IDDF2022-ABS-0107 The effect of lactobacillus reuteri probiotic as an adjunct treatment for helicobacter pylori infection in adults

Background

The local studies on Helicobacter pylori (H. pylori) eradication following standard triple therapy demonstrated a suboptimal eradication rate with an emerging clarithromycin resistance rate from 6.8% to 14.8%. In this study, we aim to investigate the efficacy of Lactobacillus reuteri probiotic in improving the eradication rate of H. pylori as well as alleviating H. pylori-associated gastrointestinal symptoms and treatment adverse effects.

Methods

This was a prospective, randomised, double-blind, placebo-controlled trial involving recently diagnosed H. pylori patients. Patients were prescribed with standard triple therapy for 2 weeks and supplemented with either probiotics or placebo for 4 weeks. Patients were interviewed for any treatment adverse effects and given a Gastrointestinal Symptom Rating Scale (GSRS) questionnaire to answer during the study. The eradication rate post-treatment was assessed via ¹⁴C urea breath test (UBT).

Results

Ninety eligible subjects were recruited for the study with one drop-out (38 males, 51 females, median age: 52.0). Forty-nine-point-four percent (n=44) subjects received probiotics and 50.6% (n=45) subjects received placebo. H. pylori eradication rate was 93.2% in the probiotic group and 68.9% in the placebo group (p=0.007). Post-treatment GSRS scores in the probiotic group showed significant score reduction in indigestion, constipation, abdominal pain and total GSRS. The mean score reduction was as following; indigestion (4.34 ± 5.00 vs 1.78 ± 5.64, p value=0.026) abdominal pain (2.64 ± 2.88 vs 0.89 ± 3.11, p value=0.007), constipation (2.34 ± 3.91 vs 0.64 ± 2.92, p value=0.023) and total GSRS score (12.41 ± 12.19 vs 4.24 ± 13.72, p=0.004). Amongst the treatment adverse effects reported, headache and abdominal discomfort demonstrated a statistically significant difference between both groups (p=0.012 and p=0.026, respectively).

Conclusions

The use of Lactobacillus reuteri as an adjunct treatment in H. pylori infection has shown significant improvement in eradication rate, gastrointestinal symptoms and treatment adverse effects.