Standard H Pylori Treatment
The standard, first-line antibiotic treatment of Helicobacter pylori infection, called triple therapy, is 14 days of:
- A proton pump inhibitor such as omeprazole, for its inhibitory effect on stomach acid, to allow healing of the stomach lining.
- Two antibiotics together, such as amoxicillin, metronidazole, or clarithromycin
However, H. pylori eradication rates with this regimen are variable, depending on the antibiotic resistance of the H. pylori strains .
Among functional medicine and naturopathic doctors, a standard treatment in clinical practice may include herbal antibiotics and probiotics as an anti-H. pylori approach.
No matter which treatment course your doctor prescribes, a lot of patients experience adverse events and side effects on antibiotics or herbal antimicrobials. This is where probiotics really shine.
H Pylori And Probiotics
The combination of H pylori and probiotics for this gastrointestinal infection makes sense because both influence the body: the first with potential harm, and the latter with numerous benefits within and beyond the GI tract. In this article you will learn a brief introduction to the bacterium, traditional treatment for infections, and exciting research on probiotics that may help.
Inoculation Of Drugs And Lactobacilli To Animals
In all of the 9 treated groups, bismuth and omeprazole were inoculated during the first week after H. pylori inoculation. Then, in the second week, the mice were treated by gavage with the following: L. acidophilus , L. plantarum , L. rhamnosus , L. acidophilus and L. plantarum , L. acidophilus and L. rhamnosus , L. rhamnosus and L. plantarum, all three Lactobacillus strains , and clarithromycin . In group 9, only bismuth and omeprazole were inoculated.
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The Probiotic Lgg Produces Antimicrobial Substances Against H Pylori
Antagonistic activity against H. pylori in vitro has been associated with lactic acid production and to a lesser extent with the production of other short-chain fatty acids . Lactic acid increases the cell wall permeability of H. pylori . Besides, production of exopolysaccharide , lectin , and/or peptides with antimicrobial activity by LGG has been shown to inhibit other pathogenic bacteria, however, this effect has not been shown for H. pylori specifically. A summary of studies on the effect of LGG on H. pylori and gastric pathology can be found in Table 3.
TABLE 3. Summary of studies on the effect of LGG on H. pylori and gastric pathology.
Probiotics As Adjuvant Therapy
Therapeutic effects of probiotics against H. pylori infection in children
There is ample evidence of the clinical effects of probiotics in treating and reducing bacterial load in children. Cruchet et al. conducted a randomized double-blind trial on children with asymptomatic H. pylori infection. In their study, the children were divided into five groups, so that four groups received probiotic Lactobacillus strains , and one group received placebo. They found that the C13UBT value in children receiving live L. johnsonii La1 was significantly lower than other groups . In a similar study, asymptomatic children were randomly treated with three regimens containing standard triple therapy . Based on several clinical trials, it has been concluded that the rate of eradication of H. pylori infection increases in children receiving probiotic diets . Some of these studies that suggested clinical efficacy of probiotic supplementation in the eradication of H. pylori infection are listed in Table . Based on these studies, probiotics can significantly increase H. pylori eradication rate particularly in patients receiving Lactobacillus spp. and Bifidobacterium spp. supplementation. These probiotics have a high potential against H. pylori infection using various mechanisms . In addition, probiotics can alter the gut microbiota to reduce gastrointestinal symptoms and drug side effects .
Table 3 Available clinical trials of probiotics in the treatment of H. pylori infection in children
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Competition For Binding Sites
In vitro pre-treatment of epithelial glandular cells with 107 cfu/ml LGG was found to inhibit subsequent adhesion by H. pylori with 53%, and at 109 cfu/ml LGG inhibited H. pylori with 66%. Competition for binding sites on the epithelial cells was cited as a probable cause , which appeared to be unrelated to adhesion capacity or organic acid production. Note that binding alone is not a marker for anti-H. pylori activity .
Secondly, a study on mice found that during a pre-treatment with a combination of the probiotic bacteria L. acidophilus R0052 and L. rhamnosus R0011 and subsequent administration of H. pylori, colonization was reduced from 100% in the control group to 50% in the probiotic pre-treated group . Note that this effect has not been proven for LGG specifically.
In a third study, a decrease in H. pylori of 27% was measured in a probiotic intervention among 13 Finnish H. pylori positive subjects, based on the well accepted 13C-Urea Breath Test, which values were an indirect indicator of H. pylori density in gastric mucosa. The subjects daily consumed a drink with four probiotic strains, including LGG, with each of the strains in a concentration of 2.5 × 109 cfu, for the duration of 56 days, for the duration of 56 days .
Treating H Pylori With Probiotics Alone
If you have tested positive for H. pylori but dont have common H. pylori symptoms, you may simply benefit from using probiotics to balance your microbiota.
A systematic review did find that a small percentage of H. pylori infections can be eradicated with probiotics alone . So, if you have tested positive for H. pylori and you DO have common H. pylori symptoms, such as gastritis, ulcers, stomach pain, or bloating, you may also choose to try a trial of probiotics alone before treating with more intensive therapy.
If your symptoms or H. pylori test dont resolve with probiotics alone, then you can consider escalating your treatment to include probiotics plus antimicrobial therapy. Be sure to discuss your treatment plans with your doctor.
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Finding A High Quality Probiotic
Look for a quality probiotic brand that contains a high CFU count and multiple strains of bacteria.
Also, make sure that the probiotic contains some form of protective technology that allows the bacteria to survive the journey through the gastrointestinal tract!
Most probiotic brands use vegetable capsules that deliver only around 4% of their bacteria safely to the gut. That’s because the veggie capsules are quickly broken down in your stomach, and the live bacteria are then exposed to your stomach acid.
Probiotic bacteria are sensitive to this highly acidic environment and most of them are killed before passing through to your intestines.
To solve this problem, we compress our bacteria into special time-release tablets using a technology named BIO-tract. When these come into contact with moisture, they form a protective gel coating that keeps the bacteria safe in your stomach. Then, when the tablet passes through to your intestines, the bacteria are slowly released over 8-10 hours.
Tests using simulated stomach acid have shown that this method safely delivers at least 15 times more bacteria, when compared to regular vegetable capsules.
Our probiotic also has 12 strains chosen for their impact on digestion and immunity, and a total of 15 billion CFUs of bacteria.
Here are a few key benefits of our probiotic:
Best Probiotics For H Pylori Treatment
Scientists have studied many different types of probiotics for their effect on H. pylori eradication rates. Some studies have tested single strains, but many different strains and combinations have been shown to be effective at improving treatment success. Lets summarize what we know about the best probiotics for H. pylori treatment.
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Why Take A Probiotic With An Antibiotic
Replenishing the gut with probiotics helps to rebalance the gut microbiome following antibiotic use. The NHS has recognised the beneficial effects of probiotic supplementation7. When prescribed antibiotics, many individuals now choose to supplement their natural bacteria with a probiotic supplement. Your local pharmacist may even recommend probiotics when dispensing antibiotics.
Antibiotic-associated diarrhoea is one of the most common side effects of antibiotics, with a prevalence of between 5 to 35%, depending on the type of antibiotic8 taken. A meta-analysis of 23 studies carried out in 2012 supported the use of probiotics in antibiotic-associated diarrhoea9. One particular form of AAD is Clostridium difficile infection, which manifests as chronic diarrhoea and in severe cases, colitis. This is of particular concern in the elderly and can sometimes be fatal. Based on a systematic review and meta-analysis of 23 randomized controlled trials including 4213 patients, evidence suggests that probiotics are both safe and effective in helping to support the health of the gut microbiome and reducing digestive upset related to Clostridium difficile-associated diarrhoea10. Health professionals can visit this article in the Professionals site to find out more about Probiotics and Clostridium difficile.
Lactobacillus Plantarum Against Helicobacter
Several strains Lactobacillus plantarum have been tested in vivo and in vitro and showed great results in inhibiting the growth of H. pylori. L. plantarum B7 was shown to inhibit the growth of H. pylori and also reduce gastric inflammation in rats. L. plantarum XB7 secrets active factors that reduce inflammation caused by H. pylori infection and can potentially be used as an additional therapy for treating H. pylori infection. Additionally, recent study with L. plantarum ZDY 2013 has demonstrated that pretreatment with this strain prior the infection positively modified intestinal microbiota and reduced inflammation compared to control group.
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How To Prevent Future Infection
The source of H. pylori is unclear. There are no formal recommendations from the CDC to prevent it. In general, you should practice good hygiene by frequently washing your hands and properly preparing your food. If youre diagnosed with H. pylori, complete your full course of treatment to reduce your risk of recurrence.
Correlation Between Diet And Lifestyle And H Pylori Associated Pathology
There is evidence for a connection between H. pylori and dyspeptic symptoms , as it has been shown that the odds ratio of a person with dyspeptic symptoms being a carrier of H. pylori is higher than the H. pylori incidence in the general population . Furthermore, H. pylori eradication leads to long-term cure in the majority of peptic ulcer patients, whereas the natural relapse rate is 70% .
However, this argument is not a definite proof for a causal relationship between H. pylori and dyspepsia. It has been suggested that genetic predisposition and environmental factors such as diet, smoking, age and the use of non-steroidal anti-inflammatory drugs can lead to high gastric acid production, which in turn can lead to gastric metaplasia and subsequent development of duodenal ulcers . Similarly, the intake of iron supplements has been associated with gastric pathology through the induction of oxidative stress . The positive correlation between H. pylori and dyspeptic symptoms is attributed to the fact that treatment of duodenal ulcer with acid-reducing medicine facilitates H. pylori colonization in the stomach. Hence, the self-reported high incidence of ulcers in Uganda might be partly a result of lifestyle and dietary habits of the local population.
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Pathogenesis And Other Consequences Of H Pylori Colonization
The high incidence of H. pylori among East African populations per se does not necessarily cause increased levels of gastric pathology, as H. pylori induced gastric pathology is influenced by genetic factors of the H. pylori strain as well as by specific immune responses of the host. At the same time, it has been reported that H. pylori might exert beneficial functions in African populations .
In the context of pathology, Blaser and Atherton distinguish two topographic distributions of H. pylori induced gastric inflammation, both having different outcomes. Firstly, inflammation could be in the lower part of the stomach only , which via a cascade of cell signaling leads to increased gastric acid output and subsequently increases the risk for duodenal ulcers. Secondly, inflammation of the whole stomach could induce cascades of signaling that lead to reduced acid output and associated increased risk for gastric ulcers. This topographic distribution might be determined by genetic factors of H. pylori strains as well as environmental factors.
Taking Probiotics With Antibiotics
There is no doubt that antibiotics have an essential role to play in modern medicine in preventing and curing bacterial infections. Thanks to antibiotics, bacterial infections are no longer the most common cause of death in the modern world1. In more recent times it has become increasingly recognised that antibiotics negatively affect our gut microbiome2. However, many people now choose to take a supplement containing probiotics to minimise digestive upset that can often be associated with antibiotic use.
In this article we will look at:
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Natural Treatment For H Pylori: What Works
Many in vivo and in vitro studies on natural H. pylori treatments have been done. Most treatments reduced the number of bacteria in the stomach but failed to permanently eradicate them.
Be sure to talk with your doctor before beginning a natural treatment regimen. You shouldnt replace your recommend treatment for H. pylori with natural remedies.
With your doctors approval, you can use natural treatments as adjuvant therapy. This may increase the effects of conventional drugs.
The Story Of Helicobacter Pylori
Helicobacter pylori, as the name suggests, is a helical- or spiral-shaped Gram-negative bacterium. It can survive with tiny amounts of air. In addition to the helical shape, it also has flagella, whip-like appendages, which allow it to move about. If it doesn’t like one area, it can move to the next. It is generally considered to be a pathogen.The bacterium has strong enzyme activity to neutralize your stomach acid that allows it to survive and drill into in your stomach lining. When numbers reach an amount to cause a detectable infection, the infection triggers your immune system to attempt to kill it. Unfortunately, your immune system attempt causes collateral damage by damaging the gastric epithelial lining, which then allows H. pylori to flourish. As it flourishes, you experience symptoms of peptic ulcer disease and are a target for other pathogens to establish themselves farther down the GI tract.
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What Is Helicobacter Pylori
Helicobacter pylori known as H. pylori for short is a spiral-tailed pathogenic bacteria that primarily resides in the stomach, though it can also live anywhere in the gastrointestinal tract .
H. pylori was discovered by two Australian researchers, Barry Marshall and Robin Warren, one of whom proved H. pylori caused gastritis by infecting himself with the bacteria . They were awarded the Nobel Prize in 2005 for this important discovery for gastroenterology.
Its estimated that more than half of the worlds population has H. pylori present in their gut . Only 10-20% of people infected will develop symptoms like peptic ulcers, and a very small percentage will develop gastric cancer .
H. pylori burrows into and inflames the stomach lining, which affects the acid-producing parietal cells of the stomach . A chronic decrease in stomach acid due to H. pylori infection is a risk factor for many conditions and side effects downstream. Low stomach acid can lead to vitamin B12 and iron deficiency, poor protein digestion, low bile and enzyme secretion, and slow gut motility [10
However, a wide range of meta-analyses, systematic reviews, and clinical trials conclude that probiotics can make a significant difference in H. pylori treatment. Given these data, the role of probiotics should be prominent during treatment.
Do Probiotics Cure H Pylori On Their Own Or Do You Need Antibiotics Too
Do probiotics cure H pylori
One of our readers Colin, from Manchester has written in asking, do probiotics cure H pylori
Thanks, Colin: This is a great question and one Im sure lots of people would love to know the answer to.
My response is both yes they can and no they cant.
I realize this is a weird response, so let me explain
My initial research into H pylori and probiotics
In 2007-8, when I did my first batch of research to answer the do probiotics cure H pylori question, I found quite a lot of data on the topic and presented it in The H Pylori Diet.
Because were now in 2016, I did some additional research this year to see if anything had changed.
Unfortunately, it hasnt, and according to the scientific and medical literature, Colins question really needs to be modified to, do probiotics cure H pylori on their own?
Do probiotics cure H pylori on their own?
To summarise all the research Ive read in a few lines is not easy, but it boils down to four main statements:
- First, probiotics alone appear to have the ability to cure H pylori .
- Second, probiotics used alongside antibiotics improve the effect of the antibiotics and cure more people.
- Third, probiotics used alongside antibiotics also reduce the side effects of the antibiotic therapy.
- Fourth, not all probiotics are effective when used as part of H pylori treatment some are better than others.
The authors drew this conclusion:
Do probiotics cure H pylori different types and species?
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Probiotics With Antibiotic H Pylori Treatment
Blending probiotics with the standard Helicobacter pylori eradication therapy increases the rate of treatment success and decreases side effects, such as antibiotic-associated diarrhea, nausea, and bloating .
Including probiotics during your anti-Helicobacter pylori treatment is highly likely to minimize these side effects, and increase your likelihood of success.
Research suggests using a diverse range of probiotics together provides better results than a single strain or variety . A simple protocol that includes one quality probiotic from each of the three main categories of probiotics simultaneously Lactobacillus-Bifidobacteria blends, Saccharomyces boulardii, and a soil-based probiotic is best.
Triple Therapies Plus Different Probiotics For Helicobacter Pylori Eradication
G. Scaccianoce1, A. Zullo2, C. Hassan2, F. Gentili2, F. Cristofari2, V: Cardinale2, F. Gigliotti2, D. Piglionica1, S. Morini2
1Digestive Endoscopy, Umberto I Hospital, Altamura, Bari 2Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome
Corresponding Author: Angelo Zullo, MD e-mail: [email protected]
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Probiotics As Adjunct Therapy For Treating H Pylori Infection
Helicobacter pylori is extremely hard infection to eradicate even with antibiotics. The most recent research in both children and adults has showed that combination of antibiotics and probiotics is more effective than antibiotics alone.
There have been several probiotic bacteria tested for this purpose.