Helicobacter Pylori – Probiotic Treatments

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Helicobacter pylori is a common inhabitant of many people’s digestive tract. Some people appear asymptomatic in the presence of the gram-negative bacteria and it seems to be unobtrusive. Others display symptoms of peptic and gastric ulcers, poor nutrient assimilation and even blood in their stools.

So far it is unclear on what the difference is between the two opposing reactions. Is it strain dependent with some strains of H. pylori being more virulent than others?

Another idea to ponder is the age of acquisition. Some have proposed that if Helicobacter pylori is introduced at a younger age the immune system, still in its developmental phase, can compensate and accommodate the bacterium. This idea is supported by a number of different points including the fact that Helicobacter pylori has been inhabiting our gastrointestinal tract since our prehistoric times on the African savannah.

This conundrum comes up countless times. Is it the bacterial ‘infection’ causing the imbalance or is the imbalance causing the overgrowth or virulence of the already present bacteria. How far back do we need to go to find that true balance with the microbes that cohabit and have co evolved with us?

The old chicken or egg discussion.

Putting those difficult to tackle questions aside for now we can see that Helicobacter pylori can and does cause moderate to severe issues for a number of people that have acquired it. And unfortunately antibiotics, the once thought wonder drugs, aren’t keeping up their end of the bargain (1).

 

Probiotic Use In Helicobacter Pylori Infections

Recently I have been reading up on probiotics and came across an interesting review in World Journal of Gastroenterology – are probiotics useful in Helicobacter pylori eradication 

The article outlines the first in vitro experiments that demonstrated that Helicobacter pylori growth was inhibited in the presence of Lactobacillus acidophilus.

Moving on to trials with H. pylori positive people, the same paper reviewed a number of trials that have looked at the use of probiotics as a treatment method. Many of the trials showed that supplementing with different probiotic strains resulted in significant reduction in the bacterial load but didn’t result in complete eradication.

It is a common misconception to look at probiotics without actually differentiating the species used and even the different strains within the species. Many unique strains exhibit different functions on the human body.

Different trials utilised one or a number of the following species and strains of probiotics with success

  • B. lactis Bb12
  • L. acidophilus La5
  • L. johnsonii La1
  • L. brevis CD2
  • B. bifidum BF-1
  • L. reuteri ATCC 55730
  • L. gasseri OLL 2716
  • Combination of L. reuteri DSM 17938 and L. reuteri ATCC PTA 6457
  • Combination of  L. rhamnosus GG, L. rhamnosus LC705, P. Freudenreichii JS and B. lactis Bb12

An interesting trial looked at the difference between antibiotic treatment, treatment with Lactobacillus acidophilus LB and Saccharomyces boulardii plus inulin (3) a prebiotic fibre.

The study found Helicobacter pylori eradication in 66% of the antibiotic group – Note this is well below the 80% effective rate that is set as a benchmark for successful interventions, especially considering the potential damaging effects of antibiotics on the microflora.

It found 12% H. pylori eradication in the Saccharomyces boulardii plus inulin group and 6.5% in the Lactobacillus acidophilus LB.

If you are thinking that these don’t seem like promising numbers in support of stand alone probiotic treatment for Helicobacter pylori I would agree with you. If I stopped digging into the literature here I would be reasonably unimpressed too.

 

Combining Probiotics with Standard Treatment Options

Combining probiotics strains with standard treatments (in the case of the two meta-analysis reviews it was front-line antibiotic treatments) significantly improved their efficacy and reduced the adverse effects from the actual treatments (5, 6).

Both probiotics alone and probiotics and antimicrobials (antibiotics in the case of the reviews) led to greater success in eliminating the Helicobacter pylori.

Because there is very little money in herbal medicine there is very little funding to run trials to compare the efficacy of herbal antimicrobial treatments. With that said we can only speculate and make some conservative guesses that combining probiotic supplementation, particularly the strains that have shown promise in reducing H. pylori bacterial load, could improve the herbal treatment protocols on hand.

 

If you have experience with probiotics and bacterial infection share your experience in the comments below

 

Resources and References

  1. Antibiotic treatment for Helicobacter pylori: Is the end coming?
  2.  World Journal of Gastroenterology – are probiotics useful in Helicobacter pylori eradication 
  3. Effect of regular ingestion of Saccharomyces boulardii plus inulin or Lactobacillus acidophilus LB in children colonized by Helicobacter pylori.
  4. Prebiotics – Gut Boosting Review
  5. Meta-analysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment.
  6. Efficacy of Probiotic Supplementation Therapy for Helicobacter pylori Eradication: A Meta-Analysis of Randomized Controlled Trials.

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