Probiotics May Represent a Novel Approach to the Management of H. pylori Infection

Helicobacter. 2010 Apr;15(2):79-87.
Role of probiotics in pediatric patients with Helicobacter pylori infection: a comprehensive review of the literature.

Lionetti E, Indrio F, Pavone L, Borrelli G, Cavallo L, Francavilla R.

Department of Paediatrics, University of Catania, Catania, Italy. elenalionetti@inwind.it
Abstract

BACKGROUND: The current guidelines suggest the use of triple therapy as first choice treatment of Helicobacter pylori infection, although the eradication failure rate is more than 30%(1). Current interest in probiotics as therapeutic agents against H. pylori is stimulated not only by the clinical data showing efficacy of some probiotics in different gastrointestinal diseases(2) but also by the increasing resistance of pathogenic bacteria to antibiotics(1), thus the interest for alternative therapies is a real actual topic. Aim: To review in vitro and in vivo studies on the role of probiotics in H. pylori infection focusing on the paediatric literature. MATERIALS AND METHODS: Pre-clinical and clinical paediatric studies in English assessing the role of probiotics in H. pylori infection identified by MEDLINE search (1950-2009) were reviewed. RESULTS: In vitro studies demonstrated an inhibitory activity of probiotics on H. pylori growth and that this effect is extremely strain specific. Available data in children indicate that probiotics seems to be efficacious for the prevention of antibiotic associated side-effects(2), and might be of help for the prevention of H. pylori complications by decreasing H. pylori density and gastritis, and for the prevention of H. pylori colonization or re-infection by inhibiting adhesion to gastric epithelial cells.(1) There is no clear evidence that probiotics may increase the H. pylori eradication rate. CONCLUSION: Both in vitro and in vivo studies provide evidence that probiotics may represent a novel approach to the management of H. pylori infection.
Review and addition by Dr. Marcus Ettinger:
(1) Antibiotic resistant bacteria are becoming more and more of a problem for doctors, with each passing year. The causes are many. The indiscriminate and overuse of antibiotics, genetically modified food(s) (GMO) that we ingest daily with antibiotic resistant genes, biofilms that promote bacterial adhesion to tissues and that produce antibiotic neutralizing chemicals, and the ever-present – biological evolution of bacterial, are all playing their part in making the treatment of bacterial infections a far more difficult and discouraging part of ones practice.
Additional: For more on how Genetically Modified Organisms/Food affect the health of every human, plant and life-form on this planet, please watch this one hour and thirty minute long video. It is a wake-up call that everyone needs to have – “The Future of Food.”
(2)

Am J Health Syst Pharm. 2010 Mar 15;67(6):449-58.
Probiotics.

College of Pharmacy, Southwestern Oklahoma State University, Norman Regional Health System, Pharmacy Services, Norman, OK 73070-1308, USA. nancy.williams@swosu.edu

PURPOSE: The pharmacology, uses, dosages, safety, drug interactions, and contraindications of probiotics are reviewed. SUMMARY: Probiotics are live non-pathogenic microorganisms administered to improve microbial balance, particularly in the gastrointestinal tract. They consist of Saccharomyces boulardii yeast or lactic acid bacteria, such as Lactobacillus and Bifidobacterium species, and are regulated as dietary supplements and foods. Probiotics exert their beneficial effects through various mechanisms, including lowering intestinal pH, decreasing colonization and invasion by pathogenic organisms, and modifying the host immune response. Probiotic benefits associated with one species or strain do not necessarily hold true for others. The strongest evidence for the clinical effectiveness of probiotics has been in the treatment of acute diarrhea, most commonly due to rotavirus, and pouchitis. More research is needed to clarify the role of probiotics for preventing antibiotic-associated diarrhea, Clostridium difficile infection, travelers’ diarrhea, irritable bowel syndrome, ulcerative colitis, Crohn’s disease, and vulvovaginal candidiasis. There is no consensus about the minimum number of microorganisms that must be ingested to obtain a beneficial effect; however, a probiotic should typically contain several billion microorganisms to increase the chance that adequate gut colonization will occur. Probiotics are generally considered safe and well tolerated, with bloating and flatulence occurring most frequently. They should be used cautiously in patients who are critically ill or severely immuno-compromised or those with central venous catheters since systemic infections may rarely occur. Bacteria-derived probiotics should be separated from antibiotics by at least two hours. CONCLUSION: Probiotics have demonstrated efficacy in preventing and treating various medical conditions, particularly those involving the gastrointestinal tract. Data supporting their role in other conditions are often conflicting.