Cranberry juice may help curb H pylori infection

Consuming cranberry juice twice daily for 8 weeks can help suppress Helicobacter (H.) pylori infection among Chinese adults, suggests a randomized study — thus opening the door to using cranberry juice as a complementary approach to H. pylori management.

Despite the availability of effective treatment with triple or quadruple antibiotics, treatment failure still occurred in 10–30 percent of patients and increasing antibiotic resistance may pose a challenge.

"The study findings reveal that cranberry juice may be a useful aid in H. pylori management in adults in a high-risk region of China with an endemic infection rate of over 50 percent,” said principal investigator Professor Pan Kai-Feng from Peking University Cancer Hospital & Institute, Beijing, China.

“While not alternatives to antibiotics, effective complementary strategies, like cranberry, that can contribute to managing H. pylori infections without negative side effects are highly desirable,” he added.

The double-blind trial randomized 522 adults (mean age 47.24 years, 44.40 percent male) who were tested positive for H. pylori to receive any one of three doses (low, medium, high) of proanthocyanidin-standardized cranberry juice or placebo for 8 weeks. Proanthocyanidin is the active phenolic compound found in cranberry. H. pylori infection was tested using ¹³C-urea breath testing. [J Gastroenterol Hepatol 2020;doi:10.1111/jgh.15212]

After 8 weeks, the high-dose intervention (juice containing 88 mg proanthocyanidin) led to an almost 20 percent drop in H. pylori infection rate to 82.43 percent, while 93.15 percent of the patients receiving placebo remained positive for H. pylori infection in the intention-to-treat population (p=0.021). 

Similar results were seen in the per-protocol analysis, whereby the infection rate was significantly lower in the high-dose group compared with the placebo group (80.0 percent vs 92.65 percent; p=0.012).

On the other hand, lower doses of proanthocyanidin-containing cranberry juice did not have an effect on H. pylori infection. The proportion of patients who remained positive for H. pylori infection in the low- and medium-dose groups were similar as the placebo group (~92–95 percent).

Among the participants who were tested negative at 8 weeks, 75 percent of them remained free of infection when they were retested 45 days after the end of intervention.

The beneficial effect of cranberry juice may be attributed to the active phenolic compound proanthocyanidin, which can prevent bacteria from adhering to the stomach lining, according to the researchers.

“Cranberry proanthocyanidins do not appreciably degrade under the highly acidic conditions in the stomach, allowing them to maintain bioactivity,” explained Pan and co-authors.

In addition, the effects of powder formulation of proanthocyanidin were also tested. However, the powder form did not have significant effect on H. pylori suppression.

“In situations where antibiotic treatment of H. pylori is warranted but resistance to antibiotics is reducing H. pylori eradication rates, concurrent administration of cranberry might help improve treatment outcomes,” the researchers suggested.