Display options
Share it on

Therap Adv Gastroenterol. 2014 Jan;7(1):4-13. doi: 10.1177/1756283X13503514.

Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: a double-blind placebo-controlled randomized clinical trial.

Therapeutic advances in gastroenterology

Mohamed H Emara, Salem Y Mohamed, Hesham R Abdel-Aziz

Affiliations

  1. Tropical Medicine Department, Faculty of Medicine, Zagazig University, Al-Kornish Street, Zagazig 44519, Egypt.
  2. Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
  3. Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

PMID: 24381643 PMCID: PMC3871281 DOI: 10.1177/1756283X13503514

Abstract

INTRODUCTION: The eradication rate of Helicobacter pylori following the standard triple therapy is declining. This study was conducted to test whether the addition of Lactobacillus reuteri to the standard triple therapy improves the eradication rates as well as the clinical and pathological aspects in H. pylori infection.

METHODS: A total of 70 treatment-naïve patients were randomly assigned into group A (the L. reuteri treated group) and group B (the placebo control group). Patients were treated by the standard triple therapy for 2 weeks and either L. reuteri or placebo for 4 weeks. They were examined by symptom questionnaire, H. pylori antigen in stool, upper endoscopy with biopsies for rapid urease test and histopathological examination before treatment and 4 weeks after treatment.

RESULTS: The eradication rate of H. pylori infection was 74.3% and 65.7% for both L. reuteri and placebo treated groups, respectively. There was a significant difference regarding the reported side effects, where patients treated with L. reuteri reported less diarrhea and taste disorders than placebo group. A significant difference within each group was observed after treatment regarding Gastrointestinal Symptom Rating Scale (GSRS) scores; patients treated with L. reuteri showed more improvement of gastrointestinal symptoms than the placebo treated group. The severity and activity of H. pylori associated gastritis were reduced after 4 weeks of therapy in both groups. The L. reuteri treated group showed significant improvement compared with the placebo treated group.

CONCLUSION: Triple therapy of H. pylori supplemented with L. reuteri increased eradication rate by 8.6%, improved the GSRS score, reduced the reported side effects and improved the histological features of H. pylori infection when compared with placebo-supplemented triple therapy.

Keywords: Gastrointestinal Symptom Rating Scale; Helicobacter pylori; Lactobacillus reuteri; eradication rate; gastritis; triple therapy

References

  1. Anaerobe. 2008 Jun;14(3):166-71 - PubMed
  2. Am J Physiol. 1999 Apr;276(4):G941-50 - PubMed
  3. MedGenMed. 2004 Feb 17;6(1):19 - PubMed
  4. Aliment Pharmacol Ther. 2006 Nov 15;24(10):1461-8 - PubMed
  5. Afr Health Sci. 2007 Sep;7(3):143-7 - PubMed
  6. Am J Clin Nutr. 2004 Sep;80(3):737-41 - PubMed
  7. BMC Gastroenterol. 2003 Aug 11;3:20 - PubMed
  8. Gastroenterol Res Pract. 2012;2012:740381 - PubMed
  9. Gastroenterology. 2000 Jun;118(6):1072-9 - PubMed
  10. Lancet. 1991 Jan 19;337(8734):174 - PubMed
  11. Dig Liver Dis. 2001 Dec;33(9):788-94 - PubMed
  12. Aliment Pharmacol Ther. 2003 Oct 15;18(8):805-13 - PubMed
  13. Am J Gastroenterol. 2000 Jan;95(1 Suppl):S22-5 - PubMed
  14. World J Gastroenterol. 2012 Nov 21;18(43):6250-4 - PubMed
  15. Am J Gastroenterol. 1998 Sep;93(9):1432-5 - PubMed
  16. Z Gastroenterol. 1995 Apr;33(4):198-201 - PubMed
  17. Gut. 2013 Jan;62(1):34-42 - PubMed
  18. Helicobacter. 2012 Aug;17(4):254-63 - PubMed
  19. Eur Rev Med Pharmacol Sci. 2008 Jul-Aug;12(4):251-6 - PubMed
  20. Br J Nutr. 2000 Feb;83(2):167-76 - PubMed
  21. Turk J Gastroenterol. 2010 Sep;21(3):212-7 - PubMed
  22. Int J Antimicrob Agents. 2006 Jul;28(1):6-13 - PubMed
  23. J Gastroenterol Hepatol. 2003 Dec;18(12):1373-8 - PubMed
  24. J Gen Microbiol. 1992 Aug;138 Pt 8:1689-96 - PubMed
  25. PLoS One. 2012;7(2):e31951 - PubMed
  26. Dig Liver Dis. 2004 May;36(5):322-6 - PubMed
  27. Eur J Gastroenterol Hepatol. 2001 Jan;13(1):25-9 - PubMed
  28. Clin Microbiol Rev. 2007 Apr;20(2):280-322 - PubMed
  29. Helicobacter. 2008 Apr;13(2):127-34 - PubMed
  30. J Gastrointestin Liver Dis. 2011 Sep;20(3):299-304 - PubMed
  31. J Clin Gastroenterol. 1993 Jun;16(4):292-4 - PubMed
  32. Int J Antimicrob Agents. 2003 Oct;22(4):360-6 - PubMed
  33. Dig Dis Sci. 1988 Feb;33(2):129-34 - PubMed
  34. Biocell. 2000 Dec;24(3):223-32 - PubMed
  35. Digestion. 1987;37 Suppl 2:16-30 - PubMed
  36. J Infect Dev Ctries. 2009 Sep 15;3(2):137-40 - PubMed

Publication Types