Saccharomyces boulardii improves the eradication rate of Helicobacter pylori.

Helicobacter pylori is a growing infectious disease with a prevalence rate of 70-90% in developing countries and 25-50% in industrialized countries. Typical eradication therapy consists of one PPI along with two antibiotics; most commonly omeprazole is used along with amoxicillin and clarithromycin. While this therapy is effective in some, reports show this triple therapy is not as effective as it once was. In 2003, the eradication rate using triple therapy was reported to be 75%, while in 1995 it was 85%. Besides leaving 25% of the population with an active infection, triple therapy can be very difficult for patients to tolerate the side effects of the drugs. Many patients complain of diarrhea, upset stomach, and nausea while taking triple therapy.

A study out this month in the journal Helicobacter, examines the effects of adding Saccharomyces boulardii to typical triple therapy for the eradication of H.pylori. 991 patients with an active H.pylori infection who had not previously been treated for the infection before, were included in the study. Patients were randomized into three groups; group A received triple therapy only (20 mg omeprazole, 1000 mg amoxicillin, and 500 mg clarithromycin twice a day for 7 days) and group B received the triple therapy for seven days along with 250 mg (five billion CFU) three times a day of S.boulardii for four weeks, while group C received the triple therapy along with 250 mg (five billion CFU) three times a day of S.boulardii along with a mucoprotective agent, DA-9601an extract from Artemisia asiatica, for four weeks. At the end of the study, the results showed those in group A had an eradication rate of 71.6%, while in group B the rate was 80% and in group C it was 82.1%. Patients in group B and C reported they had less diarrhea than those in group A (3.3%, 3%, and 6% respectively). Patients in group A also reported more general side effects (taste disturbance, nausea, epigastric pain) than those in group B and C.

This study shows that supplementation with S.boulardii can be an effective adjunct to triple therapy for H.pylori infections. S.boulardii is well tolerated and resists the kill of antibiotics better than other strains of probiotics like Lactobacillus and Bifidobacterium. Besides increasing the rate of eradication, S.boulardii lowered the rate of some side effects including diarrhea. While more studies are needed to learn the exact mechanism of how S.boulardii acts specifically on H.pylori, we know it has immunomodulating and anti-inflammatory properties that may be playing a role.

For a comprehensive review on S.boulardii, please see the Point Institute’s Paper titled “Saccharomyces boulardii in Gastrointestinal Related Disorders.”

Source: www. validus.myompi.com