Euroasian Journal of Hepato-Gastroenterology

Register      Login

VOLUME 7 , ISSUE 1 ( January-June, 2017 ) > List of Articles

ORIGINAL ARTICLE

Are Synbiotics added to the Standard Therapy to eradicate Helicobacter pylori in Children Beneficial? A Randomized Controlled Study

Banu N Şirvan, Merve K Usta, Nuray U Kızılkan, Nafiye Urgancı

Citation Information : Şirvan BN, Usta MK, Kızılkan NU, Urgancı N. Are Synbiotics added to the Standard Therapy to eradicate Helicobacter pylori in Children Beneficial? A Randomized Controlled Study. Euroasian J Hepatogastroenterol 2017; 7 (1):17-22.

DOI: 10.5005/jp-journals-10018-1205

License: CC BY 3.0

Published Online: 01-06-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

We aimed to evaluate the role of the addition of Bifidobacterium lactis-containing synbiotic to the triple therapy in the case of Helicobacter pylori eradication, the dyspeptic symptoms, and reducing the side effects of antibiotics.

Materials and methods

A total of 104 children aged between 5 and 17 years, who were histopathologically diagnosed with H. pylori were enrolled in this study, of whom 100 were included in the analysis. Patients were randomly classified into two groups. In the first group, 50 patients were administered amoxicillin + clarithromycin + lansoprazole for 14 days and B. lactis-containing synbiotic. In the second group, 50 patients were treated with the standard triple therapy. All patients were given information after completion of therapy.

Results

H. pylori eradication was achieved in 88% in group I who received standard therapy with additional synbiotic and 72% in group II (p = 0.046). The number of patients in the second group who suffered from abdominal pain between the 3rd and 14th day of the treatment was higher (p < 0.05). The addition of probiotics to the triple therapy significantly reduced the frequency of diarrhea, but no significant difference was detected in the frequency of metallic taste (p = 0.04, p = 0.418 respectively).

Conclusion

The addition of synbiotic to the triple therapy is effective for eradicating H. pylori infection in children and is usually helpful to reduce or eliminate dyspeptic symptoms like abdominal pain, diarrhea, and vomiting. This study suggest that improved tolerance to the eradication treatment also reduces the treatment failure by adding probiotics and encourages the future study using probiotic supplementation in H. pylori treatment.

How to cite this article

Şirvan BN, Usta MK, Kızılkan NU, Urgancı N. Are Synbiotics added to the Standard Therapy to eradicate Helicobacter Pylori in Children Beneficial? A Randomized Controlled Study. Euroasian J Hepato-Gastroenterol 2017;7(1):17-22.


  1. Review article: natural history and epidemiology of Helicobacter pylori infection. Aliment Pharmacol Ther 2002 Mar;16(Suppl 1):3-15.
  2. Epidemiology of Helicobacter pylori infection. Helicobacter 2007 Oct;12(Suppl 1):1-3.
  3. Helicobacter pylori infection and childhood. Helicobacter 2010 Sep;15(Suppl 1):53-59.
  4. Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr 2011 Aug;53(2):230-243.
  5. A randomized trial of triple therapy for pediatric Helicobacter pylori infection and risk factors for treatment failure in a population with a high prevalence of infection. Clin Infect Dis 2005 Nov;41(9):1261-1268.
  6. Dual vs. triple therapy for childhood Helicobacter pylori gastritis: a double-blind randomized multicentre trial. Helicobacter 2004 Aug;9(4):293-301.
  7. Meta-analysis of randomized controlled trials on the efficacy of probiotics in Helicobacter pylori eradication therapy in children Eur J Pediatr 2014 Feb;173(2):153-161.
  8. Working group report on drafting guidelines for the evaluation of probiotics in food. London, Ontario, Canada: FAQ/WHO; 2002. [cited April 30 and May 1, 2002]. Available from: http://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf.
  9. Probiotic bacterial and fungal strains: claims with evidence. Dig Dis 2016 Mar;34(3):251-259.
  10. Probiotics for the treatment of Helicobacter pylori infection in children World J Gastroenterol 2014 Jan;20(3):673-683.
  11. Are probiotic useful in Helicobacter pylori eradication? World J Gastroenterol 2015 Oct;21(37): 10644-10653.
  12. Management of Helicobacter pylori infection-the Maastricht IV/Florence consensus report. Gut 2012 May;61(5):646-664.
  13. Meta-analysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther 2010 Nov;32(9): 1069-1079.
  14. The effect of probiotics and mucoprotective agents on PPI-based triple therapy for eradication of Helicobacter pylori. Helicobacter 2010 Jun;15(3):206-213.
  15. The efficacy and safety of adding the probiotic Saccharomyces boulardii to standard triple therapy for eradication of H. pylori: a randomized controlled trial. Gastroenterol Hepatol Bed Bench 2013 May;6(Suppl 1):S99-S104.
  16. Effect of Lactobacillus acidophilus and Bifidobacterium bifidum supplementation to standard triple therapy on helicobacter pylori eradication and dynamic changes in intestinal flora. World Microbiol Biotechnol 2014 Mar;30(3):847-853.
  17. Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther 2007 Jan;25(2):155-168.
  18. Impact of supplement with Lactobacillus and Bifidobacterium containing yogurt on triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2002 Sep;16(9):1669-1675.
  19. Effect of a probiotic food as an adjuvant to triple therapy for eradication of Helicobacter pylori infection in children. Nutrition 2006 Oct;22(10):984-988.
  20. Bifidobacterium lactis B94 plus inulin for treatment of Helicobacter pylori infection in children: does it increase eradication rate and patient compliance? Acta Gastroenterol Belg 2015 Jul-Sep;78(3): 282-286.
  21. The effects of probiotics on treatment of Helicobacter pylori eradication in children. Saudi Med J 2015 Mar;36(3):286-290.
  22. Randomized, double-blind, placebo-controlled trial: effect of lactobacillus GG supplementation on helicobacter pylori eradication rates and side effects during treatment in children. J Pediatr Gastroenterol Nutr 2009 Apr;48(4): 431-436.
  23. Lactobacillus reuteri strain combination in Helicobacter pylori infection: a randomized, double-blind, placebo-controlled study. J Clin Gastroenterol 2014 May-Jun;48(5):407-413.
  24. Lactobacillus reuteri therapy to reduce side-effects during anti-Helicobacter pylori treatment in children: a randomized placebo controlled trial. Aliment Pharmacol Ther 2006 Nov;24(10):1461-1468.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.