Efficacy of Lactobacillus reuteri Supplementation in Eradication of H. pylori: A Comparison Study with Triple Drug Therapy

Abstract

Helicobacter pylori (H. pylori) infections affect roughly one-half of the world’s population. Although many standard regimens, including triple-drug therapy, eradicate H. pylori, the success rate and efficacy have been declining due to associated side effects and symptom severity. The addition of probiotics to a standard regimen can considerably increase eradication rates. The objective is to find the efficacy of a probiotic Lactobacillus reuteri (L. reuteri) in eradicating human H. pylori infection and effect on symptoms regression and side effects associated with triple therapy. This prospective interventional study was conducted in 90 H. pylori-positive patients. 45 patients received standard triple treatment (group-I) for 14 days. Another 45 patients received a combination of standard triple therapy and L. reuteri (group-II) for 14 days. After the completion of treatment, H. pylori status was evaluated using a 13-C Urea-Breath Test (UBT). Each subject is interviewed with a validated Gastrointestinal Symptoms Rating Scale (GSRS) questionnaire to record symptoms and symptom severity before and after the therapy. Group-II patients showed a significantly higher eradication rate (86.67%) than group-I patients (66.67%). The absolute values of 13C-UBT (group-I: 14.02± 5.4, group-II: 11.9±3.73) revealed that a more substantial reduction in H. Pylori load was observed in group II. Statistical analysis proved that group II patients had a significant reduction in GSRS mean scores (baseline score: 15.39±4.52 to end score: 5.33±2.34) compared to group-I patients (baseline score: 14.47±3.67 to end score: 9.86±4.78). Addition of L. reuteri has reduced side effects associated with triple drug therapy except bloating. In conclusion,  supplementation of  L. reuteri to standard triple drug therapy significantly  improved the eradication rate of H. pylori, reduced intensity of gastrointestinal symptoms and also treatment related side effects.