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Free for all myUEG account holders. Your access level is set automatically based on your occupation. Medical professionals get full access to all content. If you are a non-medical user, you can only access UEG Week content from congresses you attended.

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Introduction

It is still controversial whether the supplementation of Saccharomyces boulardii to bismuth quadruple therapy is beneficial for Helicobacter pylori eradication. The aim of the study was to determine the effects of S. boulardii supplementation on H. pylori eradication.

Aims & Methods

We performed a systematic literature search across PubMed, Embase, Web of Science, and China National Knowledge Infrastructure for articles published up to October 2023. We calculated the pooled relative risk (RR) with the 95% confidence interval (CI). Subgroup analyses were also performed. Statistical analyses were conducted using Stata/SE 15.1 software.

Results

Ten randomized controlled trials were included. Notably, S. boulardii supplementation to bismuth quadruple therapy significantly improved H. pylori eradication rates (RR = 1.08, 95% CI: 1.04–1.12, P < 0.0001) and reduced the incidence of total adverse effects (RR = 0.53, 95% CI: 0.45–0.62, P < 0.0001). Furthermore, it reduced the incidence of some gastrointestinal adverse effects and nonspecific adverse effects, including diarrhea (RR = 0.28, 95% CI: 0.22–0.36, P < 0.0001), constipation (RR = 0.32, 95% CI: 0.18–0.55, P < 0.0001), abdominal distention (RR = 0.39, 95% CI: 0.26–0.59, P < 0.0001), nausea (RR = 0.59, 95% CI: 0.36–0.97, P = 0.039), and rash (RR = 0.49, 95% CI: 0.28–0.86, P = 0.013). In the subgroup analysis, long-term eradication duration (>10 days; RR = 1.08, 95% CI: 1.04–1.13, P < 0.0001) and S. boulardii supplementation to be started and stopped at the same time as bismuth quadruple therapy (RR = 1.09, 95% CI: 1.04–1.14, P < 0.0001) were found to significantly improve the eradication rate regardless of the S. boulardii dose (500 mg/day, RR = 1.10, 95% CI: 1.03–1.17, P = 0.003; 1000 mg/day, RR =1.08, 95% CI: 1.03–1.12, P < 0.0001).

Conclusion

The addition of S. boulardii to bismuth quadruple therapy significantly increased H. pylori eradication rates and decreased the adverse effects. We recommend adding 500 mg/day S. boulardii concurrently with bismuth quadruple therapy and continuing this therapy for >10 days for optimal H. pylori eradication efficacy.

THE EFFECT OF SACCHAROMYCES BOULARDII SUPPLEMENTATION TO BISMUTH QUADRUPLE THERAPY ON HELICOBACTER PYLORI ERADICATION

Xiaoyong Wang 1, Yizhou Jiang 2

1 The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China

2 The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China

Conference

UEG Week Vienna 2024

Topics

Stomach & H. Pylori

Submission format

Abstract

Session

H.pylori treatment: Part 2 (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Podcast Episode

Journal Podcast

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Episode 6: UEG Journal October Spotlight

Mohsan Subhani, Maria Manuela Estevinho

Topics

Endoscopy Hepatobiliary IBD Pancreas

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

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Abstract

The current consensus guideline offers a comprehensive and practical guidance on the diagnostic and monitoring of patients with inflammatory bowel disease (IBD). It provides recommendations on requirements for initial diagnosis, detection of complications, the use of monitoring tools in patients with IBD and diagnostics in specific situations, such as pregnancy, postoperatively and for cancer surveillance. The guideline is a joint project of the European Crohn’s and Colitis Organization (ECCO), the European Society of Gastrointestinal and Abdominal Radiology, the European Society of Pathology, and the International Bowel Ultrasonography Group under the leadership of ECCO.

ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1: initial diagnosis, monitoring of known inflammatory bowel disease, detection of complications

Torsten Kucharzik

Publisher

European Crohn’s and Colitis Organisation

Guideline

Clinical Practice Guideline

Topics

IBD

Citation

Journal of Crohn's and Colitis, Volume 19, Issue 7

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

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Summary

Recent years have witnessed significant advances in the imaging, molecular profiling, and systemic treatment of cholangiocarcinoma (CCA). Despite this progress, the early detection, precise classification, and effective management of CCA remain challenging. Owing to recent developments and the significant differences in CCA subtypes, EASL commissioned a panel of experts to draft evidence-based recommendations on the management of extrahepatic CCA, comprising distal and perihilar CCA. Particular attention is given to the need for accurate classification systems, the integration of emerging molecular insights, and practical strategies for diagnosis and treatment that reflect real-world clinical scenarios.

EASL Clinical Practice Guidelines on the management of extrahepatic cholangiocarcinoma

Publisher

European Association for the Study of the Liver

Guideline

Clinical Practice Guideline

Topics

Digestive Oncology Hepatobiliary

Citation

Journal of Hepatology, Volume 83, Issue 1, 211 - 238

Published

2025

UEG Standards and Guidelines

Clinical Practice Guideline

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Summary

The updated EASL Clinical Practice Guidelines on the management of hepatitis B virus (HBV) infection provide comprehensive, evidence-based recommendations for its management. Spanning ten thematic sections, the guidelines address diagnostics, treatment goals, treatment indications, therapeutic options, hepatocellular carcinoma surveillance, management of special populations, HBV reactivation prophylaxis, post-transplant care, HBV prevention strategies, and finally address open questions and future research directions. Chronic HBV remains a global health challenge, with over 250 million individuals affected and significant mortality due to cirrhosis and hepatocellular carcinoma. These guidelines emphasise the importance of early diagnosis, risk stratification based on viral and host factors, and tailored antiviral therapy. Attention is given to simplified algorithms, vaccination, and screening to support global HBV elimination targets. The guidelines also discuss emerging biomarkers and evolving definitions of functional and partial cure. Developed through literature review, expert consensus, and a Delphi process, the guidelines aim to equip healthcare providers across disciplines with practical tools to optimise HBV care and outcomes worldwide.

EASL Clinical Practice Guidelines on the management of hepatitis B virus infection

Publisher

European Association for the Study of the Liver

Guideline

Clinical Practice Guideline

Topics

Hepatobiliary

Citation

Journal of Hepatology, Volume 83, Issue 2, 502 - 583

Published

2025

UEG Mistakes In Articles

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Upper and lower gastrointestinal endoscopy examinations are performed daily as routine diagnostic procedures in a large number of patients with nonspecific indications, such as heartburn, pain, anaemia, bleeding, workup of portal hypertension and so on. Most of the examinations will point to a classic diagnosis (e.g. peptic disease, cancer, variceal management), but sometimes we see patients who've had multiple diagnostic endoscopic procedures in the previous few months with nonconclusive findings. The diagnostic mistakes discussed here are those that sprang to mind based on our endoscopic experience and they are discussed in an evidence-based approach. For therapeutic endoscopic procedures (e.g. ERCP and resections), we present the most important mistakes that are often seen in our practice and have major consequences for the patient. We propose, from our experience, a simple approach to avoid these mistakes.