Effect of Probiotics on Portal Hypertension (PH) with Cirrhosis: A Systematic Review and Meta-Analysis.

Jianhua Li, Jie Sun, Tao Li, Gang Chang

Journal: Clinics and research in hepatology and gastroenterology 2024;48(6):102361

PMID: 38701917

Full Text on Elsevier Science View on PubMed

Abstract

INTRODUCTION

There are many options for the reduction of portal hypertension (pH) in cirrhotic patients, but all the current ones have side effects. Probiotics are a new approach for ameliorating the hyperdynamic circulation of cirrhotic patients. The aim of this study is to measure the effect of probiotics on pH in cirrhosis for the first time.

METHODS

A search was conducted across four electronic databases (PubMed, Scopus, Web of Science, Cochrane) for English-language records evaluating probiotic effects on pH in cirrhotic patients. Quality assessment used the Cochrane Collaboration's tool, employing a random-effects model in statistical analysis with Stata software version 1.

RESULTS

A search yielded 1,251 articles, which were narrowed down to 5 through screening. These studies, involving 158 participants across Canada, India, Spain, and Russia, focused on probiotic interventions in cirrhotic patients. Meta-analysis of two RCTs (66 participants) indicated a significant decrease in hepatic venous pressure gradient (HVPG) (SMD: -0.60 [-1.09, -0.12]). In single-arm analysis, four studies (58 participants) showed a substantial reduction in HVPG with probiotic use compared to the control (SMD: -2.55 [-3.42, -1.68]).

CONCLUSION

In summary, it showcased a notable reduction in HVPG compared to the control group, indicating a potential advantage of probiotics in decreasing pH in cirrhotic patients. Further research with larger samples and robust designs is warranted.

Address: Department of Minimally invasive intervention, Shandong Provincial Third Hospital, Shandong University, No.11 Wuyingshan Middle Road, Tianqiao District, Jinan, Shandong 250031, PR China. Electronic address: [email protected].; Department of Gastrointestinal surgery, Shandong Provincial Third Hospital, Shandong University, No.11 Wuyingshan Middle Road, Tianqiao District, Jinan, Shandong 250031, PR China.; Department of Gastroenterology, Shandong Provincial Third Hospital, Shandong University, No.11 Wuyingshan Middle Road, Tianqiao District, Jinan, Shandong 250031, PR China.; Department of Hepatic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, PR China.

DOI: 10.1016/j.clinre.2024.102361

Link outs

Free resources

Medical:

https://medlineplus.gov/cirrhosis.html

Subscription / membership required

Full Text Sources:

MeSH Terms: Humans, Hypertension, Portal, Probiotics, Liver Cirrhosis