- Licorice may support the eradication of H. pylori as a part of a quadruple therapy
regimen including amoxicillin, metronidazole, and omeprazole.
By Carrie Decker, ND
Founder and Medical Director, Blessed Thistle, Madison, WI
Dr. Decker reports no financial relationships relevant to this field of study.
Individuals having peptic ulcer disease positive for Helicobacter pylori infection (diagnosed by endoscopy and biopsy with positive rapid urease test) were treated with either traditional quadruple therapy or quadruple therapy with licorice as a substitution for bismuth subsalicylate. After 4 weeks of treatment, eradication of H. pylori infection was comparable in both groups.
Momeni A, et al. Effect of licorice versus bismuth on eradication of Helicobacter pylori in patients with peptic ulcer disease. Pharmacognosy Res 2014;6:341-344.
Licorice, Glycyrrhiza glabra, has a history of traditional use for the relief of epigastric pain and as a supportive agent in the healing from peptic ulcer disease. It has known anti-inflammatory action and supports healing of the gastric mucosa. In vitro studies have demonstrated that licorice has antimicrobial effects, including bactericidal and growth inhibition against Helicobacter pylori.1 There currently are multiple variations of antibacterial and acid-suppressing agents used for the treatment of H. pylori infection, and resistance to treatments has been seen.
Sixty individuals diagnosed with peptic ulcer disease positive for H. pylori infection via biopsy and rapid urease test were randomized to treatment with amoxicillin (1 g twice daily), metronidazole (500 mg twice daily), omeprazole (20 mg twice daily), and bismuth subsalicylate (524 mg twice daily) or licorice (380 mg twice daily containing < 3% glycyrrhizinic acid). After 4 weeks of treatment, the success of H. pylori eradication was assessed by urea breath test. In the group randomized to licorice as a part of the quadruple therapy, 67% tested negative for H. pylori infection, while in the group randomized to bismuth subsalicylate, 57% tested negative for H. pylori infection. The eradication rate of H. pylori infection was not significantly different in either group (P = 0.428).
Although no significant adverse effects were seen, and all individuals were noted to have completed this study, non-cooperation of patients was noted as exclusion criteria for the study bringing into question the reliability of the results. In general, due to small population and treatment limited to a single proprietary licorice formulation, further studies should be performed before this information is used clinically.
Reference
- Krausse R, et al. In vitro anti-Helicobacter pylori activity of Extractum liquiritiae, glycyrrhizin and its metabolites. J Antimicrob Chemother 2004;54:243-246.
