<i>Saccharomyces boulardii</i> as an adjuvant therapy for <i>Helicobacter pylori</i> eradication: A systematic review and meta‐analysis with trial sequential analysis

Zhou, Ben‐Gang; Chen, Lingxiao; Li, Bo; Wan, Lin‐Yan; Ai, Yaowei

doi:10.1111/hel.12651

Cited by 53 publications

(56 citation statements)

References 57 publications

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“…Yu et al, demonstrated that Lactobacillus can signi cantly eradicate H. Pylori in a meta-analysis with a sample size of 724 patients to investigate the probiotic effect of Lactobacillus in combination with a triple eradication regimen [38], which was in contrary to our ndings. Zhou et al, in a meta-analysis showed that S. boulardii can signi cantly increase eradication of H. Pylori [39], which was not consistent with our ndings. The large sample size and multi-center nature of these studies are two reasons for inconsistency between the ndings.…”

Section: Discussioncontrasting

confidence: 96%

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Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori and Treatments҆ Side Effects: A Double-Blind Placebo-Controlled Randomized Clinical Trial

Naghibzadeh

Salmani

Nomiri

et al. 2021

Preprint

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Background: The primary goal of this placebo-controlled study was to determine the effect of quadruple treatment with Saccharomyces boulardii or Lactobacillus reuteri on the eradication of Helicobacter pylori and side effects of the treatment.Results: This study was a double-blind, randomized, placebo-controlled trial. And, eradication of helicobacter pylori was reported comparing conventional anti-H. Pylori therapy versus conventional therapy supplemented with S. boulardii and L. reuteri DSMZ 17648. For this aim, a total of 156 patients were included in the current study; and patients positive for H. Pylori infection (n =156) were randomly assigned to 3 groups: 52 patients (Group P) received conventional quadruple therapy plus L. reuteri, 52 patients (Group S) received conventional quadruple therapy plus S. boulardii daily, for 2 weeks, and 52 patients were in the control group (Group C). At the end of the treatment period, all the subjects continued to take proton pump inhibitor (PPI) alone for 14 days, and then, no medication was given for 2 weeks again. During follow-up, gastrointestinal symptoms were assessed using an evaluation scale (Glasgow dyspepsia questionnaire (GDQ)), and adverse events were assessed at 7, 14, 21, and 28 days. As a result, eradication therapy was effective for 94.2% of subjects in Group S, 92.3% of subjects in Group P, and 86.5% of subjects in the control group, with no differences between treatment arms. In Group S, the chance of developing symptoms of nausea (OR=2.74), diarrhea (OR=3.01), headache (OR=10.51), abdominal pain (OR=3.21), and anxiety (OR=3.58) was significantly lower than in the control group (p<0.05).Conclusion: In general, our findings revealed that the use of probiotic supplements containing S. boulardii or Lactobacillus reuteri (DSMZ 17648 strain) improved the eradication rate of H. Pylori infection, but it was not statistically significant. Therefore, it is recommended to conduct future research with a larger sample size to investigate the effect of S. boulardii supplementation on eradicating H. pylori infection and reducing treatment side effects.Trial registration: IRCT20200106046021N1, this trial was registered on Jan 14, 2020.

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Section: Discussioncontrasting

confidence: 96%

“…Yu et al,[38] in a meta-analysis found that Lactobacillus reduces treatment-related side effects, which was in contrary to our ndings. Zhou et al, discovered that S. boulardii could signi cantly reduce treatments side effects, particularly diarrhea and constipation [39], which was consistent with our ndings.…”

Section: Discussionsupporting

confidence: 92%

Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori and Treatments҆ Side Effects: A Double-Blind Placebo-Controlled Randomized Clinical Trial

Naghibzadeh

Salmani

Nomiri

et al. 2021

Preprint

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“…However, according to some studies, probiotic supplementation was significantly ineffective in improving the eradication rate of infection; in their network meta-analysis, Wang et al found that probiotics in combination with triple therapy could not increase the eradication rate of infection [ 186 ]. In addition, most studies have shown that adverse events were significantly lower in the group receiving probiotics plus antibiotic than in the control group, but this was not the case in a number of other studies [ 178 , 181 , 185 ]. It is important to note that probiotics alone are not effective, but can only be prescribed as adjunctive therapy in clinical improvement [ 174 ].…”

Section: Probiotics As Anti- H Pylori Agentsmentioning

confidence: 96%

“…(Among all probiotics, the clinical effects of Lactobacillus spp. and S. boulardii have been further studied; S. boulardii and Lactobacillus species such as L. casei , L. reuteri , and L. rhamnosus GG are all safe and improve the quality of treatment [ 172 , 183 , 185 ]. It seems that multi-strain probiotics supplementation has a significant effect on the treatment of infection [ 173 , 181 , 182 ].…”

Section: Probiotics As Anti- H Pylori Agentsmentioning

confidence: 99%

Probiotics as the live microscopic fighters against Helicobacter pylori gastric infections

Keikha

Karbalaei

2021

BMC Gastroenterol

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Background Helicobacter pylori (H. pylori) is the causative agent of stomach diseases such as duodenal ulcer and gastric cancer, in this regard incomplete eradication of this bacterium has become to a serious concern. Probiotics are a group of the beneficial bacteria which increase the cure rate of H. pylori infections through various mechanisms such as competitive inhibition, co-aggregation ability, enhancing mucus production, production of bacteriocins, and modulating immune response. Result In this study, according to the received articles, the anti-H. pylori activities of probiotics were reviewed. Based on studies, administration of standard antibiotic therapy combined with probiotics plays an important role in the effective treatment of H. pylori infection. According to the literature, Lactobacillus casei, Lactobacillus reuteri, Lactobacillus rhamnosus GG, and Saccharomyces boulardii can effectively eradicate H. pylori infection. Our results showed that in addition to decrease gastrointestinal symptoms, probiotics can reduce the side effects of antibiotics (especially diarrhea) by altering the intestinal microbiome. Conclusion Nevertheless, antagonist activities of probiotics are H. pylori strain-specific. In general, these bacteria can be used for therapeutic purposes such as adjuvant therapy, drug-delivery system, as well as enhancing immune system against H. pylori infection.

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“…The first meta-analysis study conducted in 2010 on the use of Saccharomyces boulardi as an adjuvant therapy found that it generally reduced the side effects of H. pylori infection [175]. Saccharomyces boulardi supplementation along with the standard triple therapy provided additional support to increase H. pylori eradication rates [176].…”

Section: H Pylori and Probioticsmentioning

confidence: 99%

Overview of Helicobacter pylori Infection: Clinical Features, Treatment, and Nutritional Aspects

et al. 2021

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Helicobacter pylori (H. pylori) is a 0.5–1 µm wide, 2–4 µm long, short helical, S-shaped Gram-negative microorganism. It is mostly found in the pyloric region of the stomach and causes chronic gastric infection. It is estimated that these bacteria infect more than half of the world’s population. The mode of transmission and infection of H. pylori is still not known exactly, but the faecal–oral and oral–oral routes via water or food consumption are thought to be a very common cause. In the last three decades, research interest has increased regarding the pathogenicity, microbial activity, genetic predisposition, and clinical treatments to understand the severity of gastric atrophy and gastric cancer caused by H. pylori. Studies have suggested a relationship between H. pylori infection and malabsorption of essential micronutrients, and noted that H. pylori infection may affect the prevalence of malnutrition in some risk groups. On the other hand, dietary factors may play a considerably important role in H. pylori infection, and it has been reported that an adequate and balanced diet, especially high fruit and vegetable consumption and low processed salty food consumption, has a protective effect against the outcomes of H. pylori infection. The present review provides an overview of all aspects of H. pylori infection, such as clinical features, treatment, and nutrition.

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Saccharomyces boulardii as an adjuvant therapy for Helicobacter pylori eradication: A systematic review and meta‐analysis with trial sequential analysis

Cited by 53 publications

References 57 publications

Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori and Treatments҆ Side Effects: A Double-Blind Placebo-Controlled Randomized Clinical Trial

Investigating the Effect of Quadruple Therapy with Saccharomyces Boulardii or Lactobacillus Reuteri Strain (DSMZ 17648) Supplements on Eradication of Helicobacter Pylori and Treatments҆ Side Effects: A Double-Blind Placebo-Controlled Randomized Clinical Trial

Probiotics as the live microscopic fighters against Helicobacter pylori gastric infections

Overview of Helicobacter pylori Infection: Clinical Features, Treatment, and Nutritional Aspects

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