Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2015; 21(37): 10644-10653
Published online Oct 7, 2015. doi: 10.3748/wjg.v21.i37.10644
Are probiotics useful in Helicobacter pylori eradication?
Matjaž Homan, Rok Orel
Matjaž Homan, Rok Orel, University Children’s Hospital, 1000 Ljubljana, Slovenia
Author contributions: Homan M was responsible for literature review and wrote the paper; Orel R was responsible for the critically revising the paper and making important suggestions.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Matjaž Homan, MD, PhD, University Children’s Hospital, Bohoričeva 20, 1000 Ljubljana, Slovenia.
Telephone: + 386-15229276 Fax: + 386-15229206
Received: February 28, 2015
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.

Keywords: Helicobacter pylori, Probiotics, Eradication therapy, Adverse effects, Strain

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.