What is H. Pylori? How to Diagnose and Treat H. Pylori
Summary
TLDRJulianne, a functional medicine practitioner and gut health expert, delves into H. pylori, a widespread and resilient pathogen affecting two-thirds of the global population. She explains its transmission, symptoms, and the significant impact on digestive health, including low stomach acid and nutrient deficiencies. Julianne discusses diagnostic tests, conventional treatments involving antibiotics, and the functional medicine approach, emphasizing probiotics, natural remedies, and dietary changes. She also highlights the importance of addressing stress management, dental hygiene, and potential transmission within families.
Takeaways
- 🦠 H. pylori is a spiral-shaped, gram-negative bacteria known as one of the most successful pathogens in human history, affecting around two-thirds of the world's population.
- 💊 The gram-negative nature of H. pylori makes it difficult to treat because its double outer cell wall layer resists antimicrobial drugs and herbs.
- 👶 H. pylori is often contracted in childhood, commonly through contaminated water, sharing drinks, or utensils, and can be transmitted via saliva and feces.
- 🧫 H. pylori can reduce stomach acid, leading to issues like low stomach acid, poor digestion, nutrient deficiencies, and potentially more serious conditions like ulcers.
- 🧪 Testing for H. pylori can be done through blood tests, breath tests, endoscopy, or stool tests, with the GI Map test being the most comprehensive method.
- ⚠️ Untreated H. pylori infections can lead to symptoms like bloating, gas, indigestion, nutrient deficiencies, and even mood disorders due to nervous system inflammation.
- 🔬 Conventional treatment for H. pylori often involves a combination of antibiotics and medications like proton pump inhibitors, though functional medicine offers alternative approaches.
- 🌿 Functional medicine treatments include probiotics, Mastic Gum, Berberine, olive leaf, and digestive support supplements like Betaine HCL and digestive enzymes.
- 🥦 Dietary recommendations for H. pylori include a well-balanced diet rich in probiotics, omega-3 fatty acids, polyphenols, and avoiding caffeine, carbonated beverages, and spicy foods.
- 🦷 Addressing dental hygiene and potential sources of H. pylori exposure, like contaminated water or family members, is crucial in preventing reinfection and ensuring effective treatment.
Q & A
What is H. pylori and why is it considered the most successful pathogen in human history?
-H. pylori is a spiral-shaped, gram-negative bacterium that has been around for at least 200,000 years. It's considered the most successful pathogen in human history due to its long existence and widespread infection rate, affecting approximately two-thirds of the world's population.
Why is H. pylori difficult to eradicate with antimicrobial drugs?
-H. pylori is difficult to eradicate because it is a gram-negative bacterium, which means it has two cell walls. This double outer layer makes it harder for antimicrobial drugs and herbs to penetrate and kill the bacteria.
How is H. pylori typically transmitted, and who is most at risk of contracting it?
-H. pylori is primarily transmitted through saliva and feces. People in developing countries, those of low socioeconomic status, and individuals living in poor conditions are at higher risk. In developed countries, it can be contracted through sharing drinks or utensils with an infected person.
What role does stomach acid play in the presence of H. pylori, and how does the bacteria affect stomach acid levels?
-Stomach acid is crucial for digestion and acts as a first line of defense against pathogens. H. pylori produces an enzyme called urease, which neutralizes stomach acid, leading to low stomach acid (hypochlorhydria). This reduction in stomach acid can cause digestion issues and nutrient deficiencies.
What are some common symptoms associated with H. pylori infection?
-Common symptoms include bloating, gas, constipation or diarrhea, indigestion, maldigestion, nutrient deficiencies, and potential neurological issues like mood swings, anxiety, and depression. In some cases, H. pylori can also cause ulcers.
What are the different testing methods available for diagnosing H. pylori?
-Testing methods include blood tests (which detect antibodies), breath tests (which measure carbon dioxide levels), endoscopy (an invasive procedure to biopsy the stomach mucosa), and the GI Map test (an at-home stool test that detects H. pylori antigens and virulence factors).
Why might the GI Map test be preferred over other diagnostic methods for H. pylori?
-The GI Map test is preferred because it is comprehensive, non-invasive, and uses qualitative polymerase chain reaction (qPCR) technology to detect the DNA of H. pylori and other markers of digestive health. It also identifies virulence factors that can indicate the potential for more severe conditions like ulcers or gastric cancer.
What is the conventional treatment for H. pylori, and what are some potential drawbacks?
-Conventional treatment typically involves a combination of at least two antibiotics and a proton pump inhibitor (PPI) to prevent antibiotic resistance and reduce stomach acid. However, long-term use of PPIs can lead to side effects like nutrient deficiencies, infections, and other health issues.
What alternative or functional medicine approaches are available for treating H. pylori?
-Functional medicine approaches include the use of probiotics, Mastic gum, black cumin seed, berberine, olive leaf extract, licorice, and bismuth. These natural treatments help eradicate H. pylori, support digestive health, and avoid the side effects associated with conventional treatments.
How can diet and lifestyle changes support the treatment of H. pylori?
-A well-balanced diet rich in probiotics, omega-3 fatty acids, polyphenols, and antioxidants can support the treatment of H. pylori. Avoiding caffeine, carbonated beverages, and spicy foods is also recommended. Additionally, stress management techniques like yoga, meditation, and deep breathing can help heal the gut lining and improve overall health.
Outlines
🦠 Introduction to H. pylori and Its Challenges
Julianne, a nurse practitioner and gut health expert, introduces H. pylori, a spiral-shaped gram-negative bacteria known as one of the most successful pathogens in human history. She explains its resistance to antimicrobial drugs due to its double cell wall and its high prevalence, with about two-thirds of the world’s population infected. H. pylori is commonly spread through saliva and feces, often contracted in childhood, and can reside in the stomach and vaginal cavity, leading to possible sexual transmission. Julianne emphasizes the importance of treating both the patient and their partner to avoid reinfection.
📉 Impact of H. pylori on Stomach Acid and Nutrient Absorption
The bacteria H. pylori produces the enzyme urease, which neutralizes stomach acid, leading to a condition called hypochlorhydria (low stomach acid). Low stomach acid disrupts digestion and nutrient absorption, potentially causing deficiencies in vitamins like B12, C, and A, leading to various health issues such as pernicious anemia. Symptoms of nutrient deficiencies, including brittle nails, hair loss, and fatigue, are highlighted. Julianne underscores the importance of recognizing these signs when diagnosing or managing H. pylori.
⚕️ Symptoms and Testing for H. pylori
Many people with H. pylori may not experience noticeable symptoms, but those who do might suffer from gastrointestinal issues like bloating, gas, and indigestion, as well as nutrient deficiencies and mood disorders. Testing for H. pylori includes blood tests (which may not distinguish between past and present infections), breath tests (which detect carbon dioxide from urease activity), and endoscopy (an invasive procedure used for direct examination and biopsy). Julianne also introduces the GI map test, a comprehensive at-home stool test that detects H. pylori DNA and virulence factors, providing insights into potential complications like ulcers or gastric cancer.
💊 Conventional and Functional Approaches to Treating H. pylori
Julianne explains conventional treatments for H. pylori, which often involve multiple antibiotics to prevent resistance, and proton pump inhibitors (PPIs) to reduce stomach acid. However, PPIs can exacerbate issues related to low stomach acid and have long-term side effects, including nutrient malabsorption and increased risk of infections. In contrast, the functional medicine approach focuses on probiotics, herbal remedies like Mastic Gum, Black Cumin Seed, and Berberine, and other supplements like Bismuth and Zinc Carnosine. These alternatives aim to eradicate H. pylori while supporting gut health without the adverse effects associated with conventional treatments.
🥦 Diet, Lifestyle, and Additional Support for H. pylori Patients
Dietary recommendations for H. pylori patients include a well-balanced diet rich in probiotics, omega-3 fatty acids, and anti-inflammatory foods like berries and cruciferous vegetables. Julianne advises against caffeine, carbonated beverages, and spicy foods. She also emphasizes the importance of addressing dental hygiene, as the mouth can harbor H. pylori, and educating patients about transmission risks. Stress management and supporting gut lining health with supplements like glutamine and aloe are also highlighted as essential components of a holistic treatment approach.
Mindmap
Keywords
💡H. pylori
💡Gram-negative bacteria
💡Hypochlorhydria
💡Urease
💡Nutrient deficiencies
💡GI MAP test
💡Probiotics
💡Functional medicine
💡Antibiotic resistance genes
💡Stomach acid
Highlights
H. pylori is one of the most successful pathogens in human history, having been around for at least 200,000 years.
H. pylori is a gram-negative bacterium, meaning it has two cell walls, making it harder for antimicrobial drugs and herbs to eradicate.
Approximately two-thirds of the world's population is infected with H. pylori, with higher prevalence in developing countries.
H. pylori can be contracted through contaminated drinking water or through saliva and feces, often spreading in childhood.
H. pylori primarily resides in the stomach, where it can survive in the acidic environment, and may also colonize in the vaginal cavity, potentially leading to sexual transmission.
The bacterium produces an enzyme called urease, which neutralizes stomach acid, leading to low stomach acid and various digestive issues.
Low stomach acid caused by H. pylori can result in nutrient deficiencies, including vitamin C, vitamin A, vitamin B12, and folic acid.
Symptoms of low stomach acid include feeling like food is not digesting, constipation, diarrhea, indigestion, malnutrition, and bacterial overgrowth.
H. pylori can cause neurological issues like mood swings, anxiety, and depression due to inflammation of the nervous system.
Only about 10% of H. pylori patients develop ulcers, yet over 90% of duodenal ulcers and 80% of gastric ulcers are caused by the bacterium.
Testing for H. pylori includes blood tests, breath tests, endoscopy, and the GI Map test, with the latter being the most comprehensive.
Functional medicine approaches to treating H. pylori include probiotics, Mastic Gum, black cumin seed, berberine, and zinc carnosine.
Conventional treatment usually involves a combination of antibiotics and medications like proton pump inhibitors, but these come with potential side effects.
Addressing stress management and rebuilding the gastric mucosa are essential components of H. pylori treatment.
Patients should consider testing or treating family members due to the high rate of H. pylori transmission within households.
Transcripts
hey I'm Julianne I'm a nurse
practitioner functional medicine
provider and gut health expert and today
we're going to be talking and taking a
deep dive into hpylori now H palori has
been termed the most successful pathogen
in human history it's been around for at
least 200,000 years H palori is a spiral
shaped gram negative bacteria now why is
that important well gram negative
bacteria means that it has two cell
walls Grim positive bacteria on the
other hand only have one cell wall now
this double outer layer of the gram
negative bacteria makes that bacteria
harder for antimicrobial drugs and herbs
to affect and kill the organism that's
why it's important it's actually one of
the hardest things to get rid of that I
see on functional testing it's estimated
that 2/3 thirds of the world's
population is infected with hpylori so
how does that actually happen let's talk
about how you can contract hpylori
there's a higher prevalence of the
infection in developing countries and
it's usually due to contaminated
drinking water people of low
socioeconomic status and other just poor
living conditions now for most of us in
developed countries it is as simple as
just sharing drinks or utensils with
someone who is already infected with
hpylori so it's spread primarily through
saliva and feces those are the two most
common ways to contract hpylori and it
actually often occurs in childhood we're
actually often contaminated or infected
in childhood even if we don't have
symptoms right away or ever H pylori is
found in the stomach that's kind of
where it lives in the upper
gastrointestinal tract and it's one of
the few bacteria that are able to
colonize in this really acidic
environment you should also know that H
palori may be able to colonize in the
acidic environment of the vaginal cavity
and so the vagina can act as a reservoir
allowing sexual transmission of the
bacteria very important when you're
discussing with patients talking about
transmission and talking to to their
Partners about potentially having this
bacteria as well so for these reasons
when I'm working with a patient who has
hpor it's really important to share this
and how it's transmitted and have a
conversation with their partner if they
have a partner it's recommended that
their family members especially their
partner either get tested themselves or
take the treatment because there's such
a high rate of transmission now if we
treat a patient but the partner isn't
treated they will likely just get the
infection back again and not completely
rid it from the body so this is just an
extremely important conversation to have
and concept to understand H pylori
produces an enzyme called Urias now this
enzyme makes your stomach acid less
acidic it basically neutralizes your
stomach acid the normal pH of the
stomach is around 1.5 to 3.5 and if your
stomach pH is less than three you have
normal acid levels if the pH is 3 to 5
you have something called
hypochlorhydria or low stomach acid why
is this important stomach acid is
crucial to digestion low stomach acid
causes a host of issues if you don't
have enough stomach acid you cannot
break down and digest your food properly
especially protein you also won't be
able to absorb nutrients from the food
many people with hpylori will develop
nutrient deficiencies things like
vitamin C vitamin A vitamin B12 and
folic acid deficiencies also if you have
a B12 deficiency that can lead to
something called pernicious anemia so
you can see there are can be some
significant issues with hpylori low
stomach acid and nutrient deficiencies
now just a few symptoms of nutrient
deficiencies brittle fingernails hair
loss pale skin or mucous membranes
fatigue weakness numbness or tingling in
the hands memory loss headaches so keep
these things in mind if you think or
suspect you have H pylori or you're
working with a patient who has hpylori
you may start to see some of these signs
and symptoms of nutrient deficiencies
other issues or symptoms that are
associated with low stomach acid are
just feeling like food is sitting on the
stomach and not going anywhere not
digesting it can also cause either
constipation or diarrhea indigestion
undigested food seen in the stool
malnutrition and also bacterial
overgrowth because remember every day on
a daily basis we are constantly coming
in contact with bad pathogens whether
it's a virus bacteria parasite or some
type of yeast we're coming in contact
with these things and if we ingest these
type of pathogens often the stomach acid
will destroy these pathogens before they
can start to grow and multiply in our
body that's what we want but again if we
have low stomach acid or hypochlorhydria
we have lost that first line of defense
so so that is why stomach acid is
extremely important if you suspect that
there is hypochlorhydria and it's coming
from an hpor infection there are a few
other labs that you might want to
consider getting a CBC or complete blood
count a comprehensive metabolic profile
or CMP an iron panel a thyroid panel a
B12 level and an intrinsic factor those
are some other labs that you may want to
consider getting but first let's talk
about how do you even know if you have
hpic what might be some of the symptoms
it is estimated that up to 90% of
patients with hpor actually will not
experience any specific symptoms that
they can identify but when patients do
have symptoms we're looking at things
like bloating gas constipation or
diarrhea indigestion Mal digestion
dispos which is an IM balance in good
and bad bacteria in the microbiome low
stomach acid nutrient deficiencies we
can also see things like mood swings
anxiety depression because H pylori
causes inflammation of the nervous
system so we can see these neurological
issues also about 10% of patients with
this bacteria develop ulcers now it's
estimated that more than 90% of J genal
ulcers which occur in the upper small
intestine and 80% of gastric or stomach
ulcers are caused by hpylori so if you
suspect that you have hpylori or if
you're working with a patient who you
suspect may have hpor how are you going
to know what testing is available the
first one is a blood test this test for
the antibodies to hpylori now antibodies
are protective proteins that are
produced by your immune system they
attack antigens now an antigen is really
any foreign substance or object things
like bacteria viruses parasites really
any foreign Invader the blood test will
not tell you if the infection is active
it will just tell you that you have
antibodies meaning it could be an active
or present infection or it could be a
past infection therefore the blood test
is probably not the best test for you or
your Pat
next up is the breath test now the
breath test measures the amount of
carbon dioxide that you exhale this
indicates the presence of hpylori in
your stomach so again hpylori produces
an enzyme called Urias which breaks Ura
down into ammonia and carbon dioxide so
the way this test works is first you
would exhale into a bag to measure the
level of carbon dioxide then you'll be
we asked to drink a small amount of a
solution that contains Ura 15 minutes
later after drinking the solution you
would exhale into a second bag the
amount of carbon dioxide that you exhale
into the second bag is also measured it
is based on the ability of the H pylori
to convert Ura to ammonia and carbon
dioxide if H palori is present it breaks
down the Ura solution that you drink
it's releasing carbon dioxide in the
breath that you exhale so if the amount
of carbon dioxide in your second sample
is higher than the amount in your first
sample then you have a positive test for
the presence of h palori test number
three is an endoscopy now an endoscopy
is an invasive procedure when we do an
endoscopy it's often for other reasons
to see if there are any structural
issues and just to get a good look at
the anatomy and what's going on inside
the esophagus and stomach the endoscopy
is used to culture and biopsy the
stomach mucosa for a rapid Urias test or
histologic staining so given that this
procedure it can be costly it is
invasive it's typically reserved when
again there are images needed for other
reasons and lastly my personal
preference and most comprehensive test
is called the GI map test this is an at
home stool test that looks for the
antigens to hpylori in your stool so it
relies on something called qualitative
polymerase Chain Reaction technology or
qpcr technology to detect the bacteria
by targeting the specific DNA of the
organisms that are tested now this stool
test also includes other markers for
digestion absorption inflammation immune
function and all of this helps to
evaluate over all digestive health and
function very comprehensively another
thing that we get to look at on this GI
map stool test are the detection of
virulence factors now the GI map looks
at eight different genes and these
positive variance genes represent the
potential for an hpylori strain to
create pathology such as duodenal ulcers
or gastric cancer it should also be
noted that of those that Harbor hpylori
only about 2% develop gastric cancer but
this will give us insight into genetic
characteristics for example some of the
genes such as the duodenal promoting
Gene a and the outer inflammatory
protein a are known to promote lots of
inflammation another example is
cytotoxin associated Gene a and vacula
toxin a these can disrupt the typ
injunctions in the gut lining leading to
leaky gut now why is all of that
important having this type of data can
help to guide therapy and as a
practitioner you will want to be sure
that you treat these patients with
positive veilance factors very
aggressively and be sure that we fully
eradicate the hpylori so retesting in
this population with positive variance
factors is extremely important all of
these tests can be ordered through re of
Health now that we've discussed what
this very common pathogen is what the
symptoms are and how to test for it
let's talk about how to get rid of it
first I'm going to talk about
conventional treatment modalities H
pylori infections are often
conventionally treated with at least two
antibiotics at once this helps to
prevent the bacteria from developing a
resistance to one particular antibiotic
you should also know that with a GI map
you will actually get results for
hpylori antibiotic resistant genes now
what does that mean the antibiotics
tested for are amoxicillin chloromycin
tetracycline and the class of
fluoroquinolones so if on the GI map we
see an antibiotic resistance Gene is
present then we know that that class of
antibiotics is designated positive for
antibiotic resistance a positive result
for or the presence of these resistant
genes for a given antibiotic indicates
that that antibiotic is not an ideal
choice for that particular patient's
protocol so antibiotic resistance genes
apply to all of the microorganisms found
in the sample and very cool fact
microbes can rapidly share DNA under
stress so the presence of antibiotic
resistance to any organism is reason
enough not to use that antibiotic or
antibiotic class in addition to
antibiotics conventional treatment will
also likely include medications like
proton pump inhibitors a proton pump
inhibitor is a drug that stops acid from
being produced in the stomach now some
examples of these would be things like
omeprazol esomeprazol
lansoprazol panol the problem is that we
already know hpylori typically causes
low stomach I acid and this is just
lending to the problem now these proton
pump inhibitors were originally meant to
be utilized shortterm for patients with
active ulcers and really were only meant
to be used for around 6 weeks in length
now what we're seeing is they're used
very frequently and chronically which
can actually lead to a host of other
issues like absorbing calcium and
magnesium gastric polyps vitamin B12
deficiencies the development of an
infection called claustrum diasil
community acquired pneumonia
osteoporosis and kidney disease just to
name a few bismuth is also a medication
that is often utilized and it works by
coating the stomach and protecting any
potential ulcerations from stomach acid
one last medication that you may see
used conventionally are called H2
blockers or histamine blockers now these
medications block histamine which
triggers acid production an example of
this would be sadine and these H2
blockers are typically prescribed for
hpylori infections if a proton pump
inhibitor cannot be utilized for some
reason so that is an overview of the
conventional approach now let's talk
about the functional medicine approach
which is not only very effective but
doesn't come with a lot of the negative
side effects that we see with
conventional therapy so in my opinion as
a practi practitioner the functional
medicine approach is the best approach
first up and this will also be
beneficial with conventional therapies
are probiotics these are beneficial for
repopulating the microbiome with
friendly beneficial bacteria again
whether we're talking about a
conventional or a functional approach
now there are a few specific strains
that have been highlighted in research
for their ability to fight the hpylori
BAC iial infection these are
lactobacillus fermentum lactobacillus
KCI and lactobacillus brebis now there's
also another type of probiotic that is a
yeast based probiotic called sacy's
bardi that also has some data showing
that it is beneficial with hpylori
infections Mastic Gum Mastic Gum comes
from the stem and the leaves of the
mastia tree and clinical studies have
supported and confirmed that it has
bactericidal action against HPI black
human seed has antibacterial properties
against hpor as well and it also has
gastroprotective properties bourine is a
Botanical extract found in various
plants things like Oregon grape root
Barberry and golden seal and it has
potential antimicrobial and
anti-inflammatory properties now
researches actually compare the use of
Bine to conventional quadruple hpylori
therapy which typically includes a
proton pump inhibitor two antibiotics
and bismo and they found that berberine
in comparison to quadruple therapy is
comparable safe and effective olive leaf
not only has antibacterial activity
against H palori it also has
anti-inflammatory properties licorice
research has shown licorice is
effectiveness against eradicating H
pylori and also confirms that licorice
is great for healing ulcers in patients
with hpylori induced ulcerations bismuth
again is a naturally occurring mineral
that is commonly used in functional
medicine treatment protocols because it
exerts Direct bacteriocidal effects on H
palori and helps to heal ulcers hpor
resistance against bismuth has also not
been reported zinc carnosine has been
used as an anti-ulcer supplement for
decades it's also very supportive to the
immune system and to Healing the gut
lining research also shows that
polyphenols in curcumin cranberry garlic
Licorice and brool are effective at
eradicating H palori now let's talk
about digestive support we already
mentioned the fact that it is very
common to have a Mal digestive pattern
because of the low stomach acid that
hpor typically produces so we may
consider supplementing with something
like Bane HCL or hydrochloric acid this
is commonly used as a supplement to Aid
in replacing stomach acid and really
restoring that good acidic environment
in the stomach now Bane HCL can be
supplemented with meals to support that
healthy digestion caution should be used
in patients who do have an active ulcer
or gastritis because that can be
aggravating but otherwise it is safe to
use in patients with hpylori and will
help to restore the stomach acid and
help with digestion other supplements
that you might want to consider that
will help with digestion are digestive
enzymes or digestive bitters these are
going to not only help with the
breakdown of food it will also help with
nutrient absorption what about diet what
do we tell patients with hpor to eat
there is no universally suggested diet
that is known to really expedite the
eradication of H palori now preliminary
research is suggesting that a low nickel
diet may increase eradication rates in
patients receiving antibiotic therapy
but what we really need to focus on is a
well-balanced Whole Foods diet we want
to consider a diet that is rich in
probiotics things like kefir kombucha
Sauer craft yogurt and fermented veggies
a diet high in omega-3 fatty acids like
wild caught fish flax seed chia
seeds honey especially Manuka honey in
moderation can be very supportive to
patients with hpor incorporating things
like berries raspberries strawberries
blackberries blueberries these have lots
of polyphenols and antioxidants also
cruciferous vegetables especially
broccoli and broccoli sprouts things to
consider avoiding are caffeine
carbonated beverages and spicy foods and
finally just some clinical pearls we
want to make sure that we address dental
hygiene in these patients with hpylori
because the mouth can be a reservoir
mouthwashes with things like clove can
be very supportive also consider the
source of exposure where might this
patient have contracted H palori so we
want to make sure that we are educating
on the fact that H palori is highly
transmittable again through saliva feces
and also even vaginal secretions we want
to talk about considering testing and or
treating other family members but we
want to also address Mal digestion and
or that hypochlorhydria pattern if we
suspect that that is present rebuilding
the gastric mucosa by addressing Stress
Management is also very important stress
management techniques that could be
incorporated are things like yoga
meditation deep breathing prayer and
also we want to support healing of that
gut lining with things like glutamine
aloe Licorice and vitamin A I hope that
this information has been helpful and
you can find me at juli andw
wellness.com or on Instagram at Julian
Wellness but for more educational videos
please like And subscribe to Rupa
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