title: Probiotics improve efficacy and tolerability of triple therapy to eradicate Helicobacter pylori: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Gastric colonization by Helicobacter pylori is linked to a host of diseases, but eradication rates have declined in recent years. Some experimental studies suggest that probiotics may inhibit growth of H. pylori. This investigation was conducted to assess the impact of probiotics on both efficacy and tolerability of triple therapy to eradicate H. pylori.
  
  
  METHODS
  PubMed, Web of Science, and the Cochrane Collaboration were searched for relevant articles published through August 31, 2014. All analytics relied on commercially available software (Stata 11).
  
  
  RESULTS
  Twenty-three studies (N = 3900) qualified for meta-analysis. Pooled H. pylori eradication rates for triple therapy used alone and with added probiotics were 1464/2026 (72.26%; 95% CI, 67.66%-74.13) and 1513/1874 (80.74%; 95% CI, 74.68%-82.76%), respectively (odds ratio [OR] = 0.58; 95% CI, 0.50-0.68). Loss of appetite was similar in both groups (OR = 0.94; 95% CI, 0.61-1.45), but most adverse events (nausea, diarrhea, epigastric pain, vomiting, taste distortion, and skin rash) were mitigated through addition of probiotics. Publication bias was not evident, as indicated by Begg's and Egger's tests.
  
  
  CONCLUSIONS
  Probiotics may improve the efficacy of triple therapy in eradicating gastric H. pylori and alleviate most treatment-related adverse events.
authors.affiliation: Department of Gastroenterology, Shengjing Hospital, China Medical University Shenyang, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gong
authors.affiliation: Department of Gastroenterology, Shengjing Hospital, China Medical University Shenyang, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, Shengjing Hospital, China Medical University Shenyang, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Sun
keywords: Helicobacter pylori; adverse events; eradication; probiotics; triple therapy