Probiotics Usage in Childhood Helicobacter pylori Infection

"Probiotics Usage in Childhood Helicobacter pylori Infection": chapter 51 of the volume "Probiotics,prebiotics,and synbiotics . Bioactive foods in health promotion" . Probiotics may represent a novel approach to the management of H. pylori infection. Although the majority of the studies in children have reported estimated odds ratios greater than 1.0, implying an estimated benefit for the addition of probiotics to triple H. pylori eradication therapy, only few reached statistical significance. Moreover, the very few trials performed in children on the effect of probiotics alone suggest only a temporary inhibition of H. pylori that disappears once the administration of the inhibiting factors is interrupted. Nonetheless, the majority of these studies were based on the relatively small samples, and therefore, they may lack the statistical power necessary to detect an important effect of the probiotics. Finally, in most studies, the effect of probiotic treatment on H. pylori infection in children has been estimated indirectly by 13C-UBT. Probiotic treatment seems to be able to reduce H. pylori therapy-associated side effects and indirectly may help to improve the eradication rate. However, its beneficial effects appear to be strain-specific. We conclude that standardized multicenter, placebo-controlled studies in larger series of children are needed to confirm benefits of probiotics in the management of H. pylori infection in children, including its effect on the severity of H. pylori gastritis. Additional work is necessary to determine the strain, dose and administration to be used. Long-term studies are also needed in children to prove whether the persistent-suppressive effect of probiotics on H. pylori and its associated gastritis could prevent diseases such as gastric cancer or peptic ulcer.