New Study Shows Adding Probiotics to H. pylori Eradication Regimen Is More Effective

What Causes Stomach Problems?

Helicobacter pylori (H. pylori) infection is the top cause of stomach problems like chronic active gastritis, ulcers, and even gastric cancer. Doctors have been trying different ways to get rid of the infection for a long time. A group of doctors from Greece just recommended a new method that works better than other methods.

The Ideal Treatment for Stomach Infections

The ideal way to treat a stomach infection caused by the H. pylori bacteria is a combination of four different medications — a proton pump inhibitor, amoxicillin, clarithromycin, and metronidazole. This combination of medications is more effective at treating the infection than any other single medication. Probiotics are also beneficial for gut health and immunity. They work by reinforcing the gut barrier, neutralizing carcinogens, and producing short-chain fatty acids with anti-inflammatory effects. 

Considering the opposing results from other studies on the efficiency of probiotics in eradicating H. pylori, this study was designed to assess any potential effect of probiotics over placebo as additive agents to the globally-accepted standard in H. pylori eradication treatment. The study’s main purpose was to assess whether probiotics reduce the rates of adverse events associated with the standard eradication regimen.

The Study Method on Probiotics for the Helicobacter Pylori Eradication Regimen

This prospective, randomized, placebo-controlled trial included 664 patients. All had a non-bismuth quadruple therapeutic regimen containing three antibiotics — 1 gram amoxicillin, 500 milligrams (mg) clarithromycin, 500 mg metronidazole — and 20 mg omeprazole, a proton pump inhibitor that prevents hyperacidity. These drugs were taken twice daily for ten days for H. pylori eradication. 

Of the patients randomized into groups and completed the study, 329 received probiotics (Group A), and 335 took a placebo (Group B) twice daily, two hours after a meal, for 15 days. The probiotic combined four strains —Lactobacillus Acidophilus, Lactiplantibacillus plantarum, Bifidobacterium lactis, and Saccharomyces boulardii.

After six weeks of treatment, all patients underwent the Carbon-13 Urea Breath Test. A negative test result indicates successful H. pylori eradication. At the same time, any adverse reaction, symptoms (epigastric pain, flatulence, early satiety, bitter taste, anorexia, nausea, vomiting, heartburn, skin rash, and diarrhea) experienced during the treatment period, and satisfaction or dissatisfaction with the probiotic were reported through a questionnaire.

The Results

56 (17.0%) patients in group A and 170 (50.7%) in group B reported the occurrence of new symptom/s or the aggravation of a pre-existing symptom/s associated with H. pylori treatment. On the other hand, H. pylori was successfully eradicated in 303 patients in group A (92.0%) and 291 patients in group B (86.8%). H. pylori was successfully eradicated in 303 patients in group A (92.0%) and 291 patients in group B (86.8%).

The Conclusion

Adding probiotics to the 10-day concomitant non-bismuth quadruple H. pylori eradication regimen increases the eradication rate and decreases side effects.


A Four-Probiotics Regimen Combined with a Standard Helicobacter Pylori-Eradication Treatment Reduces Side Effects and Increases Eradication Rates

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