Lactobacillus reuteri in Helicobacter pylori infection and symptoms
This was a prospective, double blind and placebo-controlled study in 40 dyspeptic adults infected with Helicobacter pylori. It tested whether Lactobacillus reuteri ATCC 55730 reduces the Helicobacter pylori levels in the stomach, decreases dyspeptic symptoms and affects the results of conventional treatment with antibiotics.
The subjects were randomly assigned to take Lactobacillus reuteri (1 x 10^8 CFU/day) once daily for 28 days, or placebo. Thereafter all were treated with three antibiotics and stomach acid suppressing medicine for 10 days. All subjects underwent upper endoscopy for biopsy samples from the stomach, 13C-urea breath test (UBT), and Helicobacter pylori stool antigen (HpSA) test at entry and after 4 weeks of treatment. The validated Gastrointestinal Symptom Rating Scale (GSRS) was used to assess changes in gastrointestinal symptoms. Lactobacillus reuteri reduced Helicobacter pylori levels in the patients after 4 weeks of treatment: UBT decreased from 33.8 to 27.3 ‰ (p < 0.05) and HpSA decreased in the Lactobacillus reuteri group from 18.1 to 14.4 Net/Co (p < 0.05). Both these parameters were increased in the placebo group.
Lactobacillus reuteri also decreased the GSRS values significantly as compared to pre-treatment value, 7.9 vs. 11.8 (p < 0.05), while there was no decrease in GSRS in those receiving placebo, 9.7 vs. 11.4 (p = not significant). Abdominal distension, disorders of defecation and gas were the symptoms affected in particular. There was no difference in the effect of subsequent antibiotic treatment of Helicobacter pylori between groups, and no report of adverse events.
Fig. 1 Helicobacter pylori bacterial load assessed by 13C-urea breath test (A) and HpSA (B) before and after placebo or Lactobacillus reuteri supplementation.
Conclusion: Lactobacillus reuteri effectively suppressed the Helicobacter pylori infection and reduced the overall occurrence of dyspeptic symptoms, particularly abdominal distension, abnormal defecation and gas. Lactobacillus reuteri did not affect or interfere with the antibiotic treatment of the infection.