Condition
    Moderate Evidence
    Effectiveness 3/5

    Lactobacillus Reuteri for H. Pylori Infection

    L. reuteri as an adjunct to H. pylori eradication mainly improves tolerability of triple therapy, with inconsistent effects on eradication success.

    Overview

    L. reuteri as an adjunct to H. pylori eradication mainly improves tolerability of triple therapy, with inconsistent effects on eradication success.

    Verdict

    Mixed evidence

    Adding L. reuteri to standard eradication therapy reliably reduces antibiotic side effects; whether it improves cure rates is less clear.

    How It Works

    Reuterin production suppresses H. pylori growth in vitro, and reuteri strains compete for gastric mucosal adhesion sites while dampening mucosal inflammatory signalling.

    Dosing & Protocol

    Typical dose

    Recommended dose
    1x10^8 CFU daily alongside the eradication course
    Expected timeframe
    Tolerability benefits appear within the first days of therapy

    Protocol

    form
    L. reuteri DSM 17938 or ATCC 55730 drops or tablets, kept within the storage conditions on the label
    duration
    Through the 10-14 day eradication course and for 2-4 weeks afterwards to support gut recovery
    co factor
    Separate the probiotic from antibiotic doses by 2-3 hours. Take with or shortly after food
    titration
    No titration; trials used a fixed daily dose. It is an adjunct to triple or quadruple therapy, never a substitute for it
    starting dose
    1x10^8 CFU L. reuteri daily, started with the eradication course

    Evidence

    What the studies say

    Randomized trials pairing L. reuteri DSM 17938 with standard triple or quadruple therapy consistently report fewer adverse events — less nausea, diarrhea and taste disturbance — which in turn improves treatment adherence. Effects on the eradication rate itself are inconsistent: some trials report modest absolute gains of a few percentage points, others show no difference, and meta-analyses are sensitive to which small studies are included. Reuteri monotherapy without antibiotics reduces urea breath test values in some trials but does not eradicate the infection. The practical conclusion is that reuteri is a tolerability adjunct, not a treatment.

    Efficacy and Safety of Postbiotic Contained Inactivated Lactobacillus reuteri (Limosilactobacillus reuteri) DSM 17648 as Adjuvant Therapy in the Eradication of Helicobacter pylori in Adults With Functional Dyspepsia: A Randomized Double-Blind Placebo-Controlled Trial.

    Score: 7/10
    2024
    rct

    Ivashkin V, Maev I, Poluektova E +1 more

    Eradication efficiency was 96.7% for the postbiotic group vs 86.0% for the placebo group (P = 0.039).

    View source

    Safety

    Caveats

    {"Does not replace antibiotic eradication therapy","Eradication-rate benefit is not consistently demonstrated","Strain and dose vary widely across trials"}

    Less likely to help if

    People who tolerate triple therapy well have little to gain.

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.