Systematic review: are probiotics useful in controlling gastric colonization by Helicobacter pylori?
Version of Record online: 30 MAR 2006
Alimentary Pharmacology & Therapeutics
Volume 23, Issue 8, pages 1077–1086, April 2006
How to Cite
GOTTELAND, M., BRUNSER, O. and CRUCHET, S. (2006), Systematic review: are probiotics useful in controlling gastric colonization by Helicobacter pylori?. Alimentary Pharmacology & Therapeutics, 23: 1077–1086. doi: 10.1111/j.1365-2036.2006.02868.x
- Issue online: 30 MAR 2006
- Version of Record online: 30 MAR 2006
- Publication data Submitted 21 November 2005 First decision 21 December 2005 Resubmitted 31 January 2006 Resubmitted 1 February 2006 Accepted 3 February 2006
Helicobacter pylori is a highly prevalent pathogen considered as an aetiological factor for gastroduodenal ulcers, and a risk factor for gastric adenocarcinoma and lymphoma in humans. Most subjects colonized by this micro-organism are asymptomatic and remain untreated. In symptomatic patients, the antibiotic treatment has a high cost and is not 100% effective because of resistance to antibiotics and to moderate patient compliance. This review discusses the role of probiotics as alternative solutions to assist in the control of H. pylori colonization in at-risk populations.
The evidence that some strains of Lactobacillus and Bifidobacterium are able to inhibit H. pylori growth through the release of bacteriocins or organic acids, and may also decrease its adhesion to epithelial cells, is reviewed. In addition, probiotics have a possible role in the stabilization of the gastric barrier function and the decrease of mucosal inflammation. Other aspects that are considered are the contribution of probiotics to the healing of the gastric mucosa linked to their antioxidant and anti-inflammatory properties.
Clinical trials in colonized adults and children are reviewed, and suggest that probiotics do not eradicate H. pylori but maintain lower levels of this pathogen in the stomach; in combination with antibiotics, probiotics may increase eradication rate and/or decrease adverse effects. Papers suggesting similar effects on H. pylori by foodstuffs such as berry juice and some milk proteins are quoted. Regular intake of these and other dietary products might constitute a low-cost, large-scale alternative solution applicable for populations at-risk for H. pylori colonization.