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

B V Niharika,Banaijingkmen Lyngkhoi,K Varsha,Kumar Parth,Ramakrishna Prudhivi,Sujatha Palatheeya,Syed Kamran Abbas

doi:10.9734/jpri/2021/v33i52b33611

B V Niharika, Banaijingkmen Lyngkhoi + Show 5 more

Open Access

https://doi.org/10.9734/jpri/2021/v33i52b33611

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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.

Highlights

Helicobacter pylori (H. pylori) is a gram-negative bacterium that colonizes the stomach and causes an illness similar to peptic ulcer disease [1]
In India, the prevalence of H. pylori infection is as high as 80 percent, with peptic ulcer disease being the most common manifestation [2]
Status of H. pylori was determined using the Urea Breath Test (UBT) before and after the therapy. 90 patients were randomly assigned to one of the following parallel groups: The objective of our study was to find out the efficacy of Pyloflush supplementation in H. pylori eradication and to compare the eradication rate of the standard triple-drug alone with standard triple therapy plus Pyloflush supplementation

Summary

Introduction

Helicobacter pylori (H. pylori) is a gram-negative bacterium that colonizes the stomach and causes an illness similar to peptic ulcer disease [1]. H. pylori infections roughly affect one-half of the world’s population. They are more prevalent in developing countries than developed countries. In India, the prevalence of H. pylori infection is as high as 80 percent, with peptic ulcer disease being the most common manifestation [2]. H. pylori infections are mostly contracted as a consequence of direct human-tohuman transmission or as a result of environmental contamination [3]. Chronic H. pylori infections are associated with chronic gastritis, gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue lymphoma [5]

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