The H pylori and SIBO Connection (Including New Research)

Summary

In this health-focused video, Dr. Daniel Richardi explores the link between H. pylori and small intestinal bacterial overgrowth (SIBO). He discusses recent research suggesting H. pylori may increase SIBO risk, particularly in younger individuals. The video also examines the effectiveness of a common H. pylori treatment, quadruple therapy, in treating SIBO, showing a 66.7% remission rate. Dr. Richardi highlights the potential cost-effectiveness of this therapy compared to other SIBO treatments, providing valuable insights for those seeking to improve their gut health.

Takeaways

• 👨‍⚕️ Dr. Daniel Richardi is a health expert, licensed pharmacist, fitness enthusiast, and creator of the 'sibo shortcut' program designed to help eliminate small intestinal bacterial overgrowth (SIBO).
• 🔬 The video discusses recent research on the relationship between Helicobacter pylori (H. pylori) and SIBO, questioning if H. pylori is a risk factor for SIBO and if a common H. pylori treatment could also be effective for SIBO.
• 📊 A 2023 meta-analysis from the Chinese Medical Journal suggests that there is a higher prevalence of SIBO in individuals with H. pylori infection, with a stronger association in younger patients.
• 🦠 H. pylori is a spiral-shaped bacteria that can affect the stomach and small intestine, with the unique ability to survive stomach acid, and is estimated to be present in the majority of people at some level.
• 🏥 H. pylori overgrowth can lead to gastritis, peptic ulcers, and an increased risk of stomach cancer, but most people do not experience symptoms unless there is an overgrowth.
• 🌐 SIBO is characterized by an excessive amount of bacteria in the small intestine, causing digestive symptoms like bloating, constipation, diarrhea, and abdominal pain, as well as non-digestive symptoms.
• 💊 A 2022 study examined the effectiveness of quadruple therapy, a common treatment for H. pylori, on SIBO patients and found a 66.7% remission rate for SIBO after H. pylori eradication.
• 📉 The same study indicated that only 5% of SIBO-negative patients became SIBO-positive after H. pylori eradication with quadruple therapy, suggesting it is not a risk factor for developing SIBO.
• 💊 Quadruple therapy includes rabeprazole (a proton pump inhibitor), bismuth potassium citrate, amoxicillin, and metronidazole, taken over two weeks.
• 💰 The cost of treating SIBO with rifaximin (brand name Xifaxan) can be significantly higher than the quadruple therapy, which may be a cost-effective alternative.
• 🔍 Dr. Richardi encourages further research on the topic and suggests that the quadruple therapy may be a viable option for patients dealing with both H. pylori and SIBO.

Q & A

What is the main topic of Dr. Daniel Richardi's video?

The main topic of the video is to discuss the relationship between H. pylori and SIBO, including whether H. pylori is a risk factor for SIBO, if a popular H. pylori treatment can also be effective for treating SIBO, and if the same treatment could be a risk factor for developing SIBO.

What is SIBO and what are its symptoms?

SIBO stands for Small Intestinal Bacterial Overgrowth. It is a condition where there are too many bacteria in the small intestine, leading to digestive symptoms like bloating, constipation, diarrhea, abdominal pain, and gas, as well as non-digestive symptoms such as brain fog, mental health conditions, and skin problems.

What is H. pylori and how is it related to the stomach?

H. pylori, also known as Helicobacter pylori, is a spiral-shaped bacteria that can affect the stomach and the small intestine. It has the unique ability to survive stomach acid, which many bacteria cannot do. An overgrowth of H. pylori can lead to conditions like gastritis, peptic ulcers, and an increased risk of stomach cancer.

What does the 2023 meta-analysis from the Chinese Medical Journal suggest about the link between H. pylori and SIBO?

The 2023 meta-analysis suggests that individuals with H. pylori infection are more likely to develop SIBO, and this association is stronger in younger patients than in older ones.

What is quadruple therapy and what does it consist of?

Quadruple therapy is a common treatment regimen for H. pylori that consists of four medications: a proton pump inhibitor (rabeprazole), bismuth potassium citrate, amoxicillin (an antibiotic), and metronidazole (another type of antibiotic), taken for two weeks.

What were the results of the 2022 study on quadruple therapy for treating SIBO?

The study found that 66.7% of the SIBO-positive patients became SIBO-negative after the eradication of H. pylori with quadruple therapy. However, 5% of the SIBO-negative patients became SIBO-positive after the treatment, suggesting that the therapy does not increase the risk of developing SIBO.

How effective is quadruple therapy in eradicating H. pylori according to the video?

Quadruple therapy is well-documented to work very well for eradicating H. pylori and the video suggests it may also be effective for treating SIBO.

What are the potential benefits of using quadruple therapy for treating both H. pylori and SIBO?

The potential benefits include a two-for-one treatment approach, where eradicating H. pylori may also alleviate SIBO symptoms, and it could be a more cost-effective treatment compared to other SIBO treatments.

Why might the cost of rifaximin, commonly used for SIBO, be a concern for some patients?

Rifaximin, or Xifaxan, can be very expensive, with some patients spending over $2,000 for a single two-week course, which can be a significant financial burden.

What is the cost comparison between rifaximin and quadruple therapy mentioned in the video?

The video suggests that even without insurance, quadruple therapy in the United States would likely not cost more than $100, which is significantly less than the cost of rifaximin.

What is Dr. Daniel Richardi's recommendation for patients with both H. pylori and SIBO based on the discussed research?

Dr. Richardi recommends that patients with both H. pylori and SIBO consider exploring quadruple therapy as a potential treatment option based on the research findings.

Outlines

00:00

🧬 H. pylori and SIBO Connection

Dr. Daniel Richardi introduces the video, discussing the potential link between H. pylori (Helicobacter pylori) and SIBO (Small Intestinal Bacterial Overgrowth). He outlines the video's agenda, which includes new research on H. pylori as a risk factor for SIBO, the effectiveness of a popular H. pylori treatment for SIBO, and the risk of developing SIBO from the same treatment. H. pylori is a bacteria that can survive in the stomach and small intestine, often asymptomatic unless overgrown, leading to gastritis, ulcers, and possibly stomach cancer. SIBO is characterized by excessive bacteria in the small intestine, causing digestive issues and potentially other health problems. The video aims to explore the relationship between these two conditions and their impact on health.

05:01

💊 Exploring Quadruple Therapy for H. pylori and SIBO

The video delves into a 2023 meta-analysis from the Chinese Medical Journal, which suggests a correlation between H. pylori infection and the development of SIBO, particularly in younger patients. A 2022 study is also discussed, examining the effects of quadruple therapy—a common treatment for H. pylori—involving rabeprazole, bismuth potassium citrate, amoxicillin, and metronidazole. The study found that 66.7% of patients with both H. pylori and SIBO tested negative for SIBO after treatment, indicating the therapy's potential dual benefit. Interestingly, only 5% of patients without SIBO developed it post-treatment, suggesting the therapy is not a significant risk factor for SIBO. The summary also touches on the cost-effectiveness of this therapy compared to other treatments like rifaximin, which can be prohibitively expensive. Dr. Richardi concludes by emphasizing the importance of ongoing research to provide the best recommendations for treating H. pylori and SIBO.

Keywords

💡Dr. Daniel Richardi

Dr. Daniel Richardi is a health expert, licensed pharmacist, fitness enthusiast, and creator of the 'sibo shortcut' program. He is the presenter of the video and discusses topics related to health, specifically focusing on Small Intestinal Bacterial Overgrowth (SIBO) and Helicobacter pylori (H. pylori). His role is central to the video's theme, as he provides insights and research findings on these health conditions.

💡Small Intestinal Bacterial Overgrowth (SIBO)

SIBO is a condition characterized by an excessive amount of bacteria in the small intestine, which can lead to various digestive symptoms such as bloating, constipation, diarrhea, and abdominal pain. In the video, SIBO is a primary focus, with discussions on its relationship with H. pylori, its symptoms, and potential treatments.

💡Helicobacter pylori (H. pylori)

H. pylori is a spiral-shaped bacteria that can affect the stomach and small intestine, and is known for its ability to survive stomach acid. The video discusses its potential as a risk factor for SIBO, its prevalence, and its association with other gastrointestinal conditions like gastritis and peptic ulcers.

💡Meta-analysis

A meta-analysis is a statistical method that combines the results of multiple scientific studies to identify patterns and trends. In the video, a 2023 meta-analysis from the Chinese Medical Journal is mentioned to determine the correlation between H. pylori and SIBO, indicating a higher prevalence of SIBO in those with H. pylori infection.

💡Quadruple Therapy

Quadruple therapy is a treatment regimen that includes four medications and is commonly used for H. pylori eradication. The video discusses a 2022 study on this therapy's effectiveness not only for H. pylori but also for SIBO, suggesting a potential dual benefit.

💡Proton Pump Inhibitor (PPI)

A PPI, such as rabeprazole mentioned in the script, is a medication that reduces stomach acid production. It is a component of the quadruple therapy discussed in the video, which is used to treat H. pylori and potentially SIBO.

💡Bismuth Potassium Citrate

Bismuth Potassium Citrate is an ingredient used in the quadruple therapy and is related to bismuth subsalicylate, the active ingredient in Pepto-Bismol. The video mentions it as a gentler alternative for the digestive tract in the treatment of H. pylori.

💡Amoxicillin

Amoxicillin is an antibiotic that is part of the quadruple therapy regimen discussed in the video. It is used in combination with other medications to treat H. pylori infections and, according to the study mentioned, may also have a positive effect on SIBO.

💡Metronidazole

Metronidazole is another antibiotic included in the quadruple therapy. The video suggests that this medication, along with others in the regimen, may contribute to the effectiveness of the therapy against both H. pylori and SIBO.

💡Rifaximin

Rifaximin, brand name Xifaxan, is a medication commonly used to treat SIBO. The video contrasts the high cost of rifaximin with the potentially lower cost of the quadruple therapy, suggesting the latter as a more affordable treatment option.

💡Gut Health

Gut health is a broad term encompassing the overall condition of an individual's digestive system, including the balance of bacteria within it. The video's theme revolves around improving gut health by addressing SIBO and H. pylori, with Dr. Richardi offering strategies and discussing treatments.

Highlights

Dr. Daniel Richard introduces himself as a health expert, licensed pharmacist, and creator of the 'sibo shortcut' program.

The video discusses three main topics: new research on H. pylori and its relation to SIBO, the effectiveness of a popular H. pylori treatment for SIBO, and the risk factors for developing SIBO.

H. pylori is a spiral-shaped bacteria that can affect the stomach and small intestine, with the unique ability to survive stomach acid.

Most people have some level of H. pylori in their body, but only experience symptoms if there's an overgrowth.

An H. pylori overgrowth can lead to gastritis, peptic ulcers, and an increased risk of stomach cancer.

SIBO (Small Intestinal Bacterial Overgrowth) is characterized by an excess of bacteria in the small intestine, causing digestive issues.

Many people suffer from SIBO symptoms for months or years without knowing they have the condition.

A 2023 meta-analysis from the Chinese Medical Journal suggests a correlation between H. pylori and SIBO.

The meta-analysis found that H. pylori infection is associated with a higher prevalence of SIBO, especially in younger patients.

A 2022 study examined the effectiveness of quadruple therapy, a common treatment for H. pylori, on SIBO.

Quadruple therapy includes a proton pump inhibitor, bismuth potassium citrate, and two types of antibiotics.

The study found a 66.7% remission rate of SIBO in patients who also had H. pylori after treatment.

Only 5% of patients without SIBO developed it after H. pylori eradication treatment, suggesting the treatment is not a risk factor for SIBO.

The study indicates that certain antibiotics used in quadruple therapy may be effective for SIBO.

Dr. Richard suggests that H. pylori could be a risk factor for SIBO and that quadruple therapy might be a potential treatment.

The cost of quadruple therapy is significantly lower than that of rifaximin, a commonly used antibiotic for SIBO.

Dr. Richard emphasizes the importance of ongoing research to provide the best recommendations for treating H. pylori and SIBO.

The video concludes with an invitation to like, subscribe, and follow for more health-related content.

Transcripts

what's up and welcome to the video my

name is Dr Daniel richardi got health

expert licensed pharmacist Fitness

Enthusiast and creator of sibo shortcut

the all-in-one program that helps you

eliminate sibo small intestinal

bacterial overgrowth quickly and easily

in this week's video we're going to

discuss three things number one brand

new research on whether H pylori AKA

helicobactor pylori is a risk factor for

sibo number two if a popular H pylori

treatment can also be effective for

treating sibo and then number three if

this same popular H pylori treatment is

also a risk factor for getting sibo very

quickly if you're not familiar with

these two conditions H pylori and sibo

helicobactor pylori AKA H pylori is a

spiral-shaped bacteria that can affect

the stomach and the small intestine one

of the unique things about it is that it

does have the ability to survive stomach

acid which is something that many

bacteria cannot do it's estimated that

the majority of people have some level

of hpylori existing in their body

however for most people unless this

level becomes in overgrowth they likely

will not experience any symptoms from it

when an overgrowth of hpylori does

happen this hpylori infection can lead

to conditions such as gastritis or

inflammation of the lining of the

stomach peptic ulcers either in the

stomach or in the upper portion of the

small intestine and it can even increase

the risk of getting stomach cancer sibo

AKA small intestinal bacterial

overgrowth is a condition where you end

up having too many bacteria in your

small intestine the majority of your

bacteria your microbiome lives in your

large intestine ideally so if you end up

with too many bacteria in your small

intestine it can cause a lot of

digestive symptoms such as bloating such

as constipation diarrhea abdominal pain

gas it can also lead to non-digestive

symptoms as well certain things such as

brain fog mental health conditions and

even skin problems unfortunately tons of

people go months or even years dealing

with sibo symptoms and if this wasn't

bad enough many of them don't even know

that they have sibo if you want to learn

how to get rid of sibo check out my

program sibo shortcut in this course I

give away all the proven science-based

strategies to heal your gut visit the

first link in the description below for

more info and now let's get back to the

video both H pilori and sibo are major

causes of a reduced quality of life for

a lot of people with that said let's

look at some research this 2023

metaanalysis from the Chinese medical

journal was just published less than 2

weeks ago a meta analysis looks at all

the past relevant medical research on a

particular topic and the idea is it

tries to give you a trend of what

generally seems to be happening in that

topic the purpose of this particular

meta analysis was to determine if you

have hpylori is it more likely that you

will also develop sibo they're probably

looking at this because hpylori has been

linked to a lot of other

gastrointestinal conditions such as IBS

such as ulcers atrophic gastritis and

coloral adenomas but up to this point

there hasn't been strong evidence that

it's also correlated with cbra the

results from this meta analysis

indicated in this systemic review and

meta analysis we pulled the results of

eight eligible observational stud

studies and found that compared to

adults without hpor infection those with

hpor infection were associated with a

higher prevalence of sibo and then it

goes on to report interestingly we found

that the association between H pylor

infection and sio was stronger in

younger than older patients for this

meta analysis it seems like having an

hpylori overgrowth will also make it

more likely that you'll develop sibo and

also in this case in this mete analysis

being younger is also worse this 2022

study also from the Chinese medical

journal studies quadruple therapy which

is a common regimen consisting of four

medications including rabi prol which is

a proton pump inhibitor which lowers

stomach acid this was taken 10 Mig twice

daily it included bismuth potassium

citrate 220 mg twice daily bismuth is

the active ingredient in Pepto Bismol

however the potassium citrate version

may be gentler on the digestive tract

than bismi silicate which is pepto

bismol it also included amoxicilin which

is an antibiotic at 1,000 Mig twice

daily and then finally metronidazol also

a different type of antibiotic but still

I would consider an antibiotic 400 mg

three times daily and this regiment was

done for 2 weeks it's well documented

that this quadruple therapy works very

well for h pylori now they're seeing if

it kind of provides that two for one

benefit where it also helps for sibo

results indicated that 66.7% or 20 out

of 30 people of the sibo positive

patients before eradication of hpylori

turned sio negative after eradication

indicating that sibo remission rate

after eradication treatment was 66.7%

while for sibo negative patients before

eradication 5% or one out of 20 people

after eradication the patient became

sibo positive there's a lot going on

here so basically this is what this

study is saying of the 30 patients that

had both H pylori and sibo to begin 20

of them became negative for sibo after

eradicating the hpylori with the krupal

therapy so 2/3 of people or 66% seem to

get this two for one benefit where it

did both also note of the 20 patients

that only had H pylori to begin and not

sibo after doing the treatment with

quadruple therapy only one out of these

20 people develop sibo two takeaways

that we're seeing are one this quadruple

therapy may be effective for sibo this

includes both hydrogen and methane

dominant so to give a further breakdown

the rate of people positive for hydrogen

went from 49% before to 15% after and

the rate of people positive for methane

went from 25% before to only 6% after

the study seem seems to suggest that you

are not at a greater risk of developing

sibo after eradication of hpylori with

this quadruple therapy I found this

relevant because there's a lot of data

suggesting that antibiotics are a risk

factor for sibo so on a surface level

this seems very surprising but if you

look a little bit deeper using

metronidazol bismuth and even research

on amoxicillin has shown that they can

be effective in their own ways for sibo

so it's not a huge shock that this

quadruple therapy seems to be favorable

in this study few conclusions from these

studies that we looked at number one H

pylori does seem to be a risk factor for

developing sibo number two quadruple

therapy which in the past has been

proven to be effective and very good for

eliminating hpylori also seems like it

may be effective for sibo and then

takeaway number three with Drupal

therapy which we looked at in the second

study does not seem to be a risk factor

for developing sibo and this is based on

the short-term followup that they did in

this study of 6 weeks knowing all this

information can be relevant because for

people with H pylori you can possibly

suspect that you may also be dealing

with sibo I'd like to continue to see

more research on this particular topic

but it seems like based on the research

that we looked at this quadruple therapy

may be an option to explore in the

future for patients that have both

hpylori and sibo the cost of treatment

may also be a potential plus different

practitioners use different treatments

for sibo but in terms of antibiotics a

product called rifaximin brand name is

zxin is probably the most commonly used

product and depending on what country

you live in what insurance you have and

a few other factors this rifaximin or

zxin can be really expensive I've known

people that have spent over $2,000 on

one single twoe course of refraim which

it's crazy that it's that expensive and

for my years of working in the pharmacy

I have a general idea what medications

will cost and this quadruple therapy in

the United States even if you didn't

have any insurance it probably wouldn't

cost you more than $100 and to be honest

it would probably be significantly less

than this I think it's exciting to keep

looking at the newest research studies

and see the new information available

this way we can keep making the best

recommendations we possibly can and help

the most people as possible that is all

for today if you enjoyed the video or

found it helpful please like And

subscribe to my channel for more related

content I post a new full length video

every Monday and YouTube shorts

throughout the week thanks so much for

watching and I'll see you in the next

video