{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T14:08:49Z","timestamp":1790431729731,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001225","name":"Marathon","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001225","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite multiple therapy regimens, the decline in the <jats:italic>Helicobacter pylori<\/jats:italic> eradication rate poses a significant challenge to the medical community. Adding <jats:italic>Lactobacillus reuteri<\/jats:italic> probiotic as an adjunct treatment has shown some promising results. This study aims to investigate the efficacy of <jats:italic>Lactobacillus reuteri DSM 17648<\/jats:italic> in <jats:italic>H. pylori<\/jats:italic> eradication and its effect in ameliorating gastrointestinal symptoms and adverse treatment effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This randomized, double\u2010blinded, placebo\u2010controlled trial involved treatment\u2010na\u00efve <jats:italic>H. pylori<\/jats:italic>\u2010positive patients. Ninety patients received standard triple therapy for 2\u2009weeks before receiving either a probiotic or placebo for 4\u2009weeks. The posttreatment eradication rate was assessed via a <jats:sup>14<\/jats:sup>C urea breath test in Week 8. The Gastrointestinal Symptom Rating Scale (GSRS) questionnaire and an interview on treatment adverse effects were conducted during this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The eradication rate was higher in the probiotic group than in the placebo group, with a 22.2% difference in the intention\u2010to\u2010treat analysis (91.1% vs. 68.9%; <jats:italic>p<\/jats:italic>\u2009=\u20090.007) and 24.3% difference in the per\u2010protocol analysis (93.2% vs. 68.9%; <jats:italic>p<\/jats:italic>\u2009=\u20090.007). The probiotic group showed significant pre\u2010 to post\u2010treatment reductions in indigestion, constipation, abdominal pain, and total GSRS scores. The probiotic group showed significantly greater reductions in GSRS scores than the placebo group: indigestion (4.34\u2009\u00b1\u20095.00 vs. 1.78\u2009\u00b1\u20095.64; <jats:italic>p<\/jats:italic>\u2009=\u20090.026), abdominal pain (2.64\u2009\u00b1\u20092.88 vs. 0.89\u2009\u00b1\u20093.11; <jats:italic>p<\/jats:italic>\u2009=\u20090.007), constipation (2.34\u2009\u00b1\u20093.91 vs. 0.64\u2009\u00b1\u20092.92; <jats:italic>p<\/jats:italic>\u2009=\u20090.023), and total score (12.41\u2009\u00b1\u200912.19 vs. 4.24\u2009\u00b1\u200913.72; <jats:italic>p<\/jats:italic>\u2009=\u20090.004). The probiotic group reported significantly fewer adverse headache (0% vs. 15.6%; <jats:italic>p<\/jats:italic>\u2009=\u20090.012) and abdominal pain (0% vs. 13.3%; <jats:italic>p<\/jats:italic>\u2009=\u20090.026) effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was a significant increase in <jats:italic>H. pylori<\/jats:italic> eradication rate and attenuation of symptoms and adverse treatment effects when <jats:italic>L. reuteri<\/jats:italic> was given as an adjunct treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13017","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T06:18:33Z","timestamp":1692857913000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Probiotic containing <i>Lactobacillus reuteri DSM 17648<\/i> as an adjunct treatment for <i>Helicobacter pylori<\/i> infection: A randomized, double\u2010blind, placebo\u2010controlled trial"],"prefix":"10.1111","volume":"28","author":[{"given":"Nur Izreena","family":"Ismail","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khairul Najmi Muhammad","family":"Nawawi","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"GUT Research Group, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah Chew Chia","family":"Hsin","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"GUT Research Group, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kok Wei","family":"Hao","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nik Ritza Kosai Nik","family":"Mahmood","sequence":"additional","affiliation":[{"name":"GUT Research Group, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary Lee Chong","family":"Chearn","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqin","family":"Wong","sequence":"additional","affiliation":[{"name":"Pantai Hospital  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azmi Mohd","family":"Tamil","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Joseph","sequence":"additional","affiliation":[{"name":"Y.S.P. 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