Helicobacter pylori (H. pylori) is a type of bacteria that infects your stomach, damages the protective lining, causes gastritis or peptic ulcers, and potentially gastric cancer. It is estimated that up to 50% of the world's population harbors this bacteria. Many are exposed in childhood and never develop symptoms. When symptoms do occur, it is typically manifested as indigestion, frequent belching, bloating, feeling full long after a meal, abdominal pain, mood swings, and/or anxiety. Patients can also experience constipation or diarrhea, mineral deficiencies (magnesium, selenium, calcium, B12, zinc), and low-grade gut inflammation.
Another common issue we see with this pathogen is hypochlorhydria or low stomach acid. H. pylori produces an enzyme called urease that neutralizes stomach acid. This is important because we need healthy levels of stomach acid to digest our food, especially protein, and absorb nutrients from the food. Often we find a pattern of hypochlorhydria on stool testing with dysbiosis and low digestive enzymes.
Long-term infection with H. pylori can lead to chronic gastritis, chronic dyspepsia, duodenal or gastric ulcer disease, or gastric malignancy, including both adenocarcinoma and B-cell lymphoma. Therefore, it is important to eradicate this bacteria, especially if patients are symptomatic.
Julianna is a 26-year-old who was diagnosed with IBS in college. She has been experiencing extreme bloating after eating any food. She reports that her PCP was no help, and she also has seen a gastroenterologist for an endoscopy and was told she had stomach polyps, inflammation, and stomach erosions but was negative for celiac. She states, "They tried to have me take Protonix, and when I questioned, they did not really have an answer. " She also has alternating diarrhea and constipation, gas, headaches, anxiety, sugar/sweet cravings, and skin breakouts. She reports a 15 lb weight gain and that she is having difficulty maintaining a healthy weight.
She is 5'0 feet tall and weighs 142 lbs with a Body Mass Index (BMI) of 27.7 (desired BMI 18.5-24.9). Her past medical history also includes anxiety, for which she tried Lexapro without positive results. She also has struggled with acne and tried both oral doxycycline and amoxicillin a couple of years ago. She is currently off all medications. She has daily bowel movements that fluctuate from loose to constipated, and not feeling like she empties fully. Her diet consists primarily of whole foods but few carbohydrates. She reports that spinach and lettuce typically cause diarrhea. She consumes only 24 ounces of water daily. She consumes rare alcohol at social events and does not use tobacco or illicit drugs. She exercises three days per week, doing barre and cardio. She sleeps an average of 6 hours per night and reports her stress level at a 10/10 recently.
Enteroinvasive E.coli/Shigella is present. These bacterial strains normally live in the intestines of people and animals. Most E. coli are harmless and actually are an important part of a healthy human intestinal tract. However, some E. coli are pathogenic. We are typically exposed via fecal contamination of beef, milk, or unpasteurized juice. Exposure can also occur from animal handling.
Helicobacter pylori (H. pylori) is also present at low levels. This pathogen is highly transmissible through saliva, feces, and/or vaginal secretions. It produces an enzyme called urease. This enzyme makes your stomach acids less acidic, a condition called hypochlorhydria. Julianna has many symptoms of H. pylori, including diarrhea and constipation, gas, bloating, headaches, anxiety, and skin breakouts.
Commensal or Keystone bacteria are the 'good bacteria' we want to have healthy levels of in the gut. Enterococcus spp. is low, which indicates insufficient levels. Lactobacillus spp. is elevated, which indicates maldigestion and possible excessive carbohydrate consumption, although she did report eating a lower-carb diet. Bacteroidetes and Firmicutes are considered large classes of bacteria that the individual strains fall under. Both large classes are elevated, indicating maldigestion, possibly excessive protein intake, and poor health of the gut lining as well as leaky gut.
Opportunistic bacterial overgrowth of Staphylococcus aureus, Streptococcus spp., and Methanobacteriaceae (family) is likely due to low stomach acid and maldigestion of food.
Julianna's protocol included 90 days of diet and lifestyle recommendations and supplementation. In month one, we focused on optimizing the detox and drainage pathways, reducing inflammation, repleting nutrients and minerals, and improving digestion. Here are the supplements we used:
Months two and three focused on killing the pathogens, repopulating the good bacteria, and healing the gut lining. Supplements included:
We also focused on diet and lifestyle modifications during the entire protocol and beyond. Rebalancing her lifestyle in terms of stress management and sleep prioritization are key components of the healing process. Suggestions included:
After following the three-month protocol, this is what Julianna said, "The last three months, I have had way less bloating, more regular bowel movements, and last time I checked, I had lost 9 pounds since August! There are some days I do feel more bloated than others, but I feel like that is normal. This process has made me feel sooooo much better!!"
One month after Julianna completed the protocol, we retested. Below are her results.
C. difficile GONE! H. pylori GONE!
Commensal balance has improved overall. She will continue probiotics and increase fiber.
She still has some opportunistic bacterial overgrowth which is part of the picture of dysbiosis. On her follow-up protocol which was 60 days in length, we used GI Microbe-X 1 pill twice daily on an empty stomach to remove/bring into balance the opportunistic bacteria.
Her SIgA is slightly lower, which can happen after the process of removing pathogens. In order to boost this, we utilized Douglas Labs Colostrum, 3 pills twice daily on an empty stomach. In addition, we continued healing the gut lining and began working more on her metabolic health. She is also continually working on rebalancing and making stress management, sleep, and water intake a priority.
After her 60-day protocol, here is what Julianna said "Before my protocol, I was bloated after EVERY single meal, no matter if it was a healthy meal or not. I started protocol in October at 140 lbs. On December 24th, I was down to 136. The last time I checked at the end of February, I was at 133. I think I look and feel less puffy, especially in my face, if that makes sense! It was also interesting because I did not change anything about my workouts and still continued to do barre classes 3 days per week and lost that weight just by the supplements and changing my diet. Overall, I look and feel 1000 times better since I started working with you, and I couldn't be more thankful for you for helping me when no one else would!"
Gastrointestinal ailments are among the most common issues in society. It is estimated that approximately 60 to 70 million people in the U.S. live with a digestive disorder, H. pylori being a very common one. It's important not to ignore symptoms as they are often easier to treat when they first arise. Gut healing takes time. However, the longer you wait, the more challenging it can be. Over time, we can begin to normalize our symptoms and believe the lie that "this is just the way I am." It's important for you to know that you are not alone and you do not have to live with chronic digestive symptoms. You, too, can heal and live a vibrant life, just like Julianna! The first step is to receive a proper diagnosis which can be achieved through high-quality stool testing. Next, working with a practitioner that creates a protocol specific to your individual needs that encompasses dietary and lifestyle modifications in addition to proper supplementation is key. Healing your gut will improve your overall wellness because, as Hippocrates said, "All disease begins in the gut."