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Probiotics and Helicobacter pylori


5.2–8.3; p<0.01), which became markedly evident at the end of follow- up (3.2±2, 95% CI 2.4–4 versus 5.8±3.4, 95% CI 4.8–6.9; p<0.009). In summary, children receiving L. reuteri complained of epigastric pain less frequently during eradicating treatment (15 versus 45%; p<0.04) as well as abdominal distension (0 versus 25%; p<0.02), belching (5 versus 35%; p<0.04), disorders of defecation (15 versus 45%; p<0.04) and halitosis (5 versus 35%; p<0.04) thereafter.


Subsequently, further trials have been conducted in children showing that the occurrence of antibiotic-associated side effects was significantly reduced by the addition of S. boulardii (8.3 versus 30.9%; p=0.047),81


while the supplementation of standard triple therapy with


L. rhamnosus GG did not significantly alter the incidence of antibiotic associated side effects (52.9 versus 40.6%; p=NS).82


Thus, results showed a positive probiotic impact on overall H. pylori therapy


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tolerability, although in the majority of the studies performed probiotic administration did not significantly affect the drop-out rate due to side effects. It is clear that not all probiotics are equal, that the beneficial effects are strain-specific and that each strain must be evaluated individually.


Conclusions and Perspectives Both in vitro and in vivo studies provide evidence that probiotics may represent a novel approach to the management of H. pylori infection. Results so far are encouraging and further clinical trials are called for. The design of such studies should be to clarify which probiotic strains are suitable, in what form, in what dose and for how long. Moreover, the type of patient should be clearly defined and the method of defining outcome should also be standardised as far as possible. Moreover, cost-effective analysis should be taken into account. n


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