STUDY: A supplement of probiotics increases the effectiveness of conventional antibiotic therapy for H pylori.

JOURNAL: Alimentary Pharmacology & Therapeutics (2002;16:1669–75).

AUTHORS:

ABSTRACT: Taking a supplement of “friendly bacteria” (probiotics) increases the effectiveness of conventional antibiotic therapy in eradicating Helicobacter pylori (H. pylori), the organism that causes peptic ulcers.

---

COMMENTARY: H. pylori is an organism that can infect the lining of the stomach. Infection with this organism is an important contributing factor to gastric and duodenal ulcers, and may also increase the risk of developing stomach cancer.

H. pylori is a persistent bug that can be difficult to eradicate. Research has determined that the most reliable way to kill this organism is by using three drugs simultaneously for a week: two antibiotics and a medication that blocks the production of stomach acid. However, as many as 50% of individuals given this triple-therapy regimen experience side effects including nausea, vomiting, diarrhea, a metallic taste, or allergic reactions. Some people are unable to complete the therapy because of these side effects.

In the new study, 160 people infected with H. pylori were randomly assigned to receive a triple-therapy regimen (lansoprazole, amoxicillin, and clarithromycin) for one week, or the same triple therapy combined with five weeks of a daily yogurt supplement that contained live lactobacilli and bifidobacteria.

Eight weeks after the triple therapy, participants were tested for the presence or absence of H. pylori in their stomach. The eradication rate was significantly higher among those who received yogurt than among those given triple therapy alone (91% vs. 78%). However, when only those who completed the full seven days of triple therapy were considered, eradication rates were similar (93.5% for the yogurt group, 89% for triple therapy alone).

That finding suggests that the main benefit of the yogurt was to help people tolerate triple therapy better and to complete the full week of treatment.

Other natural treatments may be potentially helpful in eradicating H. pylori infection; these include garlic, mastic gum, vitamin C, and certain essential fatty acids.

However, most of the studies that support the use of these treatments have been done in test tubes, and there is little evidence that these natural remedies can kill H. pylori in infected people. At present, conventional triple therapy—perhaps combined with probiotics—appears to be the most effective regimen for eradicating the ulcer bug.