Background and aimThe eradication of H. pylori infection using PPI associated with different combinations of two or three antibiotics entails high risks of side effects and non- adherence. Therefore probiotics have been proposed for H. pylori eradication.We tested the efficacy of Lactobacillus reuteri plus Pantoprazole compared to a triple regimen based on Pantoprazole plus Amoxicillin plus Clarithromycin in patients with H. pylori infection and functional dyspepsia.MethodsIn a prospective design, 46 patients (M: 13, F: 33, mean age 48.80 ± 13.82 years) fulfilled the following inclusion criteria: age at least 18, documented informed consent, positive H. pylori finding by histology, no morphological changes of the gastric mucosa at upper gastrointestinal endoscopy and complaints of functional dyspepsia according to the Rome III criteria. Exclusion criteria were: presence of any other chronic organic diseases that required drug treatment, use of antibiotics, PPIs or H2 antagonists in the previous 3 months; pregnancy or lactation. Patients were randomly divided into two equal groups (23 patients each group). One group received the standard therapy in our area: Pantoprazole 40 mg bid for 30 days associated with Amoxicillin 2×1000 mg/day and Clarithromycin 500 mg bid for 14 days. The other group received Pantoprazole 40 mg/day plus L. reuteri DSMZ 17648 twice a day for 8 weeks. Post-treatment eradication was tested by H. pylori antigen stool assay at 30 days after therapy.ResultsThe group on L. reuteri plus Pantoprazole presented 65.22% eradication rate compared to 73.91% cure rate in the group that received the Pantoprazole and Amoxicillin and Clarithromycin therapy, with no statistically significant difference in eradication rate between the two groups (p=0.75). The total adherence was good and eradication of H. pylori was associated with improvement of dyspeptic symptoms for both eradication regimens.ConclusionL. reuteri is a good alternative for patients with chronic dyspepsia for the eradication of H. pylori infection. Its efficacy is similar to the triple therapy.

The irritable bowel syndrome (IBS) is the most common chronic gastrointestinal disorder referred to gastroenterologists. One of the most common manifestations of IBS is bloating. Abdominal bloating is defined as subjective sensation of abdominal distension associated with girth increment. Therefore, it is described in the Rome IV criteria as bloating/abdominal distension. Bloating symptoms are reported by 10-30% of the general population and it was rated as the most bothersome symptom by 60% of IBS patients; the lack of specificity of this complaint prevented bloating to be included between the diagnostic criteria for IBS. Indeed, bloating may be reported also in healthy people or in other functional conditions. This paper looks to the evolutions of the concepts on bloating according to the Rome working groups from the beginning until now and it represents a comprehensive review on the prevalence and pathogenesis of bloating.

The acquisition of the infant�s microbiota is a vastly researched subject and of high interest. As more information is gathered, scientists prove the link between an unbalanced microbiome and certain afflictions. Antibiotics are widely used drugs and one of the factors that can shape the composition of the infant�s gut bacterial colonization. In this paper we aim to present the natural history of the child�s microbiome and the way it can be influenced by the use of antibiotics.

.