Published online Oct 7, 2015. doi: 10.3748/wjg.v21.i37.10644
Peer-review started: March 3, 2015
First decision: March 30, 2015
Revised: April 25, 2015
Accepted: September 2, 2015
Article in press: September 2, 2015
Published online: October 7, 2015
Helicobacter pylori (H. pylori) is considered an etiologic factor for the development of peptic ulcer disease, gastric adenocarcinoma, and MALT lymphoma. Therapeutic schemes to eradicate the bacteria are based on double antibiotic therapy and proton pump inhibitor. Despite many therapeutic improvements in H. pylori eradication treatment, it is still associated with high infection rate also in developed countries. Bacterial resistance and adverse events occurrence are among most frequent causes for anti- H. pylori treatment failure. Several studies have reported that certain probiotic strains can exhibit inhibitory activity against H. pylori bacteria. In addition, some probiotic strains can reduce the occurrence of side effects due to antibiotic therapy and consequently increase the H. pylori eradication rate. The results of the prospective double-blind placebo-controlled studies suggest that specific probiotics, such as S. boulardii and L. johnsonni La1 probably can diminish the bacterial load, but not completely eradicate the H. pylori bacteria. Furthermore, it seems that supplementation with S. boulardii is a useful concomitant therapy in the standard H. pylori eradication treatment protocol and most probably increases eradication rate. L. reuteri is equally effective, but more positive studies are needed. Finally, probiotic strains, such as S. boulardii, L. reuteri and L. GG, decrease gastrointestinal antibiotic associated adverse effects.
Core tip: Poor eradication rates in Helicobacter pylori (H. pylori) infected patients have been reported, which was mostly explained by the increased rates of bacterial resistance to antibiotics and a low compliance for those drugs. This situation needs the development of alternative treatment options for the H. pylori infection in patients. The results of recent studies suggest that certain probiotic strains supplemented to standard eradication therapy diminish the frequency of gastrointestinal adverse effects and consequently also increase the eradication rates.