Inhibition of Helicobacter pylori Infection in Humans by Lactobacillus reuteri ATCC 55730 and Effect on Eradication Therapy: A Pilot Study

Background:  Several studies report an inhibitory effect of probiotics on Helicobacter pylori. Aim:  To test whether Lactobacillus reuteri ATCC 55730 reduces H. pylori intragastric load in vivo, decreases dyspeptic symptoms, and affects eradication rates after conventional treatment. Materials and Methods:  In a double-blind placebo-controlled study, 40 H. pylori-positive subjects were given L. reuteri once a day for 4 weeks or placebo. All underwent upper endoscopy, 13C-urea breath test, and H. pylori stool antigen determination at entry and 13C-urea breath test and H. pylori stool antigen (used as both qualitative and semiquantitative markers) after 4 weeks of treatment. Sequential treatment was administered subsequently to all. Results:  In vivo, L. reuteri reduces H. pylori load as semiquantitatively assessed by both 13C-urea breath test δ-value and H. pylori stool antigen quantification after 4 weeks of treatment (p < .05). No change was shown in patients receiving placebo. L. reuteri administration was followed by a significant decrease in the Gastrointestinal Symptom Rating Scale as compared to pretreatment value (p < .05) that was not present in those receiving placebo (p = not significant). No difference in eradication rates was observed. Conclusions: L. reuteri effectively suppresses H. pylori infection in humans and decreases the occurrence of dyspeptic symptoms. Nevertheless, it does not seem to affect antibiotic therapy outcome.