Evaluation of Multi-strain Lactobacillus Capsule on Gastric Emptying Function by Tc-99m Scintigraphy in a Crossover Placebo-Controlled Clinical Trial

Current pharmacological therapy for gastroparesis is limited by a few optional agents with high side effect profiles. Probiotics, which exert both prokinetic and antibiotic properties, can be a good alternative. This study investigates the effects of capsules containing three species of Lactobacillus on gastric emptying function by using a crossover placebo-controlled clinical trial. The 15 healthy participants recruited were divided into two groups, with one group of 7 persons aged between 20-40 and another group of 8 persons aged between 41-60. All the participants in each group were provided with placebo capsules and probiotic capsules, respectively, to be taken twice a day after meals for 3 weeks with crossover in the following 3 weeks. Tc-99m scintigraphy was performed at the beginning of weeks 0, 3 and 610 determine the gastric emptying rate. All time-activity curves were constructed and the half time of gastric emptying (GEt1/2) was calculated for the same subject for comparison. The GEt1/2 of the baseline, placebo and Lactobacillus regimen periods for the 20-40 age group were 73.0 +/- 16.0, 85.7 +/- 10.5, and 87.8 +/- 10.0 min, respectively, while those for the 41-60 age group were 79.1 +/- 23.9, 70.9 +/- 33.1, and 68.4 +/- 15.2 min, respectively. Comparison of the two groups showed a positive effect of probiotics capsules on the 41 to 60-year-old participants (p=0.013) but not on the 20 to 40-year-old participants. There was no significant statistical difference between the two groups in the period of treatment with placebo. This early stage trial indicated that the multi-strain Lactobacillus capsule is safe and the results provided some evidence that it accelerated gastric emptying in healthy adults above 40 years of age and may become a therapeutic approach in future trials for pathological gastric emptying delay, by implication, especially in diabetic gastroparesis.