, GERD levies both a heavy economic and societal toll.
Though some of those suffering from GERD may blame pepperoni pizza, the pathogenesis is more complex including but not limited to motor dysfunction, hiatal hernia, and impaired mucosal resistance.
Treating GERD
First line treatment usually begins with diet and lifestyle changes:
Eat smaller meals, slowly and at least two hours before sleep lose weight if needed avoid nicotine and alcohol avoid possible triggers including peppermint, chocolate, caffeine, citrus fruits, tomatoes, and high fat foods.
Medications are frequently recommended. Antacids and H2 blockers are used to deplete acids. Proton pump inhibitors block certain acidifying protons and may also heal damaged stomach lining.
Role for probiotics in GERD?
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Hiatal Hernia: Foods That May Cause Symptoms
The following foods are highly acidic or may weaken the lower esophageal sphincter, making it easier for stomach acids to back up into your esophagus. They may cause heartburn symptoms.
- Citrus foods, such as oranges, grapefruits, and lemons, and orange juice, grapefruit juice, cranberry juice, and lemonade
- Pretzels, graham crackers, rice cakes, and baked potato chips
You may find that some of the foods listed under “foods to avoid” may not bother you, while others on the “foods to enjoy” list may cause discomfort. Everyone tolerates food differently. To determine the best diet for you, keep a food diary for a few weeks. And then avoid anything that causes you to have symptoms.
What Is The Best Probiotic Supplement
Got heartburn, acid reflux or hiatus hernia? Choosing the best probiotic supplement may be the fastest, safest management of symptoms. Heartburn, acid reflux? Similarly, if you experience bloating, bad breath, body odour, gas or excessing burping at or in between meals. Colds, constipation, diarrhoea, food cravings, PMS or hot flushes are another list of symptoms. Itchy nose and itchy bottom and allergies, stomach pain and stomach ulcers are unlikely indications for probiotic supplementing. Others are: Irritable bowel syndrome IBS, malodorous stools, thrush, urinary infections, vaginal discharge.
Our nutrition and our lifestyle work together for our health. Our body should break down food we eat properly. Then we can use the nutrients in our food for health. This includes on and off switches involved in hormone secretion. Many other functional pathways rely on healthy metabolism. Otherwise we become sick and tired literally.
Ongoing biological processes require nutrients to be bioavailable. Prescript Assist aids this process. It makes it easier for your body to eliminate waste. Also so not to confuse the goodness for waste. Prescript Assistticks the boxes you require when selecting the best probiotic.
Best Probiotics
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How Do Probiotics Help Acid Reflux
14 clinical studies have evaluated the effects of probiotics on acid reflux and 79 percent of these studies concluded that probiotics may be a beneficial add-on for people who suffer from heartburn and reflux symptoms.
Both single-strain probiotics and multi-strain probiotics seem to be helpful for acid reflux and functional dyspepsia according to research.
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What Types Of Probiotics Help Acid Reflux
Probiotics that contain strains from lactobacilli and bifidobacteria may be helpful with acid reflux and associated issues.
Probiotics of high quality can offer various benefits to the microbiome, including relief from GERD, aiding in digestion, optimizing bowel movements, supporting immune function, and weight loss. Probiotics may also be helpful with GI symptoms like irritable bowel syndrome , diarrhea, and small intestinal bacterial overgrowth .
Probiotic supplements are not regulated by the FDA in the same way that pharmaceutical drugs are. This means there is not a standard of quality that probiotics are required to meet during manufacture. When seeking relief from gastrointestinal abnormalities such as GERD, it is recommended to purchase probiotics that research has proven effective. Omni-biotic probiotics have been researched and have been shown to improve gastrointestinal symptoms by the user.
In studies, specific probiotic strains from the genus Lactobacilli have decreased gastric acid production in an animal model and increased pepsinogen . PGI may help improve digestion and decrease gastric residence time. Bifidobacterium adhered to stomach cells and prompted mucin production, improving the gastric barrier to acidic stomach content.
These bacteria strains may be more effective than other stains due to limited evidence between probiotic strains. The limited evidence is related to small quantities of available trials.
When Natural Treatments May Not Be Enough
There may be some cases when an entirely natural approach is not enough. When there is tissue damage in the esophagus, for example, a surgical procedure called gastroplication which repairs the LES valve may be necessary. These procedures dont have the potential to create nutrient deficiencies and disease the way acid blockers do. It is advisable for anyone suffering from a severe case of GERD to consult with a knowledgeable physician.
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Probiotics For Gerd And Heartburn
The gut microbiome is composed of millions of microbes living in symbiosis and regulating a number of physiologic processes including gastrointestinal motility. GERD, a multifactorial gastrointestinal motility disorder, may partly result from gut microbiome dysbiosis. Manipulation of gut microbes through diet, prebiotics, probiotics and fecal transplantation is a promising therapeutic target to eliminate heartburn.
Ritual Synbiotic+ At A Glance
Strains: Bifidobacterium animalis ssp. lactis, Lactobacillus rhamnosus
CFU count: 11 billion
- Type: vegetarian capsules
This probiotic blend provides 12 strains chosen specifically to reflect the natural diversity in the gut and restore digestive harmony.
It also contains probiotic strains, including Lactobacillus reuteri and Lactobacillus rhamnosus, that may help enhance the health of the vaginal microbiome .
Ideally, this product should be refrigerated to maximize its shelf life. It can also be stored in a cool, dry place at 77°F or below.
Though this product is not third-party tested, Renew Life notes that its supplements are produced in facilities that adhere to CGMPs.
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The Best Probiotic Supplements
While it is complicated to give a one size fits all recommendation, there are brands that tend to provide higher quality cultures than others.
We have kept an eye on brands and their lab test results and here are the ones that consistently did better when it comes to number of bacterias per pill:
If you are looking to solve a specific problem with probiotics, we recommend you look int our specialised guides below to chose the right product for you.
Hiatal Hernia: Lifestyle Tips
In addition to making adjustments to what you eat and how you cook, changing certain habits may lessen heartburn symptoms too, including:
- Do not overeat. Instead, eat small, frequent meals. And take your time. Eating fast can make heartburn symptoms worse.
- Avoid lying down or going to sleep for at least three hours after a meal.
- Do not bend over right after eating.
- Lose weight, if necessary.
- Wear loose-fitting clothes so as to not add extra pressure on your stomach.
- Raise the head of your bed 6 to 8 inches with wood blocks or some other sturdy objects. Propping your head up with pillows probably won’t give you the relief you need.
If these diet and lifestyle tips don’t help, or you need additional relief, over-the-counter antacids and acid-reducing or blocking drugs may help control your heartburn symptoms. Talk to your doctor to learn more about over-the-counter or prescription medications to treat your symptoms. Surgery may be needed in rare cases.
Hiatal hernia symptoms can be bothersome. But most people feel better after they adjust their diet and lifestyle.
Show Sources
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health: “Heartburn, Gastroesophageal Reflux , and Gastroesophageal Reflux Disease .”
HerniaSymptoms.org: “Diet for Hiatal Hernia.”
Penn State Hershey Medical Center: “Hiatal Hernia.”
McKinley Health Center, University of Illinois: “The GERD Diet.”
American Heart Association: “Cooking for Lower Cholesterol.”
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How Probiotics Can Help With Acid Reflux
Probiotics do not increase stomach acid and may help protect against the ill effects of acid reflux.
Lactobacillus johnsonii was shown to have the opposite effect on hydrochloric acid production in a study involving mice.
Bifidobacterium bifidum has been shown to promote the production of mucin, a type of protein that improves the stomach barrier to acidic gastric contents.
Lactobacillus gasseri increases pepsin, an enzyme that helps digest dietary protein, and may improve digestion and absorption. Probiotics can be a solution to GERD, and the bacteria strains listed above may help with adverse symptoms.
Probiotics may help with acid reflux by modulating the esophageal microbiome. Changes in the esophageal microbiota are associated with esophageal diseases such as GERD. Similar factors cause dysbiosis in the esophagus just as they do in the gut, including antibiotic use, lifestyle choices, and food-borne pathogens.
When dysbiosis occurs in the esophagus, an inflammatory response is activated, leading to damage by acid and bile. Probiotics that include bacteria strains from the genus lactobacillus and bifidobacterium showed reduced gastrointestinal symptoms.
The bacteria strain Bifidobacterium bifidum may help regulate a pathway that helps stimulate antibodies for the immune system. The effects of this mechanism can reduce abdominal pain and improve the interactions between nutrients, secretions, and enzymes in the gut and the esophageal tissue in people with GERD.
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The Best Probiotics For Specific Uses
General Uses
- and physical activity levels
Many disorders and diseases can have a negative effect on your guts microbiome.
Your physical surroundings can also make a great deal of difference when it comes to your gut. Pollution and other environmental factors can play a big role in the development and maintenance of good bacteria in the gut.
Deep Breathing For Acid Reflux
Beyond taking probiotics for reflux, there are a couple other ways you can help yourself manage this condition. Lets discuss those.
Your gut and your brain are connected, which means they talk to each other constantly. This explains why uncontrolled anxiety, depression, and stress can lead to an increase in GERD symptoms. Not dealing effectively with these conditions also makes it difficult for your body to heal and respond well to reflux treatment.
One simple strategy that can calm your mind and also help improve your GERD symptoms over time is diaphragmatic breathing.
To familiarize yourself with deep breathing, you can lay on the floor with a book on top of your belly. Breathe in deeply and you should see the book rise up from your stomach. What youre trying to avoid is breathing from your chest. Now, simply lay there and continue breathing deeply for a few minutes.
One of my favorite recommendations to clients is to incorporate a deep breathing practice at mealtime to help relax their body before its time to digest. To do this, they take 1-2 minutes before eating their food to sit down, relax, and breathe deeply. Bonus point for having your food in front of you so that you can smell it this gets the digestive juices flowing.
I have found this practice to be incredibly effective for just about all my digestive health clients, but especially those who deal with reflux.
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Best Probiotics For H Pylori
For individuals who undergo triple therapy to treat H. pylori infection, a probiotic supplement containing the strains Lactobacillus acidophilus Rosell-52 and Lactobacillus rhamnosus Rosell-11 should be considered. In a clinical trial comparing the effects of taking triple therapy alone compared with triple therapy and a probiotic supplement of Lactobacillus acidophilus Rosell-52 and Lactobacillus rhamnosus Rosell-11, H. pylori was shown to be successfully eradicated in 72% of the triple therapy group versus 92% of the triple therapy and probiotic group after 6 weeks5. These results suggest that taking a probiotic supplement containing Lactobacillus acidophilus Rosell-52 and Lactobacillus rhamnosus Rosell-11 alongside triple therapy improves the eradication rate of H. pylori infection which, therefore, can reduce the severity of acid reflux symptoms and may be the best probiotics for H. pylori. Find out more about the research behind Lactobacillus acidophilus Rosell-52 and Lactobacillus rhamnosus Rosell-11 on the Probiotics Database.
In addition to the improved treatment outcomes, the probiotic group also had less side-effects from the eradication therapy. Only 1.88% discontinued medical treatment due to diarrhoea, whereas 12.26% had to cease treatment for that reason in the groups that were not given the additional probiotic support.
Health professionals may wish to head over to our Probiotic Professionals site to read the following recent blog posts:
Best Probiotic Brands For Acid Reflux
NOW Supplements, Saccharomyces Boulardii, contains S. boulardii at 5 billion CFUs. This product is highly rated for improving many aspects of digestive health and very inexpensive for people on a budget.
Swansons Lactobacillus Gasseri, with 3 billion CFUs per serving-I listed this brand because it is the only single-strain probiotic of the well-researched Lactobacillus Gasseri.
This probiotic would be a good add-on for people who tend to eat probiotic foods or take another probiotic and are looking for a bit of extra benefit for acid reflux. Some people make their own yogurt out of it as well.
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New Review Investigates The Role Of Probiotics In Gastroesophageal Reflux Disease
Gastrointestinal reflux disease is a common digestive disorder characterized by chronic symptoms resulting from abnormal reflux of contents from the stomach into the esophagus, leading to mucosal damage. The underlying cause of GERD is multifactorial and can result from stress, poor diet, impaired digestion, dysbiosis, hiatal hernia, and esophageal sphincter dysfunction. Risk factors associated with GERD include smoking, alcohol, and NSAID use.
Previously, I had shared research demonstrating that the damage of the esophagus in GERD was shown to be cytokine-mediated due to inflammation and not caused directly by the acid in the stomach.
Pharmaceutical interventions may provide symptom management but they do not correct many of the underlying factors and often have side effects. Lifestyle changes and nutritional support are usually sufficient to address acid reflux. Patients should consider eating smaller portions at meals. In addition, they should avoid laying down after meals and avoid eating too close to bedtime. Also, alcohol and certain foods can trigger symptoms.
While proton pump inhibitors may help with the symptoms, they may not be the solution. Recent previous studies have linked PPIs to chronic kidney disease, cardiovascular disease and an increase risk of a heart attack. PPIs can also lead to other problems such as dysbiosis and small intestinal bacterial overgrowth .
Gastric Benefits Of Probiotics In Healthy Adults
People who are healthy experience gastric benefits of probiotics too.
For example, a follow-up study of Bifidobacterium bifidum YIT 10347 fermented milk in healthy adults found that this supplement reduced gastric pain and overall post-meal comfort compared to a placebo too.
This particular strain of probiotic is helpful at alleviating gastric pain because the results have been duplicated in two different clinical studies .
Interesting Tip: Another perk to the probiotic Lactobacillus gasseri yogurt is that it may reduce abdominal fat by as much as 8-9 percent compared to conventional yogurt over a 12 week period .
Lactobacillus gasseri also reduced waist circumference and abdominal fat according to another study especially when using a higher dose .
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