Reduction of dysbiosis in children treated with proton pump inhibitors

Background and methods

Gastroesophageal reflux (GERD) is a condition when the gastric acid content flows back into the esophagus. Proton pump inhibitors (PPI) has become the first line therapy prescribed for children over one year with GERD. According to some research the use of PPI may be involved in the pathogenesis of small intestinal bacterial overgrowth (SIBO).
In this randomized, single-blind, placebo-controlled study 128 children with GERD were treated with PPI and L. reuteri Protectis (5 drops/day), or PPI and placebo, for 12 weeks. The prevalence of SIBO was determined by glucose hydrogen breath test before and after treatment. As reference, they were also compared to 120 healthy children.


L. reuteri Protectis significantly reduced the prevalence of SIBO in children with GERD treated with PPI. In addition, L. reuteri Protectis also reduced gastrointestinal symptoms in children with SIBO.


L. reuteri Protectis as adjuvant to PPI treatment may reduce the prevalence of SIBO.