Do you struggle with reflux, indigestion, heartburn, belching, bloating? Have you had ulcers or been diagnosed with gastritis? This post is a must-read for you. It’s estimated that 80-100% of those with duodenal ulcers and 70% of people with gastric ulcers have H pylori. If you have reflux and have been taking acid-blocking drugs, H pylori may be the cause of your symptoms.
I’ve said it before, and I’ll say it again: Strong digestion is the cornerstone of good health. After all, it’s not just what you eat but what you actually absorb that counts. And if your good gut bugs, the ones working for you to digest your food and produce vitamins, are sharing space with the wrong types of bacteria and parasites in your digestive tract, your digestive function and overall health suffers.
Digestive complaints are among the most common I hear from my clients. I frequently recommend stool panels to clients to check for pathogenic bacteria, parasites, dysbiosis, and candida. H pylori is one of the most frequent bacteria I see among clients in my practice. Though you can take a course of strong antibiotics to knock it out, most of my clients opt for a more natural treatment. It’s also very important to note that many H pylori strains are resistant to antibiotics, which is why I favor an herbal approach.
You can get rid of H pylori without antibiotics!
What is H Pylori?
Helicobacter pylori is a gram negative, spiral-shaped bacterium that resides in the upper intestinal tract and in the stomach of infected individuals. Up to 50 percent of the world’s population is infected (more prevalent in developing countries). In developed nations, the percentage of infected people increases with age, with about 50 percent infected for those over the age of 60 compared with around 10 percent between 18 and 30 years. Of these, 85 percent are asymptomatic, and there is even evidence that not everyone needs to be treated, as it is theorized that the infection may actually be beneficial in influencing systemic immune responses.
I have never advised a client to NOT treat h pylori, because everyone who has noticeable (even if slight) digestive symptoms, hormone imbalance, thyroid problems, autoimmune issues, and/or vitamin-mineral deficiencies (such as iron and zinc) is likely experiencing more adverse than positive benefits from the bacterium, which acts as an added stress to the system. More on to treat or not to treat H pylori here.
Additionally, there are several different strains of H pylori, some more serious–linked to stomach cancer and peptic ulcers–and others that are considered non-virulent strains. Individuals infected with H. pylori have a 10 to 20% lifetime risk of developing peptic ulcers and a 1 to 2% risk of acquiring stomach cancer. Anyone who is experiencing or has had gastritis and/or ulcers in the stomach and small intestine should be tested for H pylori.
In order to proliferate and survive the harsh, acidic environment in the gut and stomach, H pylori neutralizes the acid in the stomach by producing large amounts of the enzyme urease, which breaks down the urea present in the stomach to carbon dioxide and ammonia. The ammonia then neutralizes stomach acid. This is one reason why H pylori causes bloating, belching, and reflux: It makes stomach acid less acidic, so food isn’t properly broken down, resulting in side effects consistent with indigestion.
Antacids are NOT the Solution
If you’re taking PPIs or acid-blocking drugs, listen up! Reflux is a very common side effect of H pylori infection for the reasons mentioned above: it causes low stomach acid. This prevents food from breaking down properly, so the food ferments, and the gases travel up the esophageal tract, causing burning. This is treated with acid-blocking drugs, which further reduce stomach acid and allow H pylori to proliferate. That’s right: reflux and heartburn are often caused by stomach acid that is too alkaline, NOT too acidic! (source) That’s why H pylori and reflux/heartburn go hand in hand. And those with low stomach acid production are at risk of SIBO and vitamin deficiencies from malabsorption.
Certain strains of H pylori that produce cytotoxins cause worse inflammation and damage to the stomach lining and intestinal cells and are more closely related to ulcers, gastritis, and cancer.
What Causes H Pylori?
It’s not known exactly how the bacterium is spread, but it has co-existed with humans for thousands of years. It can be transmitted person to person via saliva or stool, or it can hitch a ride to your stomach via undercooked food, especially chicken. Contaminated water is also a risk factor. Poor hygiene is a risk factor, making the bacterium more prevalent in underdeveloped areas.
You can prevent H pylori with good hygiene, like hand washing, but it’s important to note that if your digestive system is in good working order, you may be able to successfully ward off the bacteria if you come in contact with it. This is true of any parasite or pathogenic bacterial infection. The hydrochloric acid (HCl) produced in the stomach should have a pH of about 2, acidic enough to break down food AND kill invaders. If your immune system and digestive tract are working well, you won’t become infected even if you come in contact with these invaders because you should be able to kill them before they take root and proliferate. Many of us have inadequate HCl production, making us more susceptible to pathogens and parasites. HCl production declines with age, which may be one reason why older people have a higher rate of H pylori infection.
What are the Symptoms of H Pylori?
Note that H pylori may be asymptomatic.
- excessive belching, especially after meals
- reflux, heartburn
- nausea and/or vomiting
- lack of appetite
- unexplained weight loss
- anemia and deficiencies
- gnawing abdominal pain
How to Get Rid of H Pylori
H pylori can be diagnosed via stool, blood, or breath test. You can order your own stool test here (the GI MAP), which screens for h plyori and lets you know if you have one of the strains linked to cancer or ulcers.
The standard first-line therapy is a one-week “triple pack” consisting of proton pump inhibitors (if you have ulcers, to allow the stomach lining to heal) and the antibiotics clarithromycin and amoxicillin. If you don’t have ulcers or severe symptoms, other antibiotics may be recommended. As I mentioned above, however, I recommend extreme caution with antibiotic use due to antibiotic-resistant strains of H pylori. The stool test I use gives you results about whether the particular strain you have is resistant to the most commonly used antibiotics.
Here is the herbal protocol I use for h pylori:
- mastic, the gum resin of the mastic tree, which kills H pylori. I use this mastic gum formula combined with licorice and zinc to help reduce inflammation and heal the stomach and intestinal lining.
- I use this glutamine-based formula called GI Revive to soothe and heal leaky gut.
- I recommend digestive enzymes alongside treatment, since those with H pylori have compromised digestion.
- Saccharomyces boulardii is a specific probiotic strain that helps treatment.
- I often recommend probiotics during treatment, but it depends on the person. I ALWAYS recommend probiotic replacement therapy once the killing phase is complete.
- Many have reported success using Matula tea, but it’s very expensive from what I’ve seen.
I recommend my basic, anti-inflammatory diet during treatment. I personalize my recommendations to the client, but the guidelines are similar. Cut out inflammatory foods, coffee (which thins the gut lining and irritates an already inflamed stomach), booze, sugar. Incorporate bone broth as often as possible, and consider a fish oil supplement to further reduce inflammation.
What to Do After the Herbal Protocol
I recommend 4-8 weeks of the herbal protocol, followed by a basic leaky gut protocol with digestive enzymes and the GI Revive for several weeks following treatment. You’ll need a couple months at least of probiotic reinoculation to recolonize the gut with good bacteria. At that point, you may add back in certain foods over time (depending on how restrictive you’ve been): coffee, legumes, certain grains if you can tolerate them, dairy in some circumstances. Remember this is a very personalized program, so you may need to stay off grains and dairy indefinitely depending on your health history. But it’s critical to mind your microbiome and rebuild the probiotic diversity in the gut by getting enough prebiotic fibers.
Make sure your parters get tested and treated too. You can reinfect each other if you get treated and your partner does not. H plyori can also be spread through households and via kissing.
It should go without saying that I always recommend working with a practitioner to guide you through this process. It can be overwhelming and mind boggling to spend hours researching this stuff without help. I get so many clients who have driven themselves crazy sifting through information while trying to go it alone, and keep in mind these are only guidelines. Each person is different and requires a unique approach.
Mary Vance is a Certified Nutrition Consultant and author specializing in digestive health. She combines a science-based approach with natural therapies to rebalance the body. In addition to her 1:1 coaching, she offers courses to help you heal your gut and improve your health. Mary lives in San Francisco and Lake Tahoe in Northern California. Read more about her coaching practice here and her background here.