Role of Probiotics in the Management of Helicobacter pylori Original paper

What was studied?

This review investigates the role of probiotics in the management of Helicobacter pylori (H. pylori) infection, a major cause of gastric disorders such as gastritis, peptic ulcers, and gastric cancer. The study examines how probiotics may be used as adjunctive therapy alongside traditional antibiotics to eradicate H. pylori more effectively, while minimizing the adverse effects commonly associated with antibiotic treatments, such as diarrhea and gastric disturbances. The review discusses the mechanisms by which probiotics, particularly strains of Lactobacillus and Bifidobacterium, compete with H. pylori for adhesion sites in the gut, produce antimicrobial substances like lactic acid and hydrogen peroxide, and modulate the immune response to enhance treatment efficacy.

Who was studied?

The review includes clinical trials, meta-analyses, and randomized controlled studies involving individuals infected with H. pylori, as well as studies focusing on the use of probiotics as part of treatment regimens. Probiotic strains such as Lactobacillus reuteri, Lactobacillus acidophilus, Bifidobacterium, and Saccharomyces boulardii were studied for their efficacy in reducing H. pylori colonization, enhancing gastric mucosal protection, and alleviating side effects of conventional therapy. The review draws on studies from diverse populations, including those from Asia and Europe, to examine how probiotics influence gastric microbiota composition and contribute to the improvement of gastric symptoms and treatment compliance. Studies also focused on patients with gastrointestinal disorders and those undergoing standard H. pylori eradication therapy (including triple or quadruple antibiotic regimens) combined with probiotic supplementation.

Most important findings

The review identifies several key findings related to the role of probiotics in managing H. pylori infection. First, it highlights the mechanisms of action of probiotics, noting that they compete with H. pylori for intestinal adhesion sites, thereby preventing bacterial colonization and reducing infection load. Additionally, probiotics were found to enhance the immune system, increasing the production of IgA antibodies and promoting mucosal barrier integrity, both of which contribute to protecting the stomach lining from H. pylori-induced damage. The study also emphasized the reduction of side effects such as diarrhea, which often occur during antibiotic therapy, and increased eradication rates when probiotics are used alongside standard treatments. Several clinical trials showed that combining probiotics with antibiotic regimens increased H. pylori eradication rates by 6-15% compared to antibiotic therapy alone, suggesting that probiotics offer significant clinical benefits. However, the review also notes that the effectiveness of probiotics can vary depending on the strain used and the dosage, with some probiotics showing more promise than others in eradicating H. pylori or reducing its pathogenicity.

Key implications

The findings suggest that probiotics can play a vital role in improving H. pylori treatment outcomes by increasing eradication rates and reducing side effects associated with antibiotic use. Given the rise in antibiotic resistance and the growing need for alternative therapies, the study highlights the potential of probiotics as a cost-effective and safer adjunct to conventional treatment regimens. Probiotic supplementation can help restore gastric microbial balance, support mucosal healing, and reduce gastric inflammation, thus improving patient compliance with treatment. The findings also underline the importance of selecting the right probiotic strain for H. pylori management, as not all probiotics are equally effective. Future clinical trials are needed to determine the optimal probiotic strains, doses, and treatment durations to maximize therapeutic benefits.