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Proton pump inhibitors (PPIs) effectively control gastroesophageal reflux disease (GERD) symptoms but may contribute to gut microbiome disruption and symptom relapse after therapy cessation.
Microbiome-directed probiotic supplementation supports long-term reflux symptom improvement beyond standard acid-suppressive therapy.
Proton pump inhibitors (PPIs) effectively control gastroesophageal reflux disease (GERD) symptoms but may contribute to gut microbiome disruption and symptom relapse after therapy cessation. To explore a potential microbiome-based strategy for improving long-term disease control, researchers evaluated the efficacy of a multi-strain probiotic combined with rabeprazole and examined its impact on gut microbial and metabolic signatures in patients with GERD.
A randomized controlled trial enrolled 120 patients with GERD. Participants received rabeprazole plus either the multi-strain probiotic Lihuo or placebo for 8 weeks, followed by 4 weeks of probiotic or placebo monotherapy. Treatment efficacy was evaluated using changes in Reflux Disease Questionnaire (RDQ) scores, gastrointestinal symptom assessments, and endoscopic healing rates. To explore underlying biological effects, comprehensive multi-omics profiling—including shotgun metagenomics, phageome analysis, and targeted and untargeted metabolomics—was utilized to assess treatment-related shifts in gut microbial composition and metabolic activity.
The probiotic regimen delivered superior clinical improvement compared with placebo and was associated with targeted remodeling of gut microbial and metabolic pathways implicated in GERD (Table 1).
The observed clinical and biological benefits suggested that probiotic supplementation may help address limitations of long-term PPI therapy by promoting sustained symptom relief and restoring gut ecosystem balance. Such findings reinforced the emerging importance of microbiome-based therapeutic approaches in GERD care.
Human Microbiome
Adjunctive probiotic therapy sustains symptom relief in gastroesophageal reflux disease through gut microbiome-metabolome remodeling
Yingmeng Li et al.
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