Should probiotics star in Helicobacter pylori therapy?

There are some promising results but no firm conclusions when it comes to using probiotics against the stomach germ Helicobacter pylori, a review finds.

The review pointed towards the stimulation of acid by the probiotics as the main mechanism for this. However no “exhaustive data” was available due to poor study design.

Multicenter, high-quality, double-blind, randomised controlled trials were now needed to explore the potential of the most promising strain, Lactobacillus reuteri, they wrote in the journal Gastroenterology Clinics of North America.

Helicobacter pylori is a bacteria found in the sticky mucus that lines the stomach. About 40% of people in the UK have it, according to the UK’s National Health Service (NHS).

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While about 90% of those do not experience any problems, about 15% of the infected get ulcers either in the stomach (gastric ulcer) or in the small intestine’s duodenum (duodenal ulcer).

The germ has also been linked to a slight increase in the risk of stomach cancer, although treating H. pylori simply to reduce this risk would be ineffective, according to NHS advice.

The researchers from Baylor College of Medicine in the US, Otto-von-Guericke University in Germany and University of Parma and University of Sassari in Italy behind this latest review looked at 16 papers on different probiotic strains as both a ‘cure’ for and adjuvant therapy of H. pylori.

For Lactobacilli strains they said overall the probiotic affected affect H. pylori colonisation through acidity changes. Meanwhile some strains of lactobacilli may also exert strain-specific antimicrobial effects.

However, they concluded “few subjects were actually cured”.

Source: Gastroenterology Clinics of North America

Vol 44, Iss 3, pp. 565–575, doi:10.1016/j.gtc.2015.05.005

“Is There a Role for Probiotics in Helicobacter pylori Therapy?”

Authors: M. P. Dore, E. Goni and F. Di Mario