GASTROBARRIER
Gastroenterology
Supports recovery of GI microflora in patients with impaired intragastric acidity
Supports gastric barrier function in patients treated with PPIs
Inhibits intestinal pathogens, reducing risk of foodborne infections
Reduces bacterial overgrowth in the stomach and duodenum
Lacticaseibacillus rhamnosus LR06 (DSM 2198)
Lactiplantibacillus pentosus LPS01 (DSM 21980)
Lactiplantibacillus plantarum LP01 (LMG P-21021)
Lactobacillus delbrueckii LDD01 (DSM 22106)
N-acetyl-cysteine (NAC)
Proton pump inhibitors (PPIs) are among the top 10 most commonly used drugs worldwide. Chronic use of PPIs has been consistently associated with significant shifts towards a less healthy gut microbiome and an increased risk of gastrointestinal (GI) infections [1-4]. This heightened risk is likely due to the impairment of gastric selective barrier function and changes in the gut microbiome of PPI users. Long-term PPI treatment chronically suppresses stomach acid production, leading to hypochlorhydria. This condition alters the intraluminal environment, allowing more bacteria to survive this barrier and proliferate in the small intestine. Consequently, long-term intake of PPIs is commonly linked with small intestinal bacterial overgrowth (SIBO), with the incidence of SIBO increasing when PPI intake exceeds 6 months [5,6].
SIBO is a clinical condition characterized by the abnormal colonization of the proximal small intestine with an excessive number (>10^5/mL) of gut bacteria. Symptoms include weight loss, bloating, malabsorption, steatorrhea, and vitamin deficiency [7].
GASTROBARRIER® has been specially formulated and clinically tested to restore physiological gastric barrier effects, thereby reducing the risk of foodborne GI infections and rebalancing the gastrointestinal microflora in patients with impaired intragastric acidity. The four strains in GASTROBARRIER® were selected for their antagonistic activity against E. coli, including the enterohaemorrhagic O157:H7 strain, while Lactobacillus delbrueckii LDD01 has shown strong inhibitory properties against Klebsiella pneumoniae [9]. N-acetylcysteine (NAC) is included for its mechanical effects on bacterial biofilms, helping to prevent their formation, particularly in the stomach.
Two clinical studies in patients treated with PPIs demonstrated that 10 and 15 days of daily supplementation with GASTROBARRIER® effectively rebalanced stomach and gut microbiota composition and restored a protective barrier against harmful bacteria [10,11]:
Colonization of the stomach and duodenum, at least temporarily, reducing bacterial overgrowth.
Significant reversal of the bacterial overgrowth in the stomach and duodenum typically seen in subjects treated with PPIs for over 12 months.
Notable decrease in gram-negative bacteria, Enterococcus spp., yeasts, and molds in the gut microbiota.
1. McDonald EG, et al. Continuous proton pump inhibitor therapy and the associated risk of recurrent clostridium difficile infection. JAMA Intern Med 2015;175:784–91. Doi: 10.1001/jamainternmed.2015.42
2. Bouwknegt M, et al. Potential association between the recent increase in campylobacteriosis incidence in the Netherlands and proton pump inhibitor use—an ecological study. Eurosurveillance 2014;19:1–6. Doi: 10.2807/1560-7917.es2014.19.32.20873
3. Leonard J, et al. Systematic review of the risk of enteric infection in patients taking acid suppression. Am J Gastroenterol 2007;102:2047–56. Doi: 10.1111/j.1572-0241.2007.01275.x
4. Janarthanan S, et al. Clostridium difficile-Associated Diarrhea and Proton Pump Inhibitor Therapy: a Meta-Analysis. Am J Gastroenterol 2012;107:1001–10. Doi: 10.1038/ajg.2012.179
5. Compare D, et al. Effects of long-term PPI treatment on producing bowel symptoms and SIBO. Eur. J. Clin. Invest. 2011; 41: 380–6. Doi: 10.1111/j.1365-2362.2010.02419.x
6. Revaiah PC, et al. Risk of small intestinal bacterial overgrowth in patients receiving proton pump inhibitors versus proton pump inhibitors plus prokinetics. JGH Open. 2018 Apr 2;2(2):47-53. Doi: 10.1002/jgh3.12045
7. Krajicek EJ, Hansel SL. Small intestinal bacterial overgrowth: a primary care review. Mayo Clin. Proc. 2016; 91: 1828–33. Doi: 10.1016/j.mayocp.2016.07.025
8. Mogna L. et al. Assessment of the in vitro inhibitory activity of specific probiotic bacteria against different Escherichia coli strains. J Clin Gastroenterol. 2012; 46 Suppl:S29-32
9. Mogna L, et al. In Vitro Inhibition of Klebsiella pneumoniae by Lactobacillus delbrueckii subsp. delbrueckii LDD01 (DSM 22106): An Innovative Strategy to Possibly Counteract Such Infections in Humans? J Clin Gastroenterol. 2016 Nov/Dec;50 Suppl 2, Proceedings from the 8th Probiotics, Prebiotics & New Foods for Microbiota and Human Health meeting held in Rome, Italy on September 13-15, 2015:S136-S139.
10.Del Piano M. et al. The Innovative Potential of Lactobacillus rhamnosus LR06, Lactobacillus pentosus LPS01, Lactobacillus plantarum LP01 and Lactobacillus delbrueckii subsp. delbrueckii LDD01 to Restore the Gastric Barrier Effect” in Patients Chronically Treated with PPIs – a Pilot Study. J Clin Gastroenterol 2012;46:S18-S26. DOI: 10.1097/MCG.0b013e318267b55d
11. Del Piano M. et al. Correlation Between Chronic Treatment With Proton Pump Inhibitors (PPIs) and Bacterial Overgrowth in the Stomach – Any Possible Beneficial Role for Selected Lactobacilli? J Clin Gastroenterol 2014;48:S40-S46. DOI: 10.1097/MCG.0000000000000256
