S2067 The Role of Probiotics in Alleviating Gastroparesis Symptoms: A Systematic Review

Introduction: Gastroparesis (GP) is a chronic gastrointestinal disorder characterized by delayed gastric emptying without mechanical obstruction. It is associated with symptoms such as nausea, early satiety, and bloating, which significantly impact quality of life. Pharmacological treatments for GP are limited and are associated with unwanted side effects. Probiotics, particularly strains such as Lactobacillus, have shown promise in regulating gut motility and alleviating symptoms associated with delayed gastric emptying. This review aims to evaluate the efficacy of probiotic supplementation in alleviating GP symptoms, focusing on gastric motility, nutrient absorption, and overall symptom improvement. Methods: The search was conducted on Ovid MEDLINE, Ovid Embase, and Cochrane Central databases to identify studies assessing the effects of probiotics on gastric motility in GP. Seven clinical trials and studies were included, focusing on various strains of probiotics, including multi-strain Lactobacillus capsules, Lactobacillus gasseri OLL2716, and Lactobacillus rhamnosus GG. The studies used different methodologies to measure outcomes noted above. Results: Probiotic use was associated with improved gastric motility and symptom reduction. Multi-strain Lactobacillus capsules enhanced gastric emptying, while Lactobacillus gasseri OLL2716 improved gastric emptying in patients with mild to moderate cases, though statistical significance was not achieved. In elderly patients, Lactobacillus rhamnosus GG improved gastric motility, enhanced nutrient absorption, and was associated with better nutrient utilization. Several studies also suggested a link between gut dysbiosis and GP, indicating probiotics may influence the gut-brain axis to alleviate symptoms. Conclusion: Probiotics, particularly Lactobacillus strains, offer potential therapeutic benefits in managing GP by enhancing gastric motility, improving nutrient absorption, and possibly modulating the gut-brain axis. These effects may be mediated through restoration of gut microbiota balance, improvement in autonomic nervous system function, and regulation of gastrointestinal hormones such as motilin and neuropeptide Y. While several studies demonstrate positive outcomes, results remain variable and strain-specific, with some lacking statistical significance. Nonetheless, the emerging evidence supports probiotics as a promising adjunctive therapy, particularly in patients with microbiota dysbiosis or those who are unresponsive to conventional treatments.