As per recent study findings, in reflux esophagitis patients, esomeprazole combined with probiotics (Bacillus subtilis and Enterococcus faecium) found to improve abdominal symptoms, and lower the incidence of small intestinal bacterial overgrowth (SIBO). The combination also prolonged the time to relapse.

A study was conducted to determine the therapeutic effects of a combination of esomeprazole and probiotics [live combined Bacillus subtilis and Enterococcus faecium] in reflux esophagitis patients.

From June 2015 to December 2017, 134 reflux esophagitis patients were recruited and were randomized to either probiotics group (n=67) or placebo group (n = 67). Bacillus subtilis and Enterococcus faecium enteric-coated capsules 500 mg thrice a day and esomeprazole 20 mg twice a day were given for eight weeks to the participants in the probiotics group. Esomeprazole 20 mg twice a day and placebo for eight weeks was administered to the placebo group.

Subsequently, a 12-week follow-up was conducted on patients who attained both endoscopic and clinical cure. Notably, the lactulose hydrogen breath test, endoscopy, reflux diagnostic questionnaire (RDQ), and gastrointestinal symptom rating scale (GSRS) were carried out to examine the therapeutic effects. 

The eight-week treatment was accomplished by 64 patients in the placebo group and 66 patients in the probiotics group. No significant differences in the RDQ score and healing rate were witnessed between the two groups. In the probiotics group, the GSRS diarrhea syndrome score considerably declined, as depicted in the following figures: 

Compared to the placebo group, the SIBO negative rate was substantially elevated in the probiotics group.

Notably, out of 114 endoscopically and clinically cured patients, 96 completed the follow-up. According to the log-rank test, the time to relapse was found to be shorter in the placebo group in comparison with the probiotics group. Additionally, the therapy had a substantial influence on relapse time. Compared to the placebo group, the risk of relapse in the probiotics group was lower at any time point during the 12-week follow up as depicted in the following figure:

Combined administration of probiotics (B. subtilis and E. faecium) and esomeprazole have a beneficial effect on the treatment of reflux esophagitis.