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Helicobacter pylori (H. pylori) is a key contributor to peptic ulcers, chronic gastritis, and an elevated risk of stomach cancer.
Probiotics support better H. pylori eradication outcomes while reducing gastrointestinal discomfort and other treatment-related side effects.
Helicobacter pylori (H. pylori) is a key contributor to peptic ulcers, chronic gastritis, and an elevated risk of stomach cancer. However, rising antibiotic resistance and treatment-related side effects have prompted interest in alternative strategies, including probiotic supplementation. This study explored the safety and effectiveness of incorporating probiotics into various eradication strategies for H. pylori.
Researchers systematically searched Cochrane, Web of Science, PubMed, Embase, and Scopus for randomized controlled trials (RCTs) comparing standard H. pylori therapy (triple or quadruple regimens) with or without probiotics. Dichotomous outcomes were analyzed via odds ratios (OR) for intention-to-treat (ITT) analysis and risk ratios (RR) for adverse events, both with 95% confidence intervals (CIs).
In this systematic review and network meta-analysis, 91 RCTs involving 13,680 participants were included. The addition of probiotics to standard treatment markedly improved H. pylori eradication rates in ITT analysis (78.75% vs. 62.43%, OR = 1.62) and per-protocol (PP) analysis (80.33% vs. 72.63%, OR = 1.60).
While the rates of peptic ulcer, gastric ulcer, and dyspepsia were similar across groups, probiotic supplementation was linked with fewer adverse effects, including nausea/vomiting (RR = 0.69), headache/dizziness (RR = 0.46), epigastric pain/bloating (RR = 0.76), diarrhea (RR = 0.49), altered taste (RR = 0.64), and abdominal pain (RR = 0.68). Network meta-analysis revealed that among probiotic strains, Bifidobacterium longum portrayed the highest efficacy in H. pylori eradication when compared to placebo (ITT: 81.06% vs. 64.88%, PP: 88% vs. 75.71%, OR = 2.52).
Integrating probiotics into standard H. pylori treatment regimens boosted eradication rates while mitigating several therapy-related side effects, including abdominal pain, diarrhea, nausea, vomiting, bloating, headache, dizziness, and taste disturbances.
Clinical Nutrition ESPEN
Efficacy of probiotics regimens for Helicobacter pylori eradication: A systematic review, pairwise, and network meta-analysis of randomized controlled trials
Mohammad Tanashat et al.
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