Impact of Lactobacillus Reuteri and Three Other Probiotics in Helicobacter Pylori Eradication

Skender Telaku; Mimoza Telaku; Emir Behluli; Viktor Isjanovski; Fitim Alidema

doi:10.3889/oamjms.2022.10733

Authors

Skender Telaku Department of Medical Science, University for Business and Technology - UBT, Pristina, Kosovo https://orcid.org/0000-0001-8450-0317
Mimoza Telaku Department of General Medicine, Faculty of Medicine, Tirana, Albania https://orcid.org/0000-0003-0205-7476
Emir Behluli Pediatric Clinic, University Clinical Center Kosovo, Prishtina, Kosovo https://orcid.org/0000-0002-0889-5510
Viktor Isjanovski Department of Psychiatry, Medical Faculty, University Ss Cyril and Methodius, Skopje, Macedonia
Fitim Alidema Department of Medical Science, University for Business and Technology - UBT, Pristina, Kosovo

DOI:

https://doi.org/10.3889/oamjms.2022.10733

Keywords:

Probiotics, Lactobacillus reuteri, Helicobacter eradication

Abstract

Background/Objectives: To assess the effectiveness and safeness of Lactobacillus reuteri and additionally three other probiotics to conventional triple therapy against the Heliobacter pylori.
Materials and Methods: We randomly selected 115 H. pylori positive dyspeptic patients, to be treated for 14 days with conventional triple therapy, without and with probiotics. Our first group of 62 patients received conventional triple therapy, while the second group of 53 patients were treated with Lactobacillus reuteri, and Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium lactis, all encapsulated in PharmaS Helicobalans capsules alongside the triple conventional therapy. One month after completion of treatment, Helicobacter pylori presence was evaluated. If the Helicobacter pylori test would turn out negative, it would prove the success of the eradication.
Results: 38 patients of the first group (61,3%) were treated successfully. In the second group, where probiotics were added, the success of eradication was observed in 37 of them (69.8%).
Despite the fact that eradication was higher in the second group, the difference between the two sides in terms of statistics was non-significant (p=0.199). As for the side effects of the ordered treatment, 27 patients of the first group (43.5%) had complaints, while the secondary group had 17(32%). Again, there was seen no difference statistically important between two sides.
Conclusion: Including probiotics additionally to conventional Helicobacter pylori treatment may decrease the side effects of the therapy, and increase the Helicobacter pylori eradication success. Randomized prospective work on a larger scale is needed.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Malfertheiner P, Megraud F, O’Morain CA, Atherton J, Axon AT, Bazzoli F, et al. Management of Helicobacter pylori infection--the maastricht IV/florence consensus report. Gut. 2012;61(5):646-64. https://doi.org/10.1136/gutjnl-2012-302084 PMid:22491499 DOI: https://doi.org/10.1136/gutjnl-2012-302084

Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection-the maastricht V/florence consensus report. Gut. 2017;66(1):6-30. https://doi.org/10.1136/gutjnl-2016-312288 PMid:27707777 DOI: https://doi.org/10.1136/gutjnl-2016-312288

Lesbros-Pantoflickova D, Corthésy-Theulaz I, Blum AL. Helicobacter pylori and probiotics. J Nutr. 2007;137(3 Suppl 2):812S-8. https://doi.org/10.1093/jn/137.3.812S PMid:17311980 DOI: https://doi.org/10.1093/jn/137.3.812S

Zhu XY, Liu F. Probiotics as an adjuvant treatment in Helicobacter pylori eradication therapy. J Dig Dis. 2017;18(4):195-202. https://doi.org/10.1111/1751-2980.12466 PMid:28294543 DOI: https://doi.org/10.1111/1751-2980.12466

Wang ZJ, Chen XF, Zhang ZX, Li YC, Deng J, Tu J, et al. Effects of anti-Helicobacter pylori concomitant therapy and probiotic supplementation on the throat and gut microbiota in humans. Microb Pathog. 2017;109:156-61. https://doi.org/10.1016/j.micpath.2017.05.035 PMid:28552806 DOI: https://doi.org/10.1016/j.micpath.2017.05.035

Telaku S, Zekaj S, Veliu A, Manxhuka-Kerliu S, Fejza H, Polloshka A. Comparison of one week and two weeks of triple therapy for the eradication of Helicobacter pylori in Kosova. Turk J Gastroenterol. 2006;15(1):PB02/4.

Telaku S, Manxhuka-Kerliu S, Kraja B, Qirjako G, Prifti S, Fejza H. The efficacy of levofloxacin-based triple therapy for first-line helicobacter pylori eradication. Med Arch. 2013;67(5):348-50. https://doi.org/10.5455/medarh.2013.67.348-350 PMid:24601169 DOI: https://doi.org/10.5455/medarh.2013.67.348-350

Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document. The International Scientific Association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506-14. https://doi.org/10.1038/nrgastro.2014.66 PMid:24912386 DOI: https://doi.org/10.1038/nrgastro.2014.66

Bhatia SJ, Kochar N, Abraham P, Nair NG, Mehta AP. Lactobacillus acidophilus inhibits growth of Campylobacter pylori in vitro. J Clin Microbiol. 1989;27(10):2328-30. https://doi.org/10.1128/jcm.27.10.2328-2330.1989 PMid:2511224 DOI: https://doi.org/10.1128/jcm.27.10.2328-2330.1989

Lorca GL, Wadström T, Valdez GF, Ljungh A. Lactobacillus acidophilus autolysins inhibit Helicobacter pylori in vitro. Curr Microbiol. 2001;42(1):39-44. https://doi.org/10.1007/s002840010175 PMid:11116395 DOI: https://doi.org/10.1007/s002840010175

Lionetti E, Miniello VL, Castellaneta SP, Magistá AM, De Canio A, Maurogiovanni G, et al. Lactobacillus reuteri therapy to reduce side-effects during anti-Helicobacter pylori treatment in children: A randomized placebo controlled trial. Aliment Pharmacol Ther. 2006;24(10):1461-8. https://doi.org/10.1111/j.1365-2036.2006.03145.x PMid:17032283 DOI: https://doi.org/10.1111/j.1365-2036.2006.03145.x

Islek A, Sayar E, Yilmaz A, Artan R. Bifidobacterium lactis B94 plus inulin for treatment of Helicobacter pylori infection in children: Does it increase eradication rate and patient compliance? Acta Gastroenterol Belg. 2015;78(3):282-6. PMid:26448408

Mu Q, Tavella VJ, Luo XM. Role of Lactobacillus reuteri in human health and diseases. Front Microbiol. 2018;9:757. https://doi.org/10.3389/fmicb.2018.00757 PMid:29725324 DOI: https://doi.org/10.3389/fmicb.2018.00757

Available from: https://ljekarna.hr/en/digestion/2581-pharmas-helicobalans-capsules-20-pcs.html [Last accessed 2022 May 20].

Homan M, Orel R. Are probiotics useful in Helicobacter pylori eradication? World J Gastroenterol. 2015;21(37):10644-53. https://doi.org/10.3748/wjg.v21.i37.10644 PMid:26457024 DOI: https://doi.org/10.3748/wjg.v21.i37.10644

Losurdo G, Cubisino R, Barone M, Principi M, Leandro G, Ierardi E, et al. Probiotic monotherapy and Helicobacter pylori eradication: A systematic review with pooled-data analysis. World J Gastroenterol. 2018;24(1):139-49. https://doi.org/10.3748/wjg.v24.i1.139 PMid:29358890 DOI: https://doi.org/10.3748/wjg.v24.i1.139

Tong JL, Ran ZH, Shen J, Zhang CX, Xiao SD. Meta-analysis: The effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther. 2007;25(2):155-68. https://doi.org/10.1111/j.1365-2036.2006.03179.x PMid:17229240 DOI: https://doi.org/10.1111/j.1365-2036.2006.03179.x

Zhu R, Chen K, Zheng YY, Zhang HW, Wang JS, Xia YJ, et al. Meta-analysis of the efficacy of probiotics in Helicobacter pylori eradication therapy. World J Gastroenterol. 2014;20(47):18013-21. https://doi.org/10.3748/wjg.v20.i47.18013 PMid:25548501 DOI: https://doi.org/10.3748/wjg.v20.i47.18013

Scaccianoce G, Zullo A, Hassan C, Gentili F, Cristofari F, Cardinale V, et al. Triple therapies plus different probiotics for Helicobacter pylori eradication. Eur Rev Med Pharmacol Sci. 2008;12(4):251-6. PMid:18727457

Emara MH, Mohamed SY, Abdel-Aziz HR. Lactobacillus reuteri in management of Helicobacter pylori infection in dyspeptic patients: A double-blind placebo-controlled randomized clinical trial. Therap Adv Gastroenterol. 2014;7(1):4-13. https://doi.org/10.1177/1756283X13503514 PMid:24381643 DOI: https://doi.org/10.1177/1756283X13503514

Francavilla R, Polimeno L, Demichina A, Maurogiovanni G, Principi B, Scaccianoce G, et al. Lactobacillus reuteri strain combination in Helicobacter pylori infection: A randomized, double-blind, placebo-controlled study. J Clin Gastroenterol. 2014;48(5):407-13. https://doi.org/10.1097/MCG.0000000000000007 PMid:24296423 DOI: https://doi.org/10.1097/MCG.0000000000000007

Keikha M, Karbalaei M. Probiotics as the live microscopic fighters against Helicobacter pylori gastric infections. BMC Gastroenterol. 2021;21(1):388. https://doi.org/10.1186/s12876-021-01977-1 PMid:34670526 DOI: https://doi.org/10.1186/s12876-021-01977-1

Wang F, Feng J, Chen P, Liu X, Ma M, Zhou R, et al. Probiotics in Helicobacter pylori eradication therapy: Systematic review and network meta-analysis. Clin Res Hepatol Gastroenterol. 2017;41(4):466-75. https://doi.org/10.1016/j.clinre.2017.04.004 PMid:28552432 DOI: https://doi.org/10.1016/j.clinre.2017.04.004

Lu C, Sang J, He H, Wan X, Lin Y, Li L, et al. Probiotic supplementation does not improve eradication rate of Helicobacter pylori infection compared to placebo based on standard therapy: A meta-analysis. Sci Rep. 2016;6:23522. https://doi.org/10.1038/srep23522 PMid:26997149 DOI: https://doi.org/10.1038/srep23522

Zhou BG, Chen LX, Li B, Wan LY, Ai YW. Saccharomyces boulardii as an adjuvant therapy for Helicobacter pylori eradication: A systematic review and meta-analysis with trial sequential analysis. Helicobacter. 2019;24(5):e12651. https://doi.org/10.1111/hel.12651 PMid:31414551 DOI: https://doi.org/10.1111/hel.12651

Wang ZH, Gao QY, Fang JY. Meta-analysis of the efficacy and safety of Lactobacillus-containing and Bifidobacterium-containing probiotic compound preparation in Helicobacter pylori eradication therapy. J Clin Gastroenterol. 2013;47(1):25-32. https://doi.org//10.1097/MCG.0b013e318266f6cf PMid:23090045 DOI: https://doi.org/10.1097/MCG.0b013e318266f6cf

Lau CS, Ward A, Chamberlain RS. Probiotics improve the efficacy of standard triple therapy in the eradication of Helicobacter pylori: A meta-analysis. Infect Drug Resist. 2016;9:275-89. https://doi.org/10.2147/IDR.S117886 PMid:27994474 DOI: https://doi.org/10.2147/IDR.S117886

Shi X, Zhang J, Mo L, Shi J, Qin M, Huang X. Efficacy and safety of probiotics in eradicating Helicobacter pylori: A network meta-analysis. Medicine (Baltimore). 2019;98(15):e15180. https://doi.org/10.1097/MD.0000000000015180 PMid:30985706 DOI: https://doi.org/10.1097/MD.0000000000015180

Yu M, Zhang R, Ni P, Chen S, Duan G. Efficacy of Lactobacillus-supplemented triple therapy for H. pylori eradication: A meta-analysis of randomized controlled trials. PLoS One. 2019;14(10):e0223309. https://doi.org/10.1371/journal.pone.0223309 PMid:31577828 DOI: https://doi.org/10.1371/journal.pone.0223309

Yang C, Liu L, Majaw JK, Liang L, Chen Y. Efficacy of Lactobacillus reuteri supplementation therapy for Helicobacter pylori eradication: A meta-analysis of randomised controlled trials. Med Microecol. 2021;8(8390):100036. https://doi.org/10.1016/j.medmic.2021.100036 DOI: https://doi.org/10.1016/j.medmic.2021.100036