Role of Probiotics in Patients with Helicobacter pylori Infection

Abstract

Probiotics are defined as live, nonpathogenic microbial feeds or food supplements that exert a positive influence on their host by altering his microbial balance. As shown in several studies, probiotics also possess a direct antimicrobial effect; for this reason, several authors have tested a possible application in patients with Helicobacter pylori infection. In particular, probiotics may compete directly with H. pylori, possibly through the inhibition of adherence, as well as produce metabolites and antimicrobial molecules, properties supported only by animal or in vitro data. Moreover, implementation of standard anti-H. pylori regimens with probiotics can also improve patients' compliance to therapy, reducing the occurrence of antibiotic-related adverse events. The same effect was also reported after using a combination of two different prebiotics such as butyric acid and inulin in patients who underwent H. pylori eradication treatment. Based on current data, even though an effect against H. pylori has been described, probiotics cannot be considered as an alternative to standard anti-H. pylori treatment. Nevertheless, their use in association with standard anti-H. pylori treatment may be advisable, as they are able to improve patient compliance by reducing antibiotic-related adverse events, thus increasing the number of patients completing the eradication therapy.

Use of probiotics as an adjuvant to sequential H. pylori eradication therapy: impact on eradication rates, treatment resistance, treatment-related side effects, and patient compliance

“…However, despite the likelihood of probiotics promoting patient compliance by preventing adverse events (37,54), and the fact that non-compliance may substantially lower the eradication success (55), the influence of probiotics on patient compliance under eradication therapy has seldom been studied (38), although limited data indicates a marked influence of therapyrelated side-effects on eradication rates (40,56).…”

Helicobacter felis–Associated Gastric Disease in Microbiota-Restricted Mice

“…Many Lactobacillus spp. are used as probiotics, and it has been shown that probiotics can both prevent H. pylori infection and improve helicobacter eradication rates in humans, although the mechanism for this observation is unknown (Boonyaritichaikij et al 2009;Franceschi et al 2007;Gotteland et al 2006;Sachdeva and Nagpal 2009). This improvement in eradication rate after Lactobacillus spp.…”

Meta-analysis of the efficacy of probiotics inHelicobacter pylorieradication therapy

“…The most common microorganisms used in probiotic formulations in clinical practice include species of Lactobacillus, Bifidobacterium, Saccharomyces, and Streptococcus, as well as Enterococcus [8] . These may act in different ways, such as by direct competition with H. pylori or by improving the patients' compliance with therapy when the incidence of antibiotic-related adverse effects is reduced [9] . The inclusion of a probiotic in an H. pylori eradication therapy is thought to increase its efficacy or to reduce the adverse effects of the treatment.…”