H. pylori is a bacteria that infects the lining of the stomach, causing inflammation, pain, bloating, ulcers, and even stomach cancer. Unfortunately, the bacteria has become increasingly antibiotic resistant, creating a need for a different type of treatment method. Functional medicine’s combination of using emerging science, conventional medicine, and more natural, holistic forms of treatment is a great answer to treating H. pylori and healing the gut.
What is H. pylori?
When Helicobacter pylori bacteria enter the body, it makes a beeline for the stomach lining. It burrows there, reproducing and releasing toxins that harm and kill stomach cells (1). Stomach lining health is hugely important, and reduced cell count means less integrity and strength (leading to conditions like leaky gut). The stomach then has lowered protection from the acid it contains, leading to holes in the stomach lining, called ulcers (1). It also reduces stomach acids’ acidity, diminishing digestive effectiveness and leading to symptoms like bloating and nausea. As the immune system responds, the body may damage itself further, leading to even more discomfort and exaggerated symptoms.
How do you get H. pylori? What are the symptoms?
H. pylori is thought to be spread from person to person through contact with an infected person’s saliva, vomit, or fecal matter (1, 2, 3). It can be transferred through direct contact, or through contaminated food or water. While anyone is susceptible to it if exposed, some people are definitely at higher risk. Living or traveling to areas with crowded or unsanitary living conditions, a lack of clean running water, or living with someone who is infected will all put you at higher risk (1, 2, 3). Scientists estimate that somewhere between 50-66% of the worldwide population have an H. pylori infection (1, 3). While children are the most likely to get an infection from H. pylori, you can contract it at any age. It is hard to eradicate, so much so that over half of the people with an H. pylori infection are over the age of 50 (3). In developing countries, up to 80% of the population could be infected (4).
This could be, in part, because many people with an infection don’t have any symptoms (2, 3). However, symptoms can develop and can be quite uncomfortable. Common symptoms include (1, 2, 3):
Aching, burning, or sharp stomach pain
Bloating
Burping
Lack of appetite
Nausea or vomiting
Unintentional weight loss
Stomach pain that is more severe when the stomach is empty
Stomach pain that is relieved when treated with antacids
Inflammation of the stomach lining (gastritis)
Ulcers
Difficulty swallowing
Bloody or black stool
Trouble breathing
Dizziness, fainting
Exhaustion
Pale skin
If left unchecked, H. pylori infection can lead to chronic gastritis, peptic ulcers, duodenal ulcer disease, stomach or intestinal bleeding, holes or perforations in the stomach wall, blockages, or even stomach cancer (2, 3, 4, 5).
H. pylori Diagnosis and Conventional Treatment
If you are experiencing any of the symptoms above, your physician may suspect H. pylori and recommend running some tests. Depending on your symptoms, severity of pain, and the potential presence of ulcers, you may be offered blood tests, a stool culture, breath tests, or even an upper endoscopy (2). If H. pylori is detected, the conventional route of treatment involves antibiotics and antacids.
When H.pylori was first discovered in the 1980s, it was an incredible revelation. Ulcers were not often caused by smoking, stress, spicy foods, or acidic foods alone, as previously thought. Instead, it was this bacteria weakening the stomach lining! A regimen of three types of medication (two types of antibiotics and an acid-suppressing drug such as bismuth citrate or proton pump inhibitor) working in tandem was quickly adapted and successfully eradicated H. pylori in over 90% of cases for about twenty years (4, 5). However, H. pylori has quickly become antibiotic resistant, and rates of successful eradication have been reduced to less than 70% on the first treatment, which is about 10% lower than the general scientific consensus on acceptable rates for H. pylori treatment (5).
Four weeks after the first round of triple therapy, it is standard practice to run another test to determine if it has fully removed the H. pylori infection. If it has not, the next course of action for most conventional medicine practices is to prescribe another round of triple therapy using different types of antibiotics, or including both bismuth citrate and a proton pump inhibitor. Depending on the resistance of the particular H. pylori strain, this is effective for 75-79% of those who did not see desired results from the first round of therapy (4, 5).
However, the effects of antibiotics on the digestive system are well known and may cause greater discomfort for those already experiencing the side effects above, especially if undergoing multiple rounds of antibiotics. Nausea, diarrhea, and even further reduced gut health are common, making symptoms far worse for a time and creating a greater need for healing after treating H. pylori (4, 5). Additionally, while bismuth is generally considered nontoxic, long-term use (such as to treat chronic heartburn or ulcer pain) can occasionally cause side effects and toxicity (6, 7). With all of this in mind, the conventional treatment plan is no longer effective enough to stand alone.
A Functional Approach
Functional medicine always seeks to look at the whole picture of your health, the general side effects of any treatment plan, and how those general treatment plans may affect you specifically. In terms of H. pylori, studies have been showing with consistently positive results that probiotics, when used in tandem with conventional treatment, are far more effective than triple or quadruple therapy alone (4, 7, 8, 9). Not only do probiotics greatly reduce side effects from both the infection and course of treatment, but they also boost H. pylori eradication rates, especially when taken before and after triple or quadruple therapy (4, 9).
This is because probiotics help the gut and gut lining in a number of ways. Regular consumption of probiotics is associated with reduced inflammation, gut cell maturation and lining integrity, greater defense against pathogens, and better immune system regulation (4). When looking at fighting H. pylori infection specifically, probiotics bring a lot to the table. They help to strengthen the mucosal barrier, making it harder for H. pylori bacteria to adhere and protecting against ulcers (4, 8). Probiotics also reduce the number of adhesion receptors along the gut lining, reducing the chances of H. pylori being able to reproduce, attach, and further colonize. Lastly, probiotics are thought to secrete antibacterial substances which inhibit the spread of H. pylori (4). While any type of probiotic may be helpful, Lactobacillus and Bifidobacterium are the most widely-used and successful strains at fighting H. pylori (4, 8, 9).
Other supplements and lifestyle changes can be beneficial for supporting the body’s natural healing processes. Supporting your immune system and improving your diet to include more fruits, vegetables, healthy fats, and lean meats may all be great changes. Depending on your health and bloodwork, supplementing your diet with certain vitamins and minerals such as DHA, curcumin, vitamin D, or vitamin A, may all help strengthen your gut (10). We may have other suggestions or lifestyle changes to suggest depending on your specific health history and overall needs. If your health history includes negative reactions to bismuth or antibiotics, or even previously unsuccessful treatment of H. pylori, our methods using functional medicine can be a great help to you! And even if you don’t have an H. pylori infection, focusing on these healthy habits can improve your gut and immune health and potentially avoid future infection.
If you or a family member are concerned about H. pylori, experiencing the symptoms above, or have any gastrointestinal distress, please contact us! We would be honored to partner with you and help guide you on a path of greater health and healing.
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
info@tcimedicine.com
951-383-4333
Sources:
Bernstein, S. (n.d.). H. pylori Bacteria Infection: Symptoms, diagnosis, Treatment, Prevention. WebMD. https://www.webmd.com/digestive-disorders/h-pylori-helicobacter-pylori#:~:text=What%20to%20Avoid-,After%20H.,lining%2C%20which%20leads%20to%20ulcers.
Mayo Foundation for Medical Education and Research. (2021, May 18). Helicobacter pylori (h. pylori) infection. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/h-pylori/symptoms-causes/syc-20356171.
Helicobacter pylori. Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/helicobacter-pylori.
Goderska, K., Agudo Pena, S., & Alarcon, T. (2018). Helicobacter pylori treatment: antibiotics or probiotics. Applied microbiology and biotechnology, 102(1), 1–7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748437/
Harris A. (2001). Treatment of Helicobacter pylori. World journal of gastroenterology, 7(3), 303–307. https://doi.org/10.3748/wjg.v7.i3.303
Gordon MF;Abrams RI;Rubin DB;Barr WB;Correa DD; (n.d.). Bismuth subsalicylate toxicity as a cause of prolonged encephalopathy with myoclonus. Movement disorders : official journal of the Movement Disorder Society. https://pubmed.ncbi.nlm.nih.gov/7753066/.
Yang, N., & Sun, H. (2011). Bismuth: Environmental Pollution and Health Effects. Encyclopedia ofEnvironmental Health, 414–420. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151860/
Koga Y, Ohtsu T, Kimura K, et al. Probiotic L. gasseri strain (LG21) for the upper gastrointestinal tract acting through improvement of indigenous microbiota. BMJ Open Gastro 2019;6:e000314. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711431/pdf/bmjgast-2019-000314.pdf
Shi X, Zhang J, Mo L, Shi J, Qin M, Huang X. Efficacy and safety of probiotics in eradicating Helicobacter pylori: A network meta-analysis. Medicine (Baltimore). 2019 Apr;98(15):e15180. https://pubmed.ncbi.nlm.nih.gov/30985706/
De Santis, S., Cavalcanti, E., Mastronardi, M., Jirillo, E., & Chieppa, M. (2015). Nutritional Keys for Intestinal Barrier Modulation. Frontiers in immunology, 6, 612. https://doi.org/10.3389/fimmu.2015.00612